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. 2021 Apr 1;39(2):233-237.
doi: 10.7518/hxkq.2021.02.018.

[Interarch distance is a target restorative space value: clinical decisionmaking of implant restoration guided by measured value]

[Article in Chinese]
Yu-Qiang Zhang  1 , Hai-Yang Yu  1
Affiliations

[Interarch distance is a target restorative space value: clinical decisionmaking of implant restoration guided by measured value]

[Article in Chinese]
Yu-Qiang Zhang et al. Hua Xi Kou Qiang Yi Xue Za Zhi. .

Abstract
in English, Chinese

When design an implant restoration for edentulous patients, many doctors ignore the sufficiency of the interarch distance (vertical distance) or horizontal distance of the patient to accommodate the superstructure and restoration before designing the implant plan. However, the connotation of measuring the interarch distance or horizontal distance has not been clarified in clinical practice. It is often based on visual estimation after operation, and the decision-making path of implant restoration is inverted, resulting in many mistakes regarding the restoration after implantation. The main reason is the lack of standardized paths and practical methods to use before surgery. This article recommended initially establishing a maxillo-mandibular relationship based on natural teeth, old dentures, or new ones and then using the height and horizontal distance or angle of the target restorative space, which was easier to grasp as the measured index. The minimum vertical distance (including the height of the gingival surface and the bone surface) and the horizontal distance (or the angle from the bone or gingival surface to the proposed occlusal plane) should be measured before operation. A decision tree of edentulous jaw restoration guided by the values of the repair space was established based on the measured values. This article clarified the measuring points and planes and thus provided a quantitative relationship basis for the design of implant restoration.

无牙颌患者选择种植修复方案时，不少医生忽视了应该在建 后研判患者的颌间距离（垂直距离）或水平距离是否足够容纳种植上部结构及修复体等，再进行种植方案设计。而临床上常用的颌间距离（垂直距离）、水平距离的实测内涵和方法还有待明确，常用的术后目测估计除不准确外还易导致种植修复决策路径倒置，导致不少病例植入成功后出现了无法合理修复的尴尬，这种“想到没做到”的主要原因是缺乏关键参数的规范路径和实用工具及方法。本文推荐先建立新的或天然牙、旧义齿保留的正确颌位关系，然后采用更容易把握的目标修复空间的高度和水平距离或夹角作为实测指标，植入术前在 架或口内用实测工具采集各植入位点的骨面或龈面到拟定咬合平面的最小垂直距离（包括龈面高度和骨面高度）和水平距离或夹角，根据实测值大小建立了以修复空间的各项数值为引导的无牙颌修复方案决策树，理顺了临床决策路径；同时规范了测量方案（起止点、测量平面等），为合理制定数字化种植修复方案提供了可靠的数量关系依据。.

Keywords: clinical decision; implant overdenture; implant restoration; restoration of edentulous jaw; vertical-height target restorative space.

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Conflict of interest statement

利益冲突声明：作者声明本文无利益冲突。

Figures

图 1
图 1. 基于VTRS计算矢状面上下颌水平距离
Fig 1 Calculation of the horizontal distance between the maxilla and mandible in the sagittal plane based on VTRS
图 2
图 2. 基于VTRS的矢状面前牙咬合设计决策
Fig 2 Design of the anterior teeth occlusion in the sagittal plane based on VTRS 左：D-HTRS≤5 mm；中：510 mm。
图 3
图 3. 基于VTRS计算冠状面上下颌水平位置关系
Fig 3 Calculation of the horizontal position of the maxilla and mandible in the coronal plane based on VTRS
图 4
图 4. 基于VTRS的冠状面后牙咬合设计决策
Fig 4 Design of posterior occlusion in the coronal plane based on VTRS 左：A-HTRS≥80°或略小于80°；右：A-HTRS<80°。
图 5
图 5. G-VTRS实测值引导的无牙颌患者种植修复的决策树
Fig 5 Decision tree of implant restoration of edentulous patients guided by G-VTRS measured values
See this image and copyright information in PMC

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