Gaggl A, Schultes G, Santler G, Kärcher H
Klinische Abteilung für Mund-, Kiefer- und Gesichtschirurgie der Universitätsklinik für ZMK, Graz, Austria.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998 Oct;86(4):388-92. doi: 10.1016/s1079-2104(98)90361-4.
Three-dimensional models created by milling machines and stereolithography on the basis of 3-dimensional computed tomography scans have become essential in the diagnosis and therapy planning of oral and maxillofacial disorders. The purpose of this study, based on 3 clinical cases, was to examine the advantages of using 3-dimensional computed tomography scans and 3-dimensional milling models of the maxillary sinus before operative sinus elevation and of developing an operative layout with the aid of 3-dimensional models. REPORT DESIGN: Three patients with atrophy of the maxillary alveolar ridge received computed tomography scans before operative sinus elevation with iliac bone transplants and simultaneous dental implantation. These computed tomography data were used to create 3-dimensional graphic and plastic reconstructions of the maxillary sinuses.
The 3-dimensional milling models enabled the development of an exact preoperative layout that took into consideration the exact shape of the iliac bone and the selection of dental screw implants. Furthermore, the models offered the possibility of producing an acrylic device for precise implant insertion. Precise planning resulted in good success with implantation 2 years after surgery.
Three-dimensional diagnosis and treatment layout have become an acknowledge method of operative maxillary sinus floor augmentation combined with simultaneous dental implantation in the upper jaw in difficult cases of sinus lift operations. As far as transplant shape and sinus anatomy are concerned, this has resulted in greater intraoperative precision. A 1-step procedure can thus be performed for augmentation and implantation through use of a well-adapted block transplant and dental screw implants in patients with extensive alveolar ridge atrophy.
基于三维计算机断层扫描,通过铣床加工和立体光刻技术创建的三维模型,已成为口腔颌面部疾病诊断和治疗规划的重要手段。本研究基于3个临床病例,旨在探讨在鼻窦提升手术前使用上颌窦的三维计算机断层扫描和三维铣削模型的优势,以及借助三维模型制定手术方案。
3例上颌牙槽嵴萎缩患者在进行髂骨移植同期牙种植的鼻窦提升手术前接受了计算机断层扫描。这些计算机断层扫描数据被用于创建上颌窦的三维图形和塑料重建模型。
三维铣削模型能够制定精确的术前方案,该方案考虑了髂骨的精确形状和牙种植体的选择。此外,这些模型提供了制作用于精确植入种植体的丙烯酸装置的可能性。精确的规划使得术后2年种植成功率很高。
在复杂的上颌窦提升手术病例中,三维诊断和治疗方案已成为上颌窦底提升同期牙种植手术的公认方法。就移植骨形状和鼻窦解剖结构而言,这提高了术中的精确性。因此,对于广泛牙槽嵴萎缩的患者,通过使用适配良好的块状移植骨和牙种植体,可以一步完成增隙和种植手术。