牙槽嵴增量术个体化三维钛网固定钉的精度研究  

Accuracy of Fixing Screws for Individual 3-Dimensional Titanium Mesh during Alveolar Ridge Augmentation

作　　者：陈磊[1] 廉云敏[1] 张英怀[1] 高岚[1] 王璞[1] 怀海丽[1] 

机构地区：[1]河北医科大学第二医院口腔修复科,石家庄050000

出　　处：《解放军医药杂志》2014年第8期70-73,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：河北省卫生厅科研基金项目(20130148)

摘　　要：目的探讨用于引导骨组织再生技术(GBR)的计算机辅助设计和制作的个体化三维钛网固定钉的植入精度。方法选择9个尸体颌骨标本,采用锥形束CT(CBCT)获取颌骨三维影像数据,蓝光光栅三维扫描仪重建数字牙弓模型。运用计算机技术和快速成型技术设计并制作个体化三维钛网、钛网的定位装置、钛网固定钉的植入导板。将钛网定位于尸体颌骨,采用导板引导固定钉植入并固定钛网。采用Guidemia软件将术后CBCT颌骨数据与术前数据配准,评价虚拟设计与实际植入固定钉的三维精度的差异。结果本研究为9个尸体颌骨标本共制作15个个体化三维钛网,共植入64颗固定钉。个体化三维钛网的实际固定钉和虚拟固定钉在上、下颌之间的偏移差异无统计学意义(P>0.05),固定钉中轴线在颈部、根端的线性偏移距离为(0.89±0.28)、(1.41±0.21)mm,角度偏移量为(1.92±0.31)°。结论个体化三维钛网固定钉的植入精度与既往研究报道的口腔种植规划软件种植体的植入精度相似,该技术能够满足临床要求。Objective To evaluate the accuracy of fixing screws for individual titanium mesh fabricated with computer-aided design-computer-assisted manufacturing （ CAD-CAM ） technique. Methods Jaw samples were taken from 9 human cadavers, and the 3-dimensional image data was obtained with cone-beam CT （ CBCT） , and the digital dental arch models were rebuilt using blue-light raster of triplex scanner. Individual 3-dimensional titanium mesh, loca-ting device for titanium mesh and surgical template for fixing screws were designed and fabricated using the CAD software and rapid prototyping technique. The mesh was fixed in the cadaver using surgical template guidance of fixed screws. The Guidemia software was used to match images of the planned and placed fixing screws, and the deviation of the 3-dimen-sional accuracy between planned and placed position was evaluated. Results A total of 15 individual meshes were fabri-cated, and 64 fixing screws were implanted. The deviations between planned and placed position in upper and lower man-dibles were not statistically significant （P〉0. 05）, and the mean linear deviation was （0. 89 ± 0. 28）mm at the fixing screw neck and （1. 41 ± 0. 21） mm at the fixing screw apex compared with those of the planned fixing screws, and the mean angular deviation was （1. 92 ± 0. 31）°. Conclusion The individual 3-dimensional titanium mesh with locating de-vice and surgical template for fixing screws is equally accurate in implantation, compared with oral cavity implanting soft-ware.

关 键 词：义齿 植入物支持 牙槽嵴增高术 计算机辅助设计 计算机辅助制造 快速成型技术 个体化钛网 固定钉 

分 类 号：R782.12[医药卫生—口腔医学]