Nedelcu Luminita, Sirbu Ioan, Sirbu Valentin Daniel, Custura Andreea Mihaela, Radu Adelin, Nastasie Vladimir
University of Medicine and Pharmacy Carol Davila Bucharest Bucharest Romania.
University of Medicine and Pharmacy Carol Davila Bucharest, Oral Implantology Bucharest Romania.
Clin Case Rep. 2024 Dec 12;12(12):e9515. doi: 10.1002/ccr3.9515. eCollection 2024 Dec.
Digital technology significantly enhances subperiosteal implantology by enabling precise presurgical planning based on CBCT scans. This technology reduces patient trauma and ensures optimal implant fit, presenting a promising alternative to traditional analogue methods.
In the last decades, significant progress has been made in oral implantology, particularly with endosseous implants, primarily due to advancements brought about by the digital revolution. Although their versatility and predictability have been well-documented through clinical studies and follow-ups (, 2005; 769: 1623), endosseous implants have certain limitations from the patients' perspectives, such as general health status, bone availability, and lengthy osseointegration times. Researchers have reported that well-designed subperiosteal implants function successfully for many years and are a viable alternative to endosseous implants. The analogue method of inserting subperiosteal implants has been extensively discussed and utilized, and it represents a well-defined protocol (, 2016; 5: 98). However, the surgical step, which involves taking an impression of the residual bone, posed challenges for clinicians. These challenges included more significant trauma to the patient, who had to undergo two surgical interventions instead of one (first for the bone impression and second for the implant insertion) and the risk of implant misfit due to the contraction of the impression material. Digital technology addresses these issues by allowing clinicians to design the implant based on the patient's Cone Beam Computed Tomography (CBCT) scan long before surgery. This case report reviews the design characteristics of 3D-printed superiosteal implants, outlines the step-by-step procedure, and highlights the specific features compared to the analogue method. It also discusses the anatomy of the areas where the implants rest in the maxillae based on recent research performed in Romania in collaboration with AB Dental International (, 2003; 29: 189).
数字技术通过基于锥形束计算机断层扫描（CBCT）进行精确的术前规划，显著提升了骨膜下种植学。这项技术减少了患者创伤，并确保种植体的最佳适配，为传统的模拟方法提供了一个有前景的替代方案。
在过去几十年中，口腔种植学取得了显著进展，尤其是骨内种植体，这主要归功于数字革命带来的进步。尽管骨内种植体的多功能性和可预测性已通过临床研究和随访得到充分证明（，2005；769：1623），但从患者角度来看，骨内种植体存在某些局限性，如总体健康状况、骨量可用性以及较长的骨整合时间。研究人员报告称，设计良好的骨膜下种植体可成功发挥作用多年，是骨内种植体的可行替代方案。骨膜下种植体的模拟植入方法已得到广泛讨论和应用，它代表了一个明确的方案（，2016；5：98）。然而，涉及对剩余骨进行印模的手术步骤给临床医生带来了挑战。这些挑战包括对患者造成更大的创伤，患者必须接受两次手术干预而非一次（第一次用于骨印模，第二次用于种植体植入），以及由于印模材料收缩导致种植体适配不良的风险。数字技术通过允许临床医生在手术前很久就根据患者的锥形束计算机断层扫描（CBCT）设计种植体来解决这些问题。本病例报告回顾了3D打印骨膜上种植体的设计特点，概述了逐步操作过程，并突出了与模拟方法相比的具体特征。它还基于罗马尼亚与AB牙科国际公司合作进行的最新研究（，2003；29：189），讨论了种植体在上颌骨中植入区域的解剖结构。
