中国人上颌骨严重萎缩患者翼状种植体植入的关键解剖结构的影像学分析。
Radiographic analysis of critical anatomical structures for pterygoid implant placement in Chinese patients with a severely atrophied maxilla.
机构信息
Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People's Hospital, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China.
Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People's Hospital, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China; Department of Craniomaxillofacial and Plastic Surgery, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
出版信息
Int J Oral Maxillofac Surg. 2023 Sep;52(9):998-1004. doi: 10.1016/j.ijom.2023.01.005. Epub 2023 Jan 27.
The pterygoid implant is a feasible alternative for posterior dental rehabilitation without grafting; however, the ideal pterygoid implant placement continues to be debated. The aim of this study was to identify effective landmarks and establish valid guidelines to determine the ideal pterygoid implant placement. Cone beam computed tomography (CBCT) data of 100 severely atrophied maxillae requiring implant rehabilitation, obtained between January 2015 and December 2018, were included. The CBCT data were obtained in DICOM format from the radiographic database and imported into Nobel Clinician software (Nobel Biocare) for radiographic analysis. Virtual pterygoid implant placement was successful in 67 maxillae: a 13-mm virtual implant in four maxillae (6.0%), 15-mm in 52 maxillae (77.6%), and 18-mm in 11 maxillae (16.4%). For the virtual pterygoid implant, the mean implant angulation± standard deviation in the anteroposterior axis (sagittal view) was 45.08 ± 2.56° relative to the Frankfort plane. In the buccopalatal axis (coronal view), the mean implant angulation was 64.30 ± 4.99° relative to the Frankfort plane and the mean value for the shortest linear distance between the palatine canal and apical tip of the virtual implant was 3.91 ± 0.62 mm. A 15-mm pterygoid implant placed at 45° in the anteroposterior axis and 60° in the buccopalatal axis (relative to the Frankfort plane), is generally recommended in this Chinese patient population.
翼骨种植体是一种无需移植即可用于后牙修复的可行替代方法；然而，理想的翼骨种植体植入位置仍存在争议。本研究旨在确定有效的解剖标志，并制定有效的指导方针来确定理想的翼骨种植体植入位置。纳入了 2015 年 1 月至 2018 年 12 月期间因严重上颌萎缩而需要植入物修复的 100 例患者的锥形束 CT（CBCT）数据。CBCT 数据以 DICOM 格式从放射数据库中获取，并导入 Nobel Clinician 软件（Nobel Biocare）进行放射分析。在 67 例上颌中成功进行了虚拟翼骨种植体植入：4 例上颌植入 13mm 虚拟种植体（6.0%），52 例上颌植入 15mm 虚拟种植体（77.6%），11 例上颌植入 18mm 虚拟种植体（16.4%）。对于虚拟翼骨种植体，前-后轴（矢状面）的平均种植体角度±标准偏差为 45.08±2.56°相对于法兰克福平面。在颊-腭轴（冠状面），平均种植体角度为 64.30±4.99°相对于法兰克福平面，并且虚拟种植体的腭管和根尖最短线性距离的平均值为 3.91±0.62mm。建议在中国患者人群中，一般采用 45°前-后轴和 60°颊-腭轴（相对于法兰克福平面）的 15mm 翼骨种植体。
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