CAJ | 학술논문

背景:提高微螺钉种植体作为"绝对正畸支抗"的成功率,需要多层螺旋CT精确的影像信息辅助种植前诊断并制定严谨的种植方案,如何将精确的影像信息有效地用于种植支抗手术,尚需高效可靠的工具与方法.目的:检验自行研制的放射检查模板及隧道式外科手术模板辅助种植体支抗种植的精确性,评价其临床实用价值.方法:采用透明牙合托作标记制作放射模板,以多层螺旋CT对猪颅骨定位扫描并重建,在多层螺旋CT影像上精确设计三维种植角度.根据角度数据信息制作隧道式手术模板,并种植32枚微螺钉支抗.种植后多层螺旋CT再次扫描重建,并解剖猪颅骨牙槽突.对种植前多层螺旋CT设计角度、种植后多层螺旋CT测量角度及种植后解剖组织块实物测量角度进行比较分析.结果与结论:32枚微螺钉种植情况满意,均未伤及邻近牙根及周围重要组织结构.种植前设计与种植后多层螺旋CT测量角度比较,种植前设计与实物测量角度比较,在轴位面及侧断面上差异均无显著性意义,且一致性极好.提示自行研制的放射模板及隧道式手术模板能高效、精确地引导种植支抗手术,可为提高种植的成功率提供可靠保障.
배경:제고미라정충식체작위"절대정기지항"적성공솔,수요다층라선CT정학적영상신식보조충식전진단병제정엄근적충식방안,여하장정학적영상신식유효지용우충식지항수술,상수고효가고적공구여방법.목적:검험자행연제적방사검사모판급수도식외과수술모판보조충식체지항충식적정학성,평개기림상실용개치.방법:채용투명아합탁작표기제작방사모판,이다층라선CT대저로골정위소묘병중건,재다층라선CT영상상정학설계삼유충식각도.근거각도수거신식제작수도식수술모판,병충식32매미라정지항.충식후다층라선CT재차소묘중건,병해부저로골아조돌.대충식전다층라선CT설계각도、충식후다층라선CT측량각도급충식후해부조직괴실물측량각도진행비교분석.결과여결론:32매미라정충식정황만의,균미상급린근아근급주위중요조직결구.충식전설계여충식후다층라선CT측량각도비교,충식전설계여실물측량각도비교,재축위면급측단면상차이균무현저성의의,차일치성겁호.제시자행연제적방사모판급수도식수술모판능고효、정학지인도충식지항수술,가위제고충식적성공솔제공가고보장.
BACKGROUND: Preplant diagnosis and rigorous implant strategy based on multislice spiral computed tomography (MSCT) imaging can improve success rate of mini-implants as anchorage. Effective application of imaging information in implant anchorage requires reliable tools and methods.OBJECTIVE: To investigate the accuracy of the radiographic and tunnel-type surgical templates assisting implant anchorage surgery and evaluate the clinical significance.METHODS: The transparent radiographic templates were made with occlusal rest to assist MSCT to scan two pigs' skulls locatively. After designed the implant anchorage angles in MSCT images accurately, we made the tunnel-type surgical template by angle data. A total of 32 miniscrews were implanted by surgical template, and the two pigs skulls were rescanned by MSCT. After dissected the pig alveolar process, the MSCT preoperative planning angles, the MSCT postoperative measurement angles and the measurement angles of anatomic bone samples were analyzed statistically. RESULT AND CONCLUSION: The 32 miniscrews were implanted successfully. They did not damage dental roots or surrounding important structures. Compared MSCT preoperative planning angles with MSCT postoperative measurement angles and anatomic bone samples measurement angles, there were no significant differences on axial sections or cross-sections and the r concordance correlations were very good. Results show that the radiographic and the tunnel-type surgical templates are accurate and reliable for operation and will help to improve the success rate of implant anchorage.