A method for determining the position of dental implants at the stages of rehabilitation of a patient with missing teeth

摘要

FIELD: medicine.SUBSTANCE: invention refers to medicine, namely, to surgical and orthopedic dentistry, and is intended for determining the position of dental implants on orthopantomograms of jaws, both during planning the implantation operation and after implant placement at all stages of rehabilitation of patients with no teeth. X-ray examination of the patient is performed, as a result of which the orthopantomogram of the jaws is obtained. Main anatomically stable landmarks for determining the position of dental implants in bone tissue on the orthopantomogram of the jaws are considered to be the “Dzn” points, which are located at the intersection of the line corresponding to the projection of the distal slope of the zygomatic process of the upper jaw with the boundary of the hard palate, the "C" points, which are located near the lateral walls of the nasal passage and the “Me” point – the lowest symphysis point on the chin. On the orthopantomogram of the jaws, as shown in Fig. 1, the “Dzn” points are marked and they are interconnected with the horizontal line. Resulting segment between the "Dzn" "Dzn" points is divided into two equal segments and the “K” point is obtained, from which the perpendicular is lowered until it intersects with the boundary of the lower edge of the lower jaw and thus builds the first vertical line – the line of the aesthetic center. Distance between the points – from "Dzn" to the “Dzn” point – is divided into three equal segments and the “C” points are obtained. Distance from the “Dzn” point to the “C” point is divided into three equal segments and the "M" and "Pr" points are obtained, the distance from the “C” point to the “K” point is divided into two equal segments and the “I” point is obtained. From the "Dzn", "M", "Pr", "C" and "I" points, perpendiculars are lowered from each side of the upper jaw to the intersection with the boundary of the lower edge of the lower jaw, thus, the guidelines are obtained for determining the position of six permanent teeth of the frontal group of teeth on the upper and lower jaws, namely the central incisors, lateral incisors and canines, as well as four permanent teeth of the lateral segment on the upper and lower jaws to the right and to the left - the first and second premolars, the first and second molars, with the exception of the third permanent molars, due to their high propensity to rudimentary. Positioning of dental implants on the upper and lower jaws with respect to the obtained landmarks to the right and to the left is carried out as follows: dental implants of the upper and lower central incisors are installed in the bone tissue of the upper and lower jaws between the K and I lines, the dental implants of the upper lateral incisors are placed between the I and C lines, and the implants of the lower lateral incisors are placed on the I line, the dental implants of the maxillary canines are set in the bone tissue on the C line, and the implants of the canines of the lower jaw are placed mesial from the C line, the dental implants of the first premolars of the upper jaw are set mesially from the Pr line, and the first premolars of the lower jaw between the Pr and C lines, the dental implants of the second premolars on the upper jaw are set distally from the Pr line, and the implants of the lower second premolars are set on the Pr line, the dental implants of the first permanent molars of the upper jaw are located in the bone tissue from the distal side of the M line and tangent to it, and the dental implants of the first permanent molars of the lower jaw are placed on the M line, the dental implants of the second permanent molars of the upper jaw are set in the bone tissue from the distal side of the Dzn line and tangent to it, and the dental implants of the second permanent molars of the lower jaw are placed on the Dzn line, so that these lines are the reference points for the installation of dental implants in the absence of teeth on the upper and lower jaws.EFFECT: method, due to the use of the most accurate anatomically stable landmarks, allows to increase the accuracy of the positioning of dental implants in the area corresponding to the lost tooth, which improves the quality of the prosthetic measures during the rehabilitation of patients with no teeth.1 cl, 2 dwg