Influência do posicionamento maxilo-mandibular em exames de tomografia computadorizada de feixe cônico para planejamento de implantes

Abstract

With the introduction of osseointegration dental implants, new imaging methods have been used to ensure a more accurate planning, and the cone beam computed tomography (CBCT) a major advance in this direction. The aim of this study was to evaluate the influence of changes in the maxilo-mandibular positioning during th acquisition of the CBCT ortorradial cuts, for planning of dental implants. We used ten skulls, which received, bilaterally, metallic markers in four distinct regions: incisors, canines, premolars and molars. We obtained tomographic scans of the skulls in seven positions: standard (PN), with displacements above and below 10 ° and 20 ° (P10 +, P20 +, P10- and P20-), as well as lateral displacement of 10 ° and 20 ° (PL10 and PL20). Subsequently, we performed measurements of implant bone height and thickness in standard images and for those obtained with displacements. These measurements were performed in four distinct regions identified by markers, bilaterally, for both maxilla and jaw. The results showed that P20+ position presented the greatest difference in mean measures of bone height and thickness, when compared to the NP position. In bilateral comparison, for the regions of incisor, canine and premolar, the P20+ position showed the greatest difference compared to the PN. However, for the molar region, the P20- position showed the greatest difference in mean values. It was concluded that maxillo-mandibular positioning variations produce dimensional changes in bone height and thickness measures in ortorradial CBCT images, which may lead to errors in implants planning.