全程导板辅助无牙颌种植的精度研究  

ACCURACY OF DENTAL IMPLANTS FOR EDENTULOUS JAWS ASSISTED BY FULLY GUIDED TEMPLATE

作　　者：高洁[1] 马康傑 姜雅萍 李欣[1] 邓婧[1] 赵保东[1] GAO Jie;MA Kangjie;JIANG Yaping;LI Xin;DENG Jing;ZHAO Baodong(Department of Oral Implantology, The Affiliated Hospital of Qingdao University, Qingdao 266003, China)

机构地区：[1]青岛大学附属医院口腔种植科,青岛大学口腔医学院,青岛市口腔数字医学与3D打印工程实验室,山东青岛266003

出　　处：《精准医学杂志》2021年第2期119-122,共4页Journal of Precision Medicine

基　　金：山东省医药卫生科技发展计划项目(2019WS375)。

摘　　要：目的研究全程导板辅助无牙颌种植的精度。方法选取无牙颌的病人14例,在Straumann全程导板引导下拟植入78枚种植体,其中上颌36枚种植体,下颌42枚种植体。术前制作放射性义齿并进行颌面部锥形束计算机断层扫描(CBCT),将影像信息导入coDiagnostiX软件,利用计算机辅助设计/计算机辅助制造(CAD/CAM)技术进行全程导板的设计和3D打印。术后行CBCT并将图像导入到coDiagnostiX软件,与术前影像信息进行配准重叠,测量术前种植体虚拟植入位置与术后植入位置之间的偏差。结果种植体中心轴线角度偏差为3.56°±1.76°,种植体顶部中心偏差为(1.23±0.60)mm,种植体根尖部中心偏差为(1.51±0.59)mm,种植体植入深度偏差为(0.37±0.94)mm。上颌种植体比下颌种植体的顶部中心偏差大(t=2.18,P<0.05)。结论本研究发现的偏差范围可以为种植体术前植入位置的设计提供参考,从而避开重要的解剖结构以减少手术风险。Objective To investigate the accuracy of dental implants for edentulous jaws assisted by a fully guided template.Methods A total of 14 patients with edentulous jaws were enrolled,and 78 implants were planned to be placed using the Straumann fully guided template.There were 36 maxillary implants and 42 mandibular implants.A radiographic template was made and maxillofacial cone-beam computed tomography(CBCT)was performed before surgery.Image data were imported into the coDiagnostiX software,and the computer-aided design/manufacturing(CAD/CAM)technique was used for the design and 3D prin-ting of the fully guided template.CBCT was performed after surgery,and related data were imported into the coDiagnostiX software,which was registered to and overlapped with the image data before surgery to measure the deviation between preoperative virtual implantation location and postoperative implantation location.Results The angle deviation of the center axis of the implant was 3.56°±1.76°;the center deviation of the top of the implant was(1.23±0.60)mm,the center deviation of the root apex of the implant was(1.51±0.59)mm,and the deviation of implant depth was(0.37±0.94)mm.Maxillary implants had a significantly larger center deviation of the top than the mandibular implants(t=2.18,P<0.05).Conclusion The range of deviation found in this study can provide a reference for the design of preoperative implantation location to avoid important anatomical structures and reduce surgical risks.

关 键 词：外科手术 计算机辅助 计算机辅助设计 牙种植 精确度 颌 无牙 锥形束计算机断层扫描 

分 类 号：R782.13[医药卫生—口腔医学]