Virtuális tervezés és volumetrikus kiértékelés egy komplex parodontális defektus regeneratív-rekonstruktív sebészi ellátásában:

Aim: Our aim was to present the regenerative-reconstructive surgical treatment of a complex periodontal defect. Surgicaltreatment planning was carried out on realistic virtual hybrid models, containing all relevant anatomical structures (teeth,alveolar bone and gingiva). Additional aim was to evaluate the outcome of the surgical treatment, by the superimpositionof pre- and postoperative cone-beam computed tomography (CBCT) scans.Materials and methods: Utilizing a semi-automatic segmentation method, the 3D model of teeth and alveolar bonewas generated from the CBCT scan using the open source radiographic image processing software, 3D Slicer. Spatialregistration of the hard tissue model acquired from the CBCT scan and the digital model acquired with an intraoralscanner was performed based on anatomical landmarks. First step of the planned stepwise surgical treatment was theextraction and simultaneous alveolar ridge preservation of tooth 26. Surgery was carried out according to the extractionsite development (XSD) technique. Second step was the regenerative treatment of the horizonto-vertical periodontal defectinvolving tooth 24 and 25. Superimposition of the pre- and postoperative CBCT scans allowed to validate the volumetricand linear changes.Results: In the surgical area the cumulative hard tissue gain was 0.44 cm3. Crestal bone resorption of 0.11 cm3 occurredat the palatal and buccal aspects. Linear measurements were performed to evaluate the hard tissue fill of the periodontaldefect around tooth 24 and 26. On average the intrabony component showed a 53.88 ± 36.84% of hard tissuefill, with minor crestal bone resorption. On average a 1.22 ± 0.87 mm of gingival recession occurred around the teeth.Conclusion: It can be concluded that hybrid models acquired with the aforementioned technique allowed detailed planningof the surgical procedures. With the application of the postoperative volumetric and linear evaluation, the healingdynamics of the complex defect could be demonstrated thoroughly.