Дентальная имплантация при вторичной адентии: лучевые методы диагностики

Abstract

Пациентам выполняли конусно-лучевую томографию зубочелюстной системы и панорамную зонографию (ортопантомограмма, снимок височно-нижнечелюстных суставов). Обследования выполнены на конусно-лучевом томографе PaxZenith 3D фирмы “Vatech”. Использовались основные методики конусно-лучевой томографии: двух челюстей в окклюзии, средней зоны лица, придаточных пазух носа, височной кости. Исследования проводились на этапе планирования, послеоперационного контроля дентальной имплантации в течение реабилитационного периода. Важными анатомическими образованиями при планировании дентальной имплантации являются нижнечелюстной канал, полость носа и полость гайморовой пазухи. Описаны результаты использования конусно-лучевой томографии и панорамной зонографии при планировании и послеоперационном контроле результатов дентальной имплантации. Показаны преимущества каждого рентгенологического метода. Обоснована перспективность комбинации конусно-лучевой томографии и панорамной зонографии в практике дентальной имплантации.

Patients were performed cone-beam tomography and panoramic dental systems. Surveys were carried out on cone beam tomography PaxZenith 3D firm “Vatech”. Main methods used cone-beam tomography: two jaws in occlusion of the midface, sinuses, temporal bone. The studies were conducted at the planning stage, postoperative monitoring of dental implantation, during the rehabilitation period. The important anatomical structures in the planning of dental implants are the mandibular canal, nasal cavity and the maxillary sinus cavity. There were examined 80 patients and divided into three groups. The first group (25 patients were carried out planning of surgical interventions and post-operative monitoring only on the basis of panoramic zonography data. In the second group (25 patients) there the data were evaluated using 3D cone-beam computed tomography and panoramic zonography. The third group (30 patients) — planning and monitoring of dental implant surgery was carried out using only the cone-beam tomography. The first group of patients had incorrect placement of implants (5 persons). The main causes of which was distortion of the subject (upper and lower jaw) in size and shape, which led to the wrong choice of size and diameter of the implant to the perforation of the maxillary sinus and the upper wall of the mandibular canal. The second and third groups had not such complications, but the third group patients had complications as osteointegrations disorder between implant and osseous tissue. When performing the panoramic X-ray it was possible comprehensive assessment of dental system as a whole, taking account of the temporomandibular joint, the adjacent parts of the maxillary sinuses. The use of cone-beam tomography in all phases of dental implantation to avoid errors due to incorrect installation of the implant helps to reveal the full dentition comorbidities and upper respiratory tract, but is not sufficiently informative to monitor osseointegration before installing the abutment. These cone-beam CT scanner, complemented by panoramic X-ray give an objective evaluation of information in the planning stages and the stages of post-operative monitoring, avoid complications.