Es wurde eine virtuelle Planung des Falles vorgenommen. Cosci geplant. Am Modell werden zwei Demonstrationsimplantate eingesetzt. Der Zahntechniker modelliert anhand der Angaben die chirurgische Schablone. Der Operationssaal wurde unter sterilen Bedingungen vorbereitet, wie sie bei implantologischen Eingriffen oder bei Knochenimplantationen angewendet werden. Dieser temperaturresistente Kunststoff ist sterilisierbar.
Translation - English Use of cortico-cancellous blocks with simultaneous elevation of the floor of the maxillary sinus, with the aid of the 3D-CT block technique Jacotti, M. Numerous authors have described augmentations using bony allograft implants in recent years . The use of this technique has the advantage that the patient does not need to undergo an operation to harvest the implant from chin or body of mandible and that there are no restrictions on the material needed for the reconstruction, since it is commercially available. Computerised tomography CT has become a routine technique in the field of implantation, since it is the only method that can provide significant data on bone quality and the morphology of anatomical structures, and offer a 3D representation of the bones of the jaw 1, ].
The processing of CT data with specially designed software Vimplant, Cybermed even makes it possible to carry out 3D reconstructions of the bones of the jaw on a PC.
German to English translator specialising in medical and technical texts
Specialist service centres can convert these 3D files into solid plastic models which correspond reliably with the anatomical features. A CT scan was requested and stored on digital media. A virtual treatment plan was undertaken. With this file, a solid model can be produced using rapid prototype manufacturing with a sintering machine. On the basis of the CT data, the required cortico-cancellous block, in this case a horizontal reconstruction of teeth 24 and 25, and an elevation of the floor of the maxillary sinus was planned according to the dental lamina technique of Dr F Cosci.
Two demonstration implants were inserted into the model. The base of the bony bed of the surgical template is outlined with a felt-tip pen. The dental technician models the surgical template on the basis of the data provided. The resin template is then sealed in foil and autoclaved. The prepared jaw model was also sealed in foil and autoclaved using the normal sterilisation program. The operating theatre was prepared under sterile conditions, as used in implant procedures or bone implants. In this environment, the cortico-cancellous block was fitted to the previously sterilised 3D model while strictly following those sterile techniques that need to be followed in such cases.
After preparation of the cortico-cancellous block and its fixation to the model with appropriate synthetic bone screws, the whole preparation is placed in a double sterile package, taking care to protect the cortico-cancellous blocks on the model: one pack is sterilised with the open side in another pack.
The non-sterile assistant opens the sterile pack that contains the other sterile pack, and the sterile assistant removes the sterile pack with the open side and puts the preparation into it; the open side of the pack is then sealed.
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With this technique the model with the fitted cortico-cancellous blocks can be stored. The actual surgical phase, which has been planned with the requirements of the practice and the patient in mind, will be significantly shorter than if the same kind of procedure were carried out in the usual way. The markedly shortened operation time guarantees a better recovery for the patient, with less oedema and pain. Thanks to planning on the model, the preparation of the surgical template for the bony bed, and the modelling of the bone blocks using the 3D block technique, the standard procedure for bone blocks is significantly simplified.
However, it must still be recognised that although the operating time is drastically shortened and the possibility of errors is markedly reduced with this method, the fact remains that as with all regenerative techniques the preservation of soft tissue plays a fundamental role. The operator must therefore protect these soft tissues as well as possible in order to achieve a successful result. This temperature-resistant plastic can be sterilised. At the actual operation the cortico-cancellous block, titanium fixation screws and the collagen membrane are removed from the model and implanted in the patient.
This 3D CT block technique makes it possible to drastically shorten operating time for the patient, since the greater part of the work is carried out on the 3D model. In addition one has better control over the fitting of the cortico-cancellous blocks, which can be checked after dry modelling from various viewpoints without visual impediments such as bleeding, swabs, and the borders of the oral cavity.
Conclusion The technique proved to be very simple, and the correspondence between the solid model and the anatomy of the jaw was more than satisfactory from a clinical point of view. This profile has received 74 visits in the last month, from a total of 51 visitors. Profile last updated Sep 3.
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