mplant Planlaması Sırasında Andırkatlı Bölgelerde Kemikiçi İmplant Boyutlarının ve Pozisyonlarının Belirlenmesinde Panoramik Radyografi ve Üç Boyutlu Dental Volumetrik Tomografinin Etkinliğinin Değerlendirilmesi

Amaç: Diş hekimlerinin intraoral fotoğraf, alçı model ve iki panoramik grafilerin (OPTG) tümünden yararlanıp yaptıkları implant planlamalarındakiimplant boy, çap ve pozisyon-açılı uygulama kararları ile sadece üç boyutludental volumetrik tomografilerde (3BDVT) yaptıkları inceleme sonucu tercih ettikleri implant boy, çap ve pozisyon (açılı uygulama) kararlarındakifarklılıklar karşılaştırılacaktır.Yöntemler: Üç diş hekimliği uzmanlık öğrencisinden hastaların intraoralfotoğrafları, alçı modelleri ve OPTG’leri verilip bu hastalar için negatiftebasılmış radyolojik görüntüler üzerinde implant şablonu ile; ve sonrasında hastaların sadece 3BDVT’leri verilerek dijital ortamda 35 farklı bölgedeimplant tedavi planlaması yapmaları istenmiştir. Hastaların yapılan öncekiölçümleri ile sonraki ölçümleri arasındaki farklılıklar, bütünüyle ve çalışmaya katılımcı olarak iştirak eden hekimler (katılımcılar) ayrı ayrı tutularak istatistiksel olarak incelenmiştir.Bulgular: OPTG kayıtları, alçı modeller ve intraoral fotoğraflar ile yapılandeğerlendirmeler ile 3BDVT kayıtları ile yapılan değerlendirmeler tümdenve katılımcılar arasında ayrı ayrı karşılaştırıldığında implant uzunlukları(p=0,028), kalınlıkları (p=0,001) ve açılı pozisyonlandırmaları (p=0,001) arasında istatistiksel olarak anlamlı farklılık görülmektedir.Sonuç: Mandibula molar bölgedeki implant uygulamalarında 3BDVT radyografilerinden yararlanılması önemlidir.

Assessment of the Effectiveness of Panoramic Radiography and ThreeDimensional Dental Volumetric Tomography with Determination of Implant Size and Position of Bone in Undercuted Regions during Implant Planning

Objective: To detect and compare differences in implant length, diameter, and position angle application during implant planning, which dentists make full use of intraoral photography, plaster model, and two-dimensional panoramic radiographs (OPTGs), and review only in Three Dimensional Dental Volumetric Tomoghraphies (3DDVTs). Methods: Three dentistry students were asked to perform implant planning observing the intraoral photographs of patients, model casts, and OPTGs and a digital environment with only 3DDVTs. Differences between previous and subsequent measurements were statistically examined in 35 different records by all participating dentistry students individually and as a whole. Results: There was a statistically significant difference between implant length (p=0.028), thickness (p=0.001), and angular positioning (p=0.001) when evaluating OPTG records, model casts, and intraoral photograph data via 3DDVTs as a whole and individually. Conclusion: It is important to use 3DDVTs for implant planning in the mandibular molar region. Keywords: Panoramic

