一种切削法制作的数字化种植手术导板加工精度评价  

Evaluation of the fabrication deviation of a kind of milling digital implant surgical guides

作　　者：柴金友 刘建彰[1] 王兵[2] 屈健 孙振 高文慧 郭天晧 冯海兰[1] 潘韶霞[1] CHAI Jin-you;LIU Jian-zhang;WANG Bing;QU Jian;SUN Zhen;GAO Wen-hui;GUO Tian-hao;FENG Hai-lan;PAN Shao-xia(Department of Prosthodontics;Dental Laboratory,Peking University School and Hospital of Stomatology ＆ National Clinical Research Center for Oral Diseases ＆ National Engineering Laboratory for Digital and Material Technology of Stomatology ＆ Beijing Key Laboratory of Digital Stomatology,Beijing 100081,China)

机构地区：[1]北京大学口腔医学院.口腔医院修复科,北京100081 [2]北京大学口腔医学院.口腔医院义齿加工中心国家口腔疾病临床医学研究中心口腔数字化医疗技术和材料国家工程实验室口腔数字医学北京市重点实验室,北京100081

出　　处：《北京大学学报（医学版）》2018年第5期892-898,共7页Journal of Peking University:Health Sciences

基　　金：北京大学口腔医学院临床新技术新疗法项目基金(PKUSSNCT-16A11)~~

摘　　要：目的:评价一种切削法制作的数字化种植手术导板(Organical Dental Implant,ODI系统,R+K,德国)的加工误差。方法:试验分为两部分:(1)体外试验:通过体外模拟数字化种植手术导板的设计和加工制作,在切削加工完成后将导板进行模型扫描获得虚拟三维数据,导入设计软件融合后直接测量加工误差作为金标准,A和B两名试验者分别用检验平台测量10次加工误差,评价检验平台用于测量的可靠性。(2)临床试验:通过检验平台检验12例临床病例导板的加工精度,分析误差的大小及可能影响加工误差的因素。结果:体外试验中,两名试验者对8枚种植体导环参考点测量的标准差均小于0.4 mm,角度测量的标准差均小于0.71°。两名试验者对于每个种植体的检验结果差异均无统计学意义,对于导环参考点误差测量结果均较软件测量结果大(配对t检验,P<0.05),角度误差的测量结果差异无统计学意义(配对t检验,P>0.05)。临床试验中,12例导板共45枚种植体导环参考点加工误差为(1.06±0.29)mm(0.42～1.75 mm),根尖误差为(1.12±0.48)mm(0.41～2.44 mm),角度误差为1.42°±0.70°(0.29°～2.96°)。结论:导板的切削加工过程中也会存在一定误差,ODI系统的检验平台是测量加工误差的可靠工具。种植导板加工误差与种植体植入位置误差间的关系还需进一步研究。Objective： To evaluate the deviation of digital implant surgical guides during fabrication process in the Organical Dental Implant （ODI） system. Methods： This study included two parts. The first part was the in vitro study. A resin block with a diagnostic template was used for the planning. After cone beam computed tomography （CBCT） scanning,a surgical guide with eight implants was virtually designed using the ODI system. The guide was milled by a 5-axial numerical controlled milling machine,and an optical scanning was taken to digitalize the guide to a standard tessellation language （STL） form.The STL data were then imported into an ODI software and registered with the original design. The deviation of the sleeves between the design and the STL was measured in the ODI software and set as the golden standard. Then the ODI examination table was used to measure the deviation of the guide during fabrication. Examiners A and B measured 10 times separately. The reliability and the validity of the examination table was calculated. The second part was the in vivo study： The deviation during fabrication of 12 guides designed and fabricated by the ODI system were measured using the examination table. Results： The standard deviation of the deviation measured using the examination table by examiners A and B were all below 0. 40 mm （for the shell reference points） and 0. 71 degree （for the angles）. No significant difference was found between the two examiners for any implant sites. The result of the examination table was larger than that of the software for the shell reference point （t-test,P〈 0. 05）,but no significant difference was found for the angle deviation （t-test,P 〉0. 05）. The 45 implants positions in the 12 guides for the in vivo study were examined using the examination table. The deviations at the shell reference points were （1. 06 ± 0. 29） mm （0. 42-1. 75 mm）,and at the implant tip were （1. 12 ±0. 48） mm （0. 41-2. 44 mm）. The angle deviations were （1. 4

关 键 词：牙种植 骨内 计算机辅助设计 种植导板 加工误差 

分 类 号：R783.4[医药卫生—口腔医学]