正畸微种植体精确植入的初步临床研究  

A preliminary study on accurate placement of orthodontic miniscrew

作　　者：张梦洁[1] 孙应明[2] 王晓波[1] 章加宇[1] 

机构地区：[1]安徽医科大学无锡临床学院 [2]解放军101医院口腔科,无锡214044

出　　处：《国际口腔医学杂志》2011年第5期527-530,共4页International Journal of Stomatology

摘　　要：目的在三维牙颌数据基础上,设计制作引导模板,实现正畸微种植体的准确植入。方法对30例需要植入微种植体的正畸患者进行CT扫描和三维数据重建,在三维数据基础上设计种植体支抗的位置和引导隧道,并采用牙冠唇、腭面数据设计定位的翼板;数据采用快速成型技术,制作成实体树脂模板,并引导微种植体的植入,每位患者随机挑选一侧上颌,采用三维导板引导微种植体植入,作为实验组;另外一侧作为对照组,采用传统X线片进行定位植入。术后通过CT扫描和三维数据重建观察植入情况,并经患者5～7个月的临床使用,观察微种植体的脱落情况。结果完成微支抗种植体引导模板的设计,实体模板对种植体植入的引导稳定,种植体能够准确植入设计位置;经5～7个月的临床使用观察,实验组30枚微种植体位置、方向均与术前设计一致,并且与邻近牙根没有接触,仅1枚微种植体由于周围软组织增生干扰导致失败,成功率为96.7%。对照组30枚中有23枚微种植体稳定,7枚发生松动,成功率为76.7%。结论通过三维导向植入可以使微种植体支抗准确地达到最佳植入部位,从而有效降低种植体支抗的失败率。Objective Basing on the three-dimensional reconstruction of jaw bone data,a template was designed for the guide of implantation of miniscrew.It＇s postoperative accuracy and clinical results were also evaluated.Methods The CT scan was performed on 30 patients who needed imbed implant anchorage.Basing on the data,three-dimensional model was reconstructed and the location of implant was determined.The location plates basing on the labial and palatal surface data and guide tube that can be assembled were designed.All data we obtained were output to make to resin template using rapid prototype technology.One side of each patient＇s maxillary were randomly selected to imbed miniscrew by using three-dimensional model.The other side located miniscrew by X-ray film.The effect of template were evaluated during 5-7 months treatment.Results The template we designed can do the stable guide.The miniscrew can reach the exact place as anticipated designed.After 5-7 months of clinical observation,30 miniscrew position and orientation of experimental group consistent with the preoperative design,and no contact with adjacent teeth.A case of failure according to the interference by soft tissues,and the success rate was 96.7%.There were 23 miniscrew stability and 7 loosening in the control group.The success rate was 76.7%.Conclusion The miniscrew can be implanted accurately to the optimal location with three-dimensional guide and decrease the failure rate of implant anchorage.

关 键 词：微种植体 三维导向 种植支抗 

分 类 号：R783.5[医药卫生—口腔医学]