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利用术后锥形束计算机断层扫描(CBCT)增强全牙弓种植修复术前规划的整合

Using postoperative CBCT to enhance preoperative planning integration in complete arch implant rehabilitation.

作者信息

Hamilton Adam, Akhondi Samuel, Pala Kevser, Luz Diandra, Gallucci German O

机构信息

Senior Lecturer and Discipline Lead in Prosthodontics, University of Western Australia, Western Australia, Australia; and Lecturer, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Mass.

Research Fellow, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Mass.

出版信息

J Prosthet Dent. 2025 Sep;134(3):580-585. doi: 10.1016/j.prosdent.2025.04.047. Epub 2025 Jun 3.

Abstract

In biorestoratively driven implant treatment planning, the initial prosthetic design is determined before implant placement. However, in patients with a terminal dentition, the loss of vertical dimension after tooth extraction and the absence of reference teeth complicate the alignment of the prosthetic design with the postextraction clinical situation, as well as precise occlusal registration and optimal tooth positioning. This article introduces a novel workflow that employs an additional cone beam computed tomography (CBCT) scan after implant placement to enhance data alignment, prosthetic rehabilitation, and occlusal registration for complete arch immediate loading of dental implants. By integrating preoperative and postoperative CBCT scans and utilizing stable bony landmarks as reference structures, this method effectively transfers preoperative planning into the postoperative intraoral environment. Unlike removable appliances or fiduciary markers, which are prone to misalignment, this technique ensures accurate prosthesis insertion with minimal adjustments, is adaptable to various workflows, including freehand implant placement, and provides a reliable and versatile solution to optimizing the outcomes of implant-supported prostheses.

摘要

在生物修复驱动的种植治疗计划中,初始修复设计在种植体植入前就已确定。然而,对于牙列晚期患者,拔牙后垂直距离的丧失以及参考牙的缺失,使得修复设计与拔牙后临床情况的对齐、精确的咬合记录以及最佳牙齿定位变得复杂。本文介绍了一种新颖的工作流程,即在种植体植入后进行额外的锥形束计算机断层扫描(CBCT),以增强数据对齐、修复体康复以及牙种植体全牙弓即刻负重的咬合记录。通过整合术前和术后CBCT扫描,并利用稳定的骨性标志作为参考结构,该方法有效地将术前计划转移到术后口腔内环境。与易于错位的可摘矫治器或定位标记不同,该技术确保以最少的调整准确插入修复体,适用于各种工作流程,包括徒手种植体植入,并为优化种植体支持修复体的效果提供了可靠且通用的解决方案。

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