动态导航与静态导板对种植手术精确度影响的Meta分析  

Meta-analysis of the effect of dynamic navigation versus static guides on the accuracy of implant surgery

作　　者：刘晨曦[1] 董静博 吕鹏军 袁会平 石培凯[1] LIU Chen-xi;DONG Jing-bo;LUY Peng-jun;YUAN Hui-ping;SHI Pei-kai(Hebei Medical University Dental Hospital,Shijiazhuang 050017,China;Beijing Fangshan District Liangxiang Hospital,Beijing 102400,China;North China Medical and Health Group Fengfeng General Hospital Handan Campus,Handan 056000,China)

机构地区：[1]河北医科大学口腔医院口腔种植科,石家庄050017 [2]北京市房山区良乡医院口腔颌面外科,北京102400 [3]华北医疗健康集团峰峰总医院邯郸院区外科,邯郸056000

出　　处：《口腔颌面修复学杂志》2022年第3期183-189,共7页Chinese Journal of Prosthodontics

基　　金：河北省财政厅老年病防治项目[项目编号:361029(MXZB00340)]。

摘　　要：目的:系统评价应用计算机导航(动态引导)外科(dCAIS)与计算机引导(静态引导)外科(sCAIS对临床种植牙手术在精确度方面的影响。方法:检索Pubmed、Embase、Cochrane library、知网、维普、万方、CBM数据库及中国、美国临床试验注册中心2021-10-1日前发表的比较动态导航与静态导板的随机对照临床试验(Randomized Controlled Trial,RCT)和临床对照试验(Controlled Clinical Trial,CCT)。纳入研究的结局指标包括:测量种植体术前设计与实际位点在顶部、根尖部、深度和角度的偏差。Meta分析的计算使用Review Manager 5.4版软件进行。结果:筛选检索到的803篇文献,最终纳入7篇研究进行定量分析。Meta分析结果显示,两组在顶部(WMD=-0.01,95%CI=-0.08~0.06,P=0.79),根尖部(WMD=-0.09,95%CI=-0.21~0.03,P=0.14)及角度(WMD=-0.48,95%CI=-0.95~-0.01,P=0.05)的测量偏差无统计学差异,而动态导航组深度的测量偏差(WMD=-0.2,95%CI=-0.34~-0.06,P=0.004)小于静态导板组,差异有统计学意义。结论:在种植体顶部、根尖部和角度的植入精确度上,应用动态导航与静态导板无显著差异,但动态导航展示出了更高的植入深度精确度。Objective:To systematically evaluate the effect of dynamic computer-aided implant surgery(d CAIS)versus static computer-aided implant surgerys(sCAIS)on the accuracy of clinical dental implant surgery.Methods:Pubmed,Embase,Cochrane library,CNKI,VIP,Wanfang,CBM database and Chinese and US clinical trial registries were searched for randomized controlled trial(RCT)or controlled clinical trial(CCT)comparing dynamic navigation with static guides published before 2021-10-1.Outcome indicators in the study include deviations between the preoperative design of the implant and the actual site in terms of platform,apex,depth and angular measurements.Meta-analysis was performed using Review Manager version 5.4 software.Results:A total of 803 papers were retrieved and 7 studies were included for quantitative analysis,including 4 RCT and 3 CCT.There was no statistically significant difference in the measurement deviation of the platform(WMD=-0.01,95%CI=-0.08~0.06,P=0.79),apical(WMD=-0.09,95%CI=-0.21~0.03,P=0.14)and angular(WMD=-0.48,95%CI=-0.95~-0.01,P=0.05)areas,while the measurement deviation of the depth in the dynamic navigation group(WMD=-0.2,95%CI=-0.34~-0.06,P=0.004)was smaller than that in the static guide group,and the difference was statistically significant.Conclusion:There was no significant difference in the accuracy between the dynamic navigation and the static guide in the platform,apical and angular areas of the implant,and the dynamic navigation was more accurate in the depth of insertion.

关 键 词：动态导航 静态导板 种植 META分析 顶部的测量偏差 根尖部的测量偏差 角度的测量偏差 深度的测量偏差 

分 类 号：R783.4[医药卫生—口腔医学]