种植导板精度非放射学评价方法的建立与应用评价  

Nonradiological methods for implant surgical guide accuracy measurement

作　　者：叶盛佳 包世婕 陈渠奕 忻贤贞[1] 董建辉[2] 魏斌[3] YE Sheng-jia;BAO Shi-jie;CHEN Qu-yi;XIN Xian-zhen;DONG Jian-hui;WEI Bin(Department of Prosthodontics,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China;Department of General Dentistry,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China;Special Dental Consultation Clinic,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,College of Stomatology,Shanghai Jiao Tong University,National Center for Stomatology,National Clinical Research Center for Oral Diseases,Shanghai Key Laboratory of Stomatology,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修复科,上海200011 [2]上海交通大学医学院附属第九人民医院口腔综合科,上海200011 [3]上海交通大学医学院附属第九人民医院口腔第一门诊,上海交通大学口腔医学院,国家口腔医学中心,国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室,上海200011

出　　处：《上海口腔医学》2021年第5期467-471,共5页Shanghai Journal of Stomatology

基　　金：国家自然科学基金(81801006)。

摘　　要：目的:利用数字化印模技术建立种植导板精度的非放射学评价方法 ,评估体外全程导航手术的种植精度。方法 :利用3Shape Implant Studio软件,在15个相同的缺牙树脂模型中设计2颗平行种植体位点,生成并打印相应的数字化种植导板并在导板全程导航下植入2颗种植体。术后分别以传统放射学方法及数字化印模杆、口内扫描仪、通用逆向工程软件构成的数字化评价方法检测每组种植体偏移情况,采用SPSS 23.0软件包进行数据分析。结果:以数字化评价方法得到的全程种植导板平均精度为肩部偏差0.447 mm,根尖部偏差0.557 mm,角度平均偏差1.134°。与传统放射学评价方法相比,2种评价方法在距离偏差方面无统计学差异(P>0.05);在角度偏差分析中,数字化评价方法更优(P<0.05)。种植体偏差多集中在冠根方向,且根尖偏移较颈部偏移更明显。结论:与放射学评价手段相比,数字化非放射学评价方法可准确评价种植精度,有效减少患者辐射暴露。PURPOSE: To evaluate the accuracy of static computer-navigated implantation with surgical guides, based on a non-radiological method. Traditional measurements with a second cone-beam CT(CBCT) were applied to verify the ac-curacy. METHODS: A total of thirty template-guided implantations were designed and performed on 15 resin models.Two paralleled bone-level implants were planned in the edentulous space of each model, between which the distance was4 mm. Postoperative implant positions were detected with both CAD/CAM-based measurements applying an intraoral scan-ner(3 Shape TRIOS) and traditional ways via CBCT. Both methods were conducted with a CAD quality-control, reverse engineering software, Geomagic Studio 2013, comparing the positions with the virtual ones. Statistical analysis was processed with SPSS 23.0 software package. RESULTS: Measurements using CBCT(control group) showed a trend toward greater deviations when the results were directly compared(P<0.05). In the CAD/CAM-based evaluation of the 30 samples, the mean deviation of the insertion axis from the planned implant axis was 1.134°. The mean deviations of the implant shoulders in the horizontal direction and at the implant apices were 0.447 mm and 0.557 mm, respectively. No significant dif-ference was observed when measuring distance deviation with the two assessment ways. CONCLUSIONS: Compared with evaluation based on radiology, CAD/CAM based evaluation system is able to evaluate implant accuracy precisely, effective-ly reduce radiological exposure of patients, being suitable for clinical evaluation.

关 键 词：导航手术 种植精度 口内扫描 种植导板 

分 类 号：R783.4[医药卫生—口腔医学]