Preoperative implant planning considering alveolar bone grafting needs and complication prediction using panoramic versus CBCT images.
Preoperative implant planning considering alveolar bone grafting needs and complication prediction using panoramic versus CBCT images.
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DOI：
10.5624/isd.2014.44.3.213
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发表时间：
2014-09
影响因子：
1.8
通讯作者：
Jacobs R
中科院分区：
文献类型：
--
作者：
Guerrero ME;Noriega J;Jacobs R
本研究旨在确定观察者根据锥形束计算机断层扫描（CBCT）和全景X线摄影（PAN）计划预测骨移植需求和围手术期并发症的有效性，并与手术结局进行比较。108例需要种植体修复的部分无牙患者被转诊进行术前成像。成像包括PAN和CBCT图像。四名观察员使用PAN图像数据集进行植入计划，至少一个月后，使用CBCT图像数据集。根据他们自己的计划，观察者评估了骨移植物增强的需要以及并发症预测。对种植体长度和直径、骨移植物增强的需要以及计划和种植体放置期间解剖学并发症的发生率进行统计学比较。在108名患者中，安装了365个种植体。PAN和CBCT术前计划的受试者操作特征分析表明，在植骨增强和围手术期并发症的需求方面，CBCT的表现优于基于PAN的计划。CBCT对种植体并发症的敏感性和特异性分别为96.5%和90.5%，对植骨增强的敏感性和特异性分别为95.2%和96.3%。在基于PAN的计划和后路植入物长度的手术之间发现了显著差异。我们的研究结果表明，与手术标准相比，基于CBCT的术前植入计划能够实现更高程度的预测和一致性的治疗计划。在基于PAN的手术中，种植体长度的预测较差。
This study was performed to determine the efficacy of observers' prediction for the need of bone grafting and presence of perioperative complications on the basis of cone-beam computed tomography (CBCT) and panoramic radiographic (PAN) planning as compared to the surgical outcome. One hundred and eight partially edentulous patients with a need for implant rehabilitation were referred for preoperative imaging. Imaging consisted of PAN and CBCT images. Four observers carried out implant planning using PAN image datasets, and at least one month later, using CBCT image datasets. Based on their own planning, the observers assessed the need for bone graft augmentation as well as complication prediction. The implant length and diameter, the need for bone graft augmentation, and the occurrence of anatomical complications during planning and implant placement were statistically compared. In the 108 patients, 365 implants were installed. Receiver operating characteristic analyses of both PAN and CBCT preoperative planning showed that CBCT performed better than PAN-based planning with respect to the need for bone graft augmentation and perioperative complications. The sensitivity and the specificity of CBCT for implant complications were 96.5% and 90.5%, respectively, and for bone graft augmentation, they were 95.2% and 96.3%, respectively. Significant differences were found between PAN-based planning and the surgery of posterior implant lengths. Our findings indicated that CBCT-based preoperative implant planning enabled treatment planning with a higher degree of prediction and agreement as compared to the surgical standard. In PAN-based surgery, the prediction of implant length was poor.