PDF

___

1. Sarment DP, Sukovic P, Clinthorne N. Accuracy of implant placement with a stereolithographic surgical guide. Int J Oral Maxillofac Implants 2003; 18: 571-7.
2. Parnia F, Fard EM, Mahboub F, Hafezeqoran A, Gavgani FE. Tomographic volume evaluation of submandibular fossa in patients requiring dental implants Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 109: 32-6. [CrossRef]
3. Sarment DP, Al-shammari K, Kazor CE. Stereolithographic surgical templates for placement of Dental Implants in complex cases. Int J Periodontics Restorative Dent 2003; 23: 287-95.
4. Dao TT, Mellor A. Sensory disturbances associated with implant surgery. Int J Prosthodont 1998; 11: 462-9.
5. Kopp KC, Koslow AH, Abdo OS. Predictable implant placement with a diagnostic surgical template and advanced radiographic imaging. J Prosthet Dent 2003; 89: 611-5. [CrossRef]
6. Walton JN. Altered sensation associated with implants in the anterior mandible: a prospective study. J Prosthet Dent 2000; 83: 443-9. [CrossRef ]
7. Hofschneider U, Tepper G, Gahleitner A, Ulm C. Assessment of the blood supply to the mental region for reduction of bleeding complications during implant surgery in the interforaminal region. Int J Oral Maxillofac Implants 1999; 14: 379-83.
8. Tepper G, Hofschneider UB, Gahleitner A, Ulm C. Computed tomographic diagnosis and localization of bone canals in the mandibular interforaminal region for prevention of bleeding complication during implant surgery. Int J Oral Maxillofac Implants 2001; 16: 68-72.
9. Iplikcioglu H, Akca K, Cehreli MC. The use of computerized tomography for diagnosis and treatment planning in implant dentistry. J Oral Implan-tol 2002; 28: 29-36.
10. Guerrero ME, Noriega J, Castro C, Jacobs R. Does cone-beam CT alter treatment plans? Comparison of preoperative implant planning using panoramic versus cone-beam CT images. Imaging Sci Dent 2014; 44: 121-8. [CrossRef]
11. Greenstein G, Cavallaro J, Romanos G, Tarnow D. Clinical recommendations for avoiding and managing surgical complications associated with implant dentistry: a review. J Periodontol 2008; 79: 1317-29. [CrossRef]
12. Vazquez L, Nizam Al Din Y, Christoph Belser U, Combescure C, Bernard JP. Reliability of the vertical magnification factor on panoramic radiographs: clinical implications for posterior mandibular implants. Clin Oral Implants Res 2011; 22: 1420-5. [CrossRef]
13. Van Assche N, van Steenberghe D, Guerrero ME, Hirsch E, Schutyser F, Quirynen M, et al. Accuracy of implant placement based on pre-surgical planning of three-dimensional conebeam images: a pilot study. J Clin Periodontol 2007; 34: 816-21. [CrossRef]
14. Harris D, Horner K, Gröndahl K, Jacobs R, Helmrot E, Benic GI, et al. E.A.O. guidelines for the use of diagnostic imaging in implant dentistry 2011. A consensus workshop organized by the European Association for Osseointegration at the Medical University of Warsaw. Clin Oral Implants Res 2012; 23: 1243-53. [CrossRef]
15. Renton T, Dawood A, Shah A, Searson L, Yilmaz Z. Postimplant neuropathy of the trigeminal nerve. A case series. Br Dent J 2012; 212: 17. [CrossRef ]
16. Gerlach NL, Meijer GJ, Maal TJ, Mulder J, Rangel FA, Borstlap WA, et al. Reproducibility of 3 different tracing methods based on cone beam computed tomography in determining the anatomical position of the mandibular canal. J Oral Maxillofac Surg 2010; 68: 811-7. [CrossRef]
17. Vazquez L, Saulacic N, Belser U, Bernard JP. Efficacy of panoramic radiographs in the preoperative planning of posterior mandibular implants: a prospective clinical study of 1527 consecutively treated patients. Clin Oral Implants Res 2008; 19: 81-5.
18. Schropp L, Stavropoulos A, Gotfredsen E, Wenzel A. Comparison of panoramic and conventional cross sectional tomography for preoperative selection of implant size. Clin Oral Implants Res 2011; 22: 424-9. [CrossRef]
19. Alsaadi G, Quirynen M, Michiles K, Teughels W, Komárek A, van Steenberghe D. Impact of local and systemic factors on the incidence of failures up to abutment connection with modified surface oral implants. J Clin Periodontol 2008; 35: 51-7.
20. Niamtu J 3rd. Near fatal airway obstruction after routine implant placement. Oral Surg Oral Med Oral Path Oral Radiol Endod 2001; 92: 597-600. [CrossRef]
21. Isaacson TJ. Sublingual hematoma formation during immediate placement of mandibular endosseous implants. J Am Dent Assoc 2004; 135: 168-72. [CrossRef]
22. Quirynen M, Mraiwa N, Van Seenberghe D, Jacobs R. Morphology and dimensions of the mandibular jaw bone in the interforaminal region in patients requiring implants in the distal areas. Clin Oral Implants Res 2003; 14: 280-5. [CrossRef]
23. Parnia F, Fard EM, Mahboub F, Hafezeqoran A, Gavgani FE. Tomographic volume evaluation of submandibular fossa in patients requiring dental implants. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010 Jan; 109: 32-6.[CrossRef]