University of Düsseldorf, Düsseldorf, Germany.
University of Homburg, Traben-Trarbach, Germany.
Head Face Med. 2022 Sep 3;18(1):30. doi: 10.1186/s13005-022-00335-0.
Guided insertion of palatal miniscrews using a lateral cephalogram instead of cone beam computed tomography (CBCT) significantly reduces the radiation level for the patient. Till now no data are available on the risk of hitting the incisors in this regard, which is one of the worst clinical complications when inserting a paramedian miniscrew. Hence, this study aims to investigate the distance between the mini-implant and the roots of the central and lateral incisors.
Lateral cephalogram, an intraoral scan, and CBCT of 20 patients were superimposed. After a miniscrew (1.7 × 8 mm) placement based on intraoral scan and lateral cephalogram, the CBCT was used as control for the distance between the miniscrews and the roots of the incisors.
The mean value of the shortest distance between the miniscrew and roots of the incisors in the lateral cephalogram was 4.74 ± 1.67 mm. The distance between both miniscrews and the central incisors measured in the CBCT was 5.03 ± 2.22 mm and 5.26 ± 2.21 mm and between the two miniscrews and the lateral incisors was 4.93 ± 1.91 mm and 5.21 ± 2.64 mm. No significant differences between the distances in the CBCT and the lateral cephalogram could be observed. In one case, the CBCT control revealed the penetration of two palatally displaced canines after insertion based on intraoral scan and lateral cephalogram.
The use of an intraoral scan and a lateral cephalogram for guided paramedian insertion of palatal miniscrews can prevent incisor root damage. This may reduce the radiation since no CBCT seems necessary. The current investigation focuses on the anterior paramedian area of the palate. Outside that region and in complex cases with displaced teeth in the palatal area, a CBCT might be indicated.
使用侧位头颅侧位片而非锥形束 CT（CBCT）引导腭部微螺钉植入，可显著降低患者的放射剂量。迄今为止，尚无关于在此方面切入中切牙风险的数据，这是插入中轴微螺钉时最严重的临床并发症之一。因此，本研究旨在探讨微型植入物与中切牙和侧切牙牙根之间的距离。
对 20 名患者的侧位头颅侧位片、口内扫描和 CBCT 进行叠加。在基于口内扫描和侧位头颅侧位片植入微螺钉（1.7×8mm）后，使用 CBCT 作为对照，评估微螺钉与切牙牙根之间的距离。
在侧位头颅侧位片中，微螺钉与切牙牙根最短距离的平均值为 4.74±1.67mm。CBCT 测量的两个微螺钉与中切牙之间的距离分别为 5.03±2.22mm 和 5.26±2.21mm，两个微螺钉与侧切牙之间的距离分别为 4.93±1.91mm 和 5.21±2.64mm。CBCT 与侧位头颅侧位片之间的距离无显著差异。有一例患者，在基于口内扫描和侧位头颅侧位片植入后，CBCT 显示有两颗腭向错位的尖牙穿透。
使用口内扫描和侧位头颅侧位片引导腭部微螺钉的正中植入，可以防止切牙牙根受损。这可能会减少辐射，因为似乎不需要 CBCT。本研究主要集中在前部正中腭区。在该区域之外，以及在腭部有牙齿移位的复杂病例中，可能需要进行 CBCT。
