2016-02-20
これは、下の奥歯のインプラント埋入手術直後に撮影したＣＴ像です．
術前のＣＴで、神経までの距離が近いことは診断できていました．
インプラントが神経に、触れていないのは絶対に確実でしたが、
ある程度以上神経に近いと圧迫して神経麻痺が発生しること
があるといわれています．
その為、術後インプラントを少しだけ逆回転させて浅く植えなおしました．
当院では、術後に必ずＣＴ撮影を行っています．
過去数回、このように術後インプラントの埋入位置を変えたこともあります．
10年以上前、日本に歯科用ＣＴが１０数台しかない時代に当院は
ＣＴを導入しました．当時から術前 術後に必ずＣＴの撮影をしていました．
当時はＣＴは必要なときだけとるもので、全ての患者さんに撮影する
のは被爆させすぎだと学会でも批判されていましたが、現在では術前の
ＣＴ撮影は当然で、術後に撮影することも良いとされています．
当時歯科用ＣＴはウン千万円したのですが、現在は簡易のＣＴなら
数百万円でも導入できるようです．
（当院のＣＴは最新の機種のため、相変わらず高いですが）
その様な経緯もあり、現在ではインプラントをされる医院の殆どが
ＣＴ装置を導入されているようです．
自院にＣＴ装置がなく、医科にＣＴを依頼して撮影される医院もまだ
あるようですが、そのような場合には、医科のＣＴは歯科専用のＣＴに
比べ数倍の被爆量があるとされています．そのためどうしても撮影
回数を制限してしまい、結果として患者さんに不利益をあたえてしまう
のでは無いかと思ってしまいます。
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