动态导航下不同深度环钻定位精确度的体外评价  

In vitro evaluation of positioning accuracy of trephine bur at different depths by dynamic navigation

作　　者：刘思民 赵一姣[2] 王晓燕[1] 王祖华[1] LIU Si-min;ZHAO Yi-jiao;WANG Xiao-yan;WANG Zu-hua(Department of Conservative Dentistry and Endodontics,Peking University School and Hospital of Stomatology&National Center 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&NHC Research Center of Engineering and Technology for Computerized Dentistry,Beijing 100081,China;Center for Digital Dentistry,Peking University School and Hospital of Stomatology&National Center 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&NHC Research Center of Engineering and Technology for Computerized Dentistry,Beijing 100081,China)

机构地区：[1]北京大学口腔医学院·口腔医院牙体牙髓科,国家口腔医学中心,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,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,北京100081 [2]北京大学口腔医学院·口腔医院口腔医学数字化研究中心,国家口腔医学中心,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,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,北京100081

出　　处：《北京大学学报（医学版）》2022年第1期146-152,共7页Journal of Peking University:Health Sciences

摘　　要：目的:通过3D打印的体外模型评价使用动态导航系统引导下环钻在不同深度定位的精确度。方法:设计并使用3D打印技术以Veroclear树脂制作标准化模型,分别在距离模型外表面5、10、15 mm深度预留半球型空腔。拍摄锥形束CT(cone beam CT,CBCT)并将数据导入动态导航软件中(迪凯尔公司,中国),建立导航路径规划。在导航引导下使用直径4.5 mm的环钻完成入路操作,每个深度完成10例入路。拍摄术后模型的CBCT,重建导航下的入路轨迹,并与设计路径进行对比,计算实际动态导航路径与设计路径之间的二维距离偏差、深度偏差、三维距离偏差及角度偏差。结果:5 mm深度下动态导航终点位置与目标位置的二维距离偏差为(0.37±0.06)mm、深度偏差为(0.06±0.05)mm、三维距离偏差为(0.38±0.07)mm、角度偏差为2.46°±0.54°;10 mm深度下动态导航终点位置与目标位置的4项偏差分别为(0.44±0.05)mm、(0.16±0.06)mm、(0.47±0.05)mm、2.45°±1.21°;15 mm深度下动态导航终点位置与目标位置的4项偏差分别为(0.52±0.14)mm、(0.16±0.07)mm、(0.55±0.15)mm、3.25°±1.22°。随着进入深度的增加,动态导航系统的三维及深度精确度均下降(P<0.01),定位角度偏差与进入深度无关(P>0.01)。结论:动态导航技术在15 mm的深度范围内仍可以达到较高的定位精确度,但其偏差值随着进入深度的增加而增大。Objective:To evaluate the accuracy of trephine bur drilling at different depths guided by dynamic navigation system in 3D printing in vitro model.Methods:A model at the depth of 5 mm,10 mm,and 15 mm from the outer surface of which hemispherical cavities was reserved and the 3D printing technology was used to make the standardized model with Veroclear resin.The cone beam CT(CBCT)was taken and the data were imported into the dynamic navigation software(DCARER,China)to establish navigation path programming.Under the guidance of dynamic navigation,a trephine bur with a diameter of 4.5 mm was used to complete the access operation.At each depth,10 approaches were completed.The postoperative model CBCT was taken.The approach trajectory under navigation was reconstructed and compared with the designed path.The two-dimensional distance deviation,depth deviation,three-dimensional distance deviation,and angle deviation between the actually prepared path and the designed path were calculated.Results:At the depth of 5 mm,the two-dimensional distance deviation between the end position of the prepared path and the designed path was(0.37±0.06)mm,the depth deviation was(0.06±0.05)mm,the three-dimensional distance deviation was(0.38±0.07)mm,and the angle deviation was 2.46°±0.54°;At the depth of 10 mm,the four deviations between the end position of prepared path and the designed path were(0.44±0.05)mm,(0.16±0.06)mm,(0.47±0.05)mm,and 2.45°±1.21°,respectively;At the depth of 15 mm,the four deviations were(0.52±0.14)mm,(0.16±0.07)mm,(0.55±0.15)mm,and 3.25°±1.22°,respectively.With the increase of entry depth,the three-dimensional and depth accuracy of dynamic navigation system decreased(P<0.01),and the positioning angle deviation had no relation with the entry depth(P>0.01).Conclusion:Dynamic navigation technology can achieve high positioning accuracy in the depth range of 15 mm,but its deviation increases with the increase of entry depth.

关 键 词：动态导航 打印 三维 牙模型 定位标记 

分 类 号：R783.3[医药卫生—口腔医学]