多层螺旋CT影像基础重建三维种植角度隧道式模板辅助微种植体的精确性(英文)  

Accuracy of tunnel-type template assisting mini-implant anchorage surgery based on multislice spiral computed tomography

作　　者：陈京奕[1] 单丽华[2] 

机构地区：[1]邯郸市中心医院口腔科,河北省邯郸市056001 [2]河北医科大学第二医院口腔正畸科,河北省石家庄市050000

出　　处：《中国组织工程研究与临床康复》2010年第26期4920-4923,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：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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。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 ofimaging 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 ofimplant anchorage.

关 键 词：遂道式模板 微种植体 种植支抗 多层螺旋CT 图像重建 

分 类 号：R318[医药卫生—生物医学工程]