Verstreken K, Van Cleynenbreugel J, Martens K, Marchal G, van Steenberghe D, Suetens P
Laboratory for Medical Image Computing, Katholieke Universiteit Leuven, ESAT/Radiology, University Hospital Gasthuisberg, Belgium.
IEEE Trans Med Imaging. 1998 Oct;17(5):842-52. doi: 10.1109/42.736056.
A preoperative planning system for oral implant surgery was developed which takes as input computed tomographies (CT's) of the jaws. Two-dimensional (2-D) reslices of these axial CT slices orthogonal to a curve following the jaw arch are computed and shown together with three-dimensional (3-D) surface rendered models of the bone and computer-aided design (CAD)-like implant models. A technique is developed for scanning and visualizing an eventual existing removable prosthesis together with the bone structures. Evaluation of the planning done with the system shows a difference between 2-D and 3-D planning methods. Validation studies measure the benefits of the 3-D approach by comparing plans made in 2-D mode only with those further adjusted using the full 3-D visualization capabilities of the system. The benefits of a 3-D approach are then evident where a prosthesis is involved in the planning. For the majority of the patients, clinically important adjustments and optimizations to the 2-D plans are made once the 3-D visualization is enabled, effectively resulting in a better plan. The alterations are related to bone quality and quantity (p < 0.05), biomechanics (p < 0.005), and esthetics (p < 0.005), and are so obvious that the 3-D plan stands out clearly (p < 0.005). The improvements often avoid complications such as mandibular nerve damage, sinus perforations, fenestrations, or dehiscences.
开发了一种用于口腔种植手术的术前规划系统，该系统将颌骨的计算机断层扫描（CT）作为输入。计算这些与沿着牙弓的曲线正交的轴向CT切片的二维（2-D）重切片，并将其与骨骼的三维（3-D）表面渲染模型和计算机辅助设计（CAD）类种植体模型一起显示。开发了一种技术，用于扫描和可视化最终现有的可摘义齿以及骨骼结构。对该系统所做规划的评估显示了二维和三维规划方法之间的差异。验证研究通过仅比较二维模式下制定的计划与使用系统的完整三维可视化功能进一步调整后的计划，来衡量三维方法的优势。当规划中涉及义齿时，三维方法的优势就很明显了。对于大多数患者，一旦启用三维可视化，就会对二维计划进行临床上重要的调整和优化，从而有效地制定出更好的计划。这些改变与骨质量和骨量（p < 0.05）、生物力学（p < 0.005）和美学（p < 0.005）有关，而且非常明显，以至于三维计划明显突出（p < 0.005）。这些改进通常可以避免诸如下颌神经损伤、鼻窦穿孔、开窗或骨裂等并发症。
