EVALUATION OF NEEDED GRAFT VOLUME FOR SINUS FLOOR AUGMENTATION USING THREE-DIMENSIONAL COMPUTERIZED TOMOGRAPHY

Öz

Purpose: The objective of this study was to evaluate the augmentation volume needed for different sinus lift levels (from 10 mm to 18 mm) with 3D CT, and software. Material and Methods: Data from 15 CTscans was obtained from 15 adult patients (ten male/ five female) for the purposes of this study. The CT data, in DICOM format, was read into Mimics software from Materialize (Leuven, Belgium), with a slice thickness of 0.5 mm. Different levels of sinus lift augmentation (from 10 mm to 18 mm) volume were calculated on the 3D images using Mimics software. Results: The average calculated augmentation volume for an augmentation height of 10 mm was 1665.49 ± 657.18 mm3 and needed amount of graft was 2.32 cm3 ; for an augmentation height of 18 mm, the average volume required was 5057.73 ± 1619.36 mm3 and needed amount of graft was 6.67 cm3. Conclusion: Using three-dimensional computerized tomography (3D CT) technique, to determine preoperative knowledge of the sinus lift augmentation volume and needed amount of graft material would be increase long-term success of surgery operation and implants.

Anahtar Kelimeler

• Sinus augmentation
• three dimensional
• computerized tomography

SİNÜS TABANI YÜKSELTİLMESİ İÇİN GEREKLİ GRAFT HACMİNİN ÜÇ BOYUTLU BİLGİSAYARLI TOMOGRAFİ YÖNTEMİ İLE DEĞERLENDİRİLMESİ

Öz

Amaç: Bu çalışmanın amacı farklı seviyelerdeki sinüs tabanı yükseltmelerinde gerekli olan greft ihtiyacını üç boyutlu bilgisayarlı tomografi (3B-BT) ve yazılım yardımıyla değerlendirmekti. Materyal ve Method:Bu çalışmada 15 erişkin hastadan (10 erkek/5 bayan) alınan bilgisayarlı tomografi dataları kullanıldı. Dicom formatında, 0.5 mm kesit kalınlığındaki BT dataları Materiliase (Leuven, Belçika) firmasının Mimics adı verilen yazılımına aktarıldı. Sinüs tabanının farklı seviyelerde (10 mm’den -18 mm) yükseltilmesi için gerekli hacim 3B-BT görüntüleri ve mimics yazılımı kullanılarak hesaplandı. Bulgular: 10 mm agmentasyon yüksekliği için gerekli agmentasyon hacmi 1665.49 ± 657.18 mm3 ve gerekli greft miktarı ise standart sapmalar da dikkate alındığında yaklaşık olarak 2.32 cm3 olarak hesaplanırken, 18 mm agmentasyon yüksekliği için gerekli agmentasyon hacmi 5057.73 ± 1619.36 mm3 gerekli greft miktarı ise 6.67 cm3 olarak hesaplandı. Sonuç: Üç boyutlu bilgisayarlı tomografi (3BBT) tekniği kullanılarak operasyon öncesi sinüs agmentasyonu için gerekli hacmi ve kullanılacak greft materyali miktarının belirlenmesi, cerrahi müdahalenin ve yerleştirilecek implantların uzun dönem başarısını olumlu yönde arttıracaktır. 

