Cumbo Enzo, Gallina Giuseppe, Messina Pietro, Scardina Giuseppe A
Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.), University of Palermo, Palermo, Italy.
Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.), University of Palermo, Palermo, Italy -
Minerva Dent Oral Sci. 2025 Feb;74(1):26-34. doi: 10.23736/S2724-6329.24.04998-2. Epub 2024 Oct 8.
All dental implants must be placed following radiological, clinical and aesthetic indications in compliance with prosthetic principles avoiding iatrogenic damage to patients. In implantology, among the key choices, to obtain predictable results, it is essential to establish (by cone beam computed tomography [CBCT]) the sites where to insert the implants; these sites must be identified, during the surgical phase, in the oral cavity. Surgical guides represent a valid aid especially in complex cases that require multiple implants. For some clinical conditions, expert operators choose the free hand technique during which identifying the chosen implant sites on CBCT in the oral cavity is more difficult.
This experimental study is based on the use of thermo-molded mask as an alternative to surgical guides when the freehand technique is adopted in totally edentulous patients. These innovative masks, containing radiopaque references, are initially worn by patients during the execution of the CBCT, and later during surgery to identify the implant sites in the oral cavity.
The procedure described proved to be very useful and able to increase the precision of the freehand technique even if it does not provide information on the inclination of the implants. The metal references help clinical identification of the implant site.
Our thermo-molded masks, in particular clinical conditions, could represent a valid and economical alternative to the classic surgical guide. The described procedure does not increase costs for the patient and significantly increases the precision in inserting the implants during free-hand techniques.
所有牙种植体的植入都必须遵循放射学、临床和美学指征,符合修复原则,避免对患者造成医源性损伤。在种植学中,为了获得可预测的结果,关键选择之一是(通过锥形束计算机断层扫描[CBCT])确定植入种植体的部位;在手术阶段必须在口腔中确定这些部位。手术导板是一种有效的辅助工具,尤其在需要植入多个种植体的复杂病例中。对于某些临床情况,专业操作人员会选择徒手技术,但在此过程中,在口腔中根据CBCT确定选定的种植体部位会更加困难。
本实验研究基于在全口无牙患者采用徒手技术时,使用热成型面罩替代手术导板。这些创新的面罩含有不透射线的标记物,患者在进行CBCT时佩戴,随后在手术中用于确定口腔中的种植体部位。
所描述的方法被证明非常有用,即使它不能提供种植体倾斜度的信息,也能够提高徒手技术的精度。金属标记物有助于临床识别种植体部位。
在特定临床情况下,我们的热成型面罩可能是经典手术导板的有效且经济的替代方案。所描述的方法不会增加患者的费用,并且在徒手技术植入种植体时显著提高了精度。