牙科植牙的放射線檢查

Radiographic Examination of Dental Implants

賴玉玲(Yu-Lin Lai) ； 李士元(Shyh-Yuan Lee)

《中華牙醫學雜誌》 22卷4期 (2003/12) Pp. 351-362

摘要

放射線攝影是牙科植體治療的重要診斷工具之一。採用放射線檢查，術前可評估骨量、骨質以及解剖構造，術後可瞭解骨癒合的情現。植體治療常用的放射線攝影，包括牙根尖放射線攝影、環口放射線攝影、斷層攝影以及電腦斷層攝影。牙根尖放射線攝影可清晰的顯示局部植牙區域的結構，環口攝影可初步檢查全口牙齒和顎骨的狀況，斷層攝影以及電腦斷層攝影能夠呈現頰舌側的影像。環口攝影和斷層攝影的解析度較差、放大率較大，較難以這兩種攝影方式，準確地測量骨長度和寬度。採用平行攝影法的牙根尖放射線攝影和電腦斷層的影像清晰，放大率極小，適合以此兩種攝影來評估骨量以決定植體的長度和種植的角度。在輻射劑量方面，電腦斷層的劑量遠高於其他的放射線攝影。在植體治療過程中，臨床醫師需依病患的狀況，綜合各種放射線攝影的利弊以及考慮到放射線攝影的劑量，選擇適當的攝影方法。

關鍵字

牙科放射線攝影 ； 牙科植體 ； 診斷

並列摘要

Radiographic examination is one of the most frequently used diagnostic methods applied in patients with implant therapy. Radiographic images provide preoperative evaluation of the external architecture or volume of the alveolar bone for accurate installation of the implant relative to several important anatomic structures. Radiographs are also used for assessing peri-implant bone changes after implant placement. Diagnostic imaging in implant dentistry includes periapical, panoramic, and tomographic imaging as well as computed tomography. Periapical radiography with the long-cone parallel technique has limited magnification to depict the local structure of the alveolus and to elucidate details. Panoramic survey provides an overview of the dentition and bone topography, and furnishes information on the location of important anatomical structures, while tomography provides valuable cross-sectional images. Nevertheless, nonuniform magnification and poor resolution qualities of panoramic and tomographic images hinder precise estimation of bone dimensions. Up to now, computed tomography has been the most accurate radiograph for demonstrating a 3-dimensional image for implant dentistry. However, it delivers the greatest radiation dosage. Based on the clinical needs of and biologic risks to the patient, proper imaging modalities should be adopted for implant therapy.

並列關鍵字

dental radiography ； dental implant ； diagnosis