多排螺旋CT在颌骨非安全区及牙槽骨缺损区牙种植术前的应用

Application of multi-slice spiral CT before dental implantation in non-security area of jaw or defected alveolar bone

目的探讨在牙种植术前应用多排螺旋CT对拟种植区域牙槽骨形态和质地评估的意义。方法在牙种植术前通过普通牙片及颌骨全景片筛选出17例不能明确牙槽骨的条件能否接受种植的患者,取牙模型,在拟种植区制作带有钛管的放射导板,戴入患者口腔,进行颌骨多排螺旋CT扫描,通过三维重建图像测量牙槽突的高度、宽度和密度,判断是否具备种植条件,对于符合种植条件者采用ITI种植系统进行牙种植术。结果15例患者成功接受牙种植治疗,2例分别因牙槽骨宽度不足5.3mm和牙槽嵴顶距上颌窦距离不足3mm被判定其骨组织条件不能直接接受牙种植手术。结论三维重建能为种植术前颌骨非安全区及牙槽骨缺损区提供可靠且较为全面的参考信息。

Objective To evaluate the shape and texture of the alveolar bones before dental implantation using three-dimension reconstruction techniques by multi-slice spiral CT （ MSCT）. Methods Seventeen patients,whose alveolar condition was not clear enough to receive dental implantation,were screened out using conventional dental periapical and panoramic X-ray examination. The occlusion cast was made and a radiological guide template with titanium tube was prepared in the implantation area. The mandibular and maxillary bone was scanned with MSCT. The height,width and density of the alveolar were measured through three-dimensional reconstruction,so as to determine whether the alveolar was suitable for dental implant surgery. Implantation using ITI dental implant system was performed in patients whose alveolar condition met the implantation criteria. Results Pre-operation MSCT examination indicated that two cases were not suitable for the surgery due to a width of alveolar bone less than 5. 3 mm and a height of the residual bone under the maxillary sinus less than 3 mm. Fifteen patients suitable for the surgery underwent successful implantation. Conclusion The three-dimensional reconstruction of MSCT images of the jaws can provide more comprehensive and reliable information of the non-security areas and mandibular or maxillofacial alveolar bone defects before implantation.