Demidova E. Panoramic x-ray and cone-beam computer tomography in planning of dental implants and stages of surgical rehabilitation of patients with a secondary edentia

Increasing the efficiency of the dental implant planning through the use of modern methods of radiation diagnosis, panoramic X-ray and cone-beam computed tomography with the development of a diagnostic algorithm support. Work contains the actual decision of task for x-ray diagnostics and stomatology: increasing the efficiency of the dental implant planning through the use of modern methods of radiation diagnosis, panoramic X-ray. We examined 114 patients with secondary edentia and 20 patients were the control group. At all we examined 134 patients. To all patients were carried out cone-beam tomography of maxillofacial area and a panoramic X-ray. A survey carried out on the cone-beam tomography PaxZenith 3D "Vatech". Study of 114 patients were in the planning stage, postoperative monitoring dental implant throughout the rehabilitation period. Surveyed patients with secondary edentia in the number of 114 people were divided into two groups according to the etiology of secondary edentia. The first group of 82 patients (71%) - secondary edentia as a consequence of inflammatory changes in the periodontal tissues and periodontal. The second group of patients, 32 patients (29%) - secondary edentia as a consequence - the dock of traumatic damages. The nature of traumatic damages as a result of a home accident in 2 patients (1%), and as a result of road accidents - 30 patients (26%). The distribution of patients according to the severity of the secondary edentia. The first group was - 14 people (12%) with full secondary edentia. The second group was represented by patients with a partial secondary edentia - 100 (88%) people. Defined diagnostic information panoramic X-ray and CBCT, and their combined use in the diagnosis of pathological conditions of the maxillofacial region. Panoramic X-ray: accuracy - 57.74% sensitivity - 84.2% specificity - 27.27%; CBCT: accuracy - 97.92%; sensitivity - 84.04%; specificity - 93.75%, the combined use panoramic X-ray that CBCT: accuracy - 98.13%; sensitivity - 89.52%; specificity - 91.67%. It is proved that implantation opportunity toothless jaw segment defined by the presence of bone tissue, a type of bone tissue and the presence of sufficient mineral density of the implant field. It is established that definition of existence and quality of osteointegration is possible only in the panoramic Х-ray, with performing CBCT the distortion of adjacent sites to an implant of bone fabric is noted. Diagnostic accuracy of OPTG and CBCT, calculated on the basis of image quality assessment in the diagnosis of complications of dental implants made by OPTG accuracy - 33.3%; sensitivity - 54.14%; specificity - 27.27%. At the CBCT: accuracy - 90.9%; sensitivity - 95%; specificity - 50%. The combined use panoramic X-ray that CBCT: accuracy - 83.3%; sensitivity - 87.5%; specificity - 33.3%.The algorithm of diagnostic escort of patients with a secondary edentia is developed and effectively approved at preimplantation diagnostics of pathological conditions of maxillofacial area, when planning dental implantation and at stages of surgical rehabilitation.