Anahtar Kelimeler

• Sinüs agmentasyonu
• üç boyutlu
• bilgisayarlı tomografi

Kaynakça

1. Bergh van den JPA, Bruggenkate ten CM, Krekeler G, Tuinzing DB. Sinus flor elevation and grafting with autogenous iliac crest bone. Clin Oral Implants Res 1998; 9:429-435.
2. Boyne PJ, James RA. Grafting of the maxillary sinus floor with autogenous marrow and bone. J Oral Surg 1980; 38:613-616.
3. Kahnberg KE, Rasmusson L, Zellin G. Bone grafting techniques for maxillary implants. Munksgaard, 2005:33 34. Blackwell
4. Zijderveld SA, Zerbo IR, van den Bergh JP, Schulten EA, ten Bruggenkate CM. Maxillary sinus floor augmentation using a beta-tricalcium phosphate (Cerasorb) alone compared to autogenous bone grafts. J Oral Maxillofac Implants 2005; 20:432-440.
5. Alfaro FH. Bone grafting in oral implantology. ed.1, 16. de Oliveira RC, Leles CR, Normanha LM, Lindh C, Spain: Quintessence Publishing Co.Ltd, 2006:27 83.
6. Sethi A, Kaus T. Practical Implant Dentistry. ed.1, Germany: Quintessence Publishing Co.Ltd, 2005:221 223.
7. Uchida Y, Goto M, Katsuki T, Akiyoshi T. A cadaveric study of maxillary sinus size as an aid in bone grafting of the maxillary sinus floor. J Oral Maxillofac Surg 1998; 56:1158-1163.
8. Jun BC, Song SW, Park CS, Lee DH, Cho KJ, Cho JH. The analysis of maxillary sinus aeration according to aging process; volume assessment by 3-dimensional reconstruction by high-resolutional CT scanning. Otolaryngol Head Neck Surg 2005; 132:429-434.

9. Kirmeier R, Payer M, Wehrschuetz M, Jakse N, Platzer S, Lorenzoni M. Evaluation of three- dimensional changes after sinus floor augmentation with different grafting materials. Clin Oral Implants Res 2008; 19:366-372.
10. Güngörmüş M, Yilmaz AB, Ertaş U, Akgül HM, Yavuz MS, Harorli A. Evaluation of the mandible as an alternative autogenous bone source for oral and maxillofacial reconstruction. J Int Med Res 2002; 30:260-264.
11. Crespi R, Vinci R, Capparè P, Gherlone E, Romanos GE. Calvarial versus iliac crest for autologous bone graft material for a sinus lift procedure: a histomorphometric study. Int J Oral Maxillofac Implants 2007; 22:527-532.
12. Hatano N, Shimizu Y, Ooya K. A clinical long-term radiographic evaluation of graft height changes after maxillary sinus floor augmentation with a 2:1 autogenous simultaneous placement of dental implants. Clin Oral Implants Res 2004; 15:339-345. and
13. Montazem A, Valauri DV, St-Hilaire H, Buchbinder D. The mandibular symphysis as a donor site in maxillofacial bone grafting: a quantitative anatomic study. J Oral Maxillofac Surg 2000; 58:1368-1371.
14. Assesment of correlation between computerized tomography values f the bone, and maximum torque and resonance frequency values at dental implant placement. J Oral Rehabilitation 2006; 33:881-888
15. Jensen J, Kragskov J, Wenzel A, Sindet-Pedersen S.In vitro analysis of the accuracy of subtraction radiography and computed tomography scanning for determination of bone graft volume. J Oral Maxillofac Surg 1998;56: 743-748 Ribeiro-Rotta RF. Assessments of trabecular bone density at implant sites on CT images. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 Feb;105(2):231-8
16. Kim HJ, Yoon HR, Kim KD, Kang MK, Kwak HH, Park HD, Han SH, Park CS. Personal-computer-based three-dimensional reconstruction and simulation of maxillary sinus. Surg Radiol Anat 2003; 24:393-399.
17. Szabó G, Huys L, Coulthard P, Maiorana C, Garagiola U, Barabás J, Németh Z, Hrabák K, Suba Z. A prospective multicenter randomized clinical trial of phosphate graft alone for bilateral sinus elevation: histologic and histomorphometric evaluation. Int J Oral Maxillofac Implants 2005; 20:371-381.
18. Anagnostopoulou S,Venieratos D, Spyropoulos N.Classification of according to their geometric features.Anat Anz 1991;173:121-130 maxillary sinuses
19. Ariji Y, Kuroki T, Moriguchi S, Ariji E, Kanda S. Age changes in the volume of the human maxillary sinus: a study using computed tomography. Dentomaxillofac Radiol 1994; 23:163-168.
20. Uchida Y, Goto M, Katsuki T, Soejima Y. Measurement of maxillary sinus volume using computerized tomographic images. Int J Oral Maxillofac Surg 1998; 13:811-818.