动态导航技术辅助双侧双颧种植的精度分析及临床效果评估  

Accuracy and clinical outcome of a real-time surgical navigation system for the placement of quad zygomatic implants

作　　者：陶宝鑫 王凤[2] 沈意涵 樊圣祈 黄伟[2] 王跃平[1] 吴轶群[1] Tao Baoxin;Wang Feng;Shen Yihan;Fan Shengqi;Huang Wei;Wang Yueping;Wu Yiqun(Department of Second Dental Center,Ninth People′s Hospital,Shanghai Jiao Tong University School of Medicine&Shanghai Key Laboratory of Stomatology&Shanghai Research Institute of Stomatology National Clinical Research Center for Oral Diseases,Shanghai 201999,China;Department of Oral Implantology,Ninth People′s Hospital,Shanghai Jiao Tong University School of Medicine&Shanghai Key Laboratory of Stomatology&Shanghai Research Institute of Stomatology&National Clinical Research Center for Oral Dinseases,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院口腔第二门诊部,上海市口腔医学重点实验室,上海市口腔医学研究所,国家口腔疾病临床医学研究中心,201999 [2]上海交通大学医学院附属第九人民医院口腔种植科,上海市口腔医学重点实验室,上海市口腔医学研究所,国家口腔疾病临床医学研究中心,200011

出　　处：《中华口腔医学杂志》2020年第11期845-850,共6页Chinese Journal of Stomatology

基　　金：国家重点研发计划(2017YFB1302904);上海交通大学医学院附属第九人民医院临床研究型MDT项目(2017-1-005)。

摘　　要：目的评价动态导航技术辅助双侧双颧种植的植入精度及临床效果。方法回顾2015年1月至2019年12月期间于上海交通大学医学院附属第九人民医院口腔第二门诊部及口腔种植科就诊的动态导航下进行双侧双颧种植的24例患者,男性9例,女性15例,年龄(50.8±14.7)岁,共植入96枚颧种植体。将术前规划种植体数据和术后实际植入种植体的螺旋CT或锥形束CT数据经图像融合,测量并记录两者的入口偏差、出口偏差和角度偏差;种植体分别依据种植体植入方式(导航引导下植入12枚,徒手植入84枚)、种植体长度(<47.5 mm为短种植体组,28枚;≥47.5 mm为长种植体组,68枚)和植入位置(近中植体及远中植体各48枚)进行分组,分析不同组间种植体植入精度差异。记录患者术中及术后并发症情况,术后6个月随访评估种植体存留率。结果96枚颧种植体入口偏差为(1.49±0.64)mm,出口偏差为[2.03(1.58,2.40)]mm,角度偏差为2.49°±1.12°。导航引导下植入组与徒手植入组的入口偏差[分别为(1.45±0.60)和(1.50±0.64)mm]、出口偏差[分别为(1.96±0.44)和(2.04±0.79)mm]、角度偏差[分别为2.66°±1.13°和2.50°±1.13°]差异均无统计学意义(P>0.05)。种植体长度<47.5 mm组与≥47.5 mm组的入口偏差[分别为(1.42±0.60)和(1.52±0.65)mm]、出口偏差[分别为(2.13±0.60)和(1.98±0.82)mm]、角度偏差[分别为2.61°±1.08°和2.43°±1.14°]差异均无统计学意义(P>0.05)。近中植体组与远中植体组的入口偏差[分别为(1.55±0.69)和(1.43±0.57)mm]、出口偏差[分别为(2.05±0.92)和(2.01±0.57)mm]、角度偏差[分别为2.48°±1.16°和2.49°±1.10°]的差异均无统计学意义(P>0.05)。导航引导下双侧双颧种植手术均顺利进行,无术中并发症发生,3例患者出现可逆的术后并发症。6个月随访期内2枚颧种植体出现松动,种植体存留率为97.9%(94/96)。结论动态导航系统辅助双侧双颧种植可获得良好的植入�Objective To evalute the accuracy and clinical outcome of a real-time navigation system for the placement of quad zygomatic implants.Methods Twenty-four patients[9 males and 15 females,mean age was(50.8±14.7)years old],from January 2015 to December 2019,with 96 zygomatic implants placed under a real-time navigation system in Department of Second Dental Center and Department of Oral Implantology of Ninth People′s Hospital,Shanghai Jiaotong University School of Medicine were included in the study.The preoperative and the postoperative multislice CT or cone-beam CT were fused to measure and record the entry,exit and angle deviation between the planned and placed implants.The implants were divided into groups according to implant insertion approach(real-time navigation and free-hand),implant length(<47.5 mm and≥47.5 mm)and implant position(proximal and distal implant).And the differences of implant accuracy were analyzed.The intraoperative and postoperative complications were also recorded.The implant survival rate was evaluated after 6 months follow-up.A P value<0.05 indicates statistical significance.Results The mean entry,exit and angle deviation of zygomatic implants were(1.49±0.64)mm,[2.03(1.58,2.40)]mm and(2.49°±1.12°),respectively.The average entry,exit and angle deviation of the navigation guided implant insertion group were(1.45±0.60)mm,(1.96±0.44)mm and(2.66±1.13°)respectively,while those of the free-hand group were(1.50±0.64)mm,(2.04±0.79)mm and(2.50°±1.13°)respectively.There was no significant difference between the two groups(P>0.05).The average entry,exit and angle deviation of the group with length<47.5 mm were(1.42±0.60)mm,(2.13±0.60)mm and(2.61°±1.08°)respectively and those of the group with length≥47.5 mm were(1.52±0.65)mm,(1.98±0.82)mm and(2.43°±1.14°)respectively.No significant difference was found between the two groups(P>0.05).In proximal implant group,the average entry,exit and angle deviation were(1.55±0.69)mm,(2.05±0.92)mm and(2.48°±1.16°)respectively while

关 键 词：牙种植体 牙修复体 颧骨 颌 无牙 外科手术 计算机辅助 

分 类 号：R783.6[医药卫生—口腔医学]