State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China.
Hua Xi Kou Qiang Yi Xue Za Zhi. 2023 Apr 1;41(2):134-139. doi: 10.7518/hxkq.2023.2022386.
When selecting implant guidance methods or judging whether the patient can be implanted, many doctors ignore or only use visual inspection to estimate a patient's mouth opening. This phenomenon often leads to failure to complete the implantation due to insufficient mouth opening or the deflection of the implant due to limited angle, resulting in the high incidence of corresponding complications. The main reason is that doctors lack accurate analysis and control of the overall geometric conditions of the intraoral surgical area, and three-dimensional position blocking of surgical instruments occurs during the operation. In the past, mouth opening was defined as the distance between the incisor edges of the upper and lower central incisors when the patient opens his mouth widely, and the implant area could be in any missing tooth position. When it is in the posterior tooth area, the specific measurement scheme of the mouth opening could not be simply equivalent to the previous measurement method in the anterior tooth area. However, how to measure quickly and conveniently the mouth opening of any surgical area to determine whether it could be implanted and meet the needs of the selected guidance method remains unclear. This paper introduces new concepts, establishes new classification and corresponding accurate measurement scheme of implant area, and establishes a decision tree of implant methods guided by the actually measured value. Results provide a quantitative basis for rational formulation and implementation of implant treatment.
在选择种植导板方法或判断患者是否可以植入时，许多医生忽略或仅使用视觉检查来估计患者的张口度。这种现象常常导致由于张口度不足或由于角度有限导致种植体偏转而无法完成植入，从而导致相应并发症的发生率较高。主要原因是医生缺乏对口腔手术区域整体几何条件的准确分析和控制，并且在手术过程中会发生手术器械的三维位置阻塞。过去，张口度被定义为患者张口时上下中切牙切缘之间的距离，种植区域可以位于任何缺牙位置。当下颌后牙区时，张口度的具体测量方案不能简单地等同于前牙区的先前测量方法。然而，如何快速方便地测量任何手术区域的张口度以确定是否可以植入并满足所选引导方法的需求仍不清楚。本文介绍了新的概念，建立了新的种植区域分类和相应的精确测量方案，并建立了基于实际测量值的种植方法引导决策树。结果为合理制定和实施种植治疗提供了定量依据。
