3D导板引导下微种植支抗精准植入的应用研究  

Research on the application of precise implantation of micro-implant anchorage guided by 3D guide plate

作　　者：朱房勇 薛黛[2] 许艳华 高宇峰 吴祥冰[4] Zhu Fangyong;Xue Dai;Xu Yanhua;Gao Yufeng;Wu Xiangbing(Department of Stomatology,Affiliated Hospital of Jiangnan University,Wuxi 214021,China;Department of Stomatology,Wuxi Children's Hospital,Wuxi 214021,China;Department of Orthodontics,Yunnan Stomatological Hospital,Kunming 650106,China;Department of Stomatology,Wuxi People's Hospital,Wuxi 214021,China)

机构地区：[1]江南大学附属医院口腔科,无锡214021 [2]无锡市儿童医院口腔科,无锡214021 [3]云南省口腔医院正畸科,昆明650106 [4]无锡市人民医院口腔科,无锡214021

出　　处：《国际医药卫生导报》2022年第22期3109-3112,共4页International Medicine and Health Guidance News

基　　金：国家自然基金面上项目(30700964);无锡市双百医疗卫生拔尖人才项目(HB20200045);江南大学附属医院临床研究与转化医学研究项目(LCYJ202223)。

摘　　要：目的进行微种植支抗精准植入的计算机导航设计和3D打印系统的建立,并对此技术的精准度进行研究。方法选取2020年11月至2021年11月江南大学附属医院口腔科就诊的15例(共30颗)需行微种植体植入术的患者,其中男6例,女9例,年龄(17.11±6.28)岁。术前需要在3 ShapeDentalSystem软件中将锥形束CT(CBCT)的医学数字成像和通信(DICOM)文件与模型所扫描的STL文件导入其中,需要处理完成相关数据拟合匹配操作,设计出3D导板。术中采用助攻法植入,术后CT评估微种植支抗的位置和植入角度。采用配对t检验。结果确定3D导板引导下微种植支抗精准植入方法的可行性,设计制作流程,完成微种植体手术导板的设计与制作。经过CBCT验证,在微种植体颈部、根部与原设计的平均偏差值分别为(0.40±0.13)mm、(0.60±0.21)mm,角度平均偏差值在近远中向、颊舌向分别为(3.21±1.15)°、(3.71±1.25)°,差异均无统计学意义(均P>0.05)。Ⅰ级、Ⅱ级各为26颗、4颗,无Ⅲ级。术后1、3个月微种植体均无松动记录。结论3D导板引导下,微种植体的植入更精确,该技术做到精确定位,从而保证了植入后的安全性、稳定性和成功率。Objective To design a computer navigation and establish a 3D printing system for precise implantation of micro-implant anchorage,and to study the accuracy of the technology.Methods A total of 15 patients(30 microimplants)who required microimplant implantation and were admitted to Department of Stomatology,Affiliated Hospital of Jiangnan University from November 2020 to November 2021 were selected,including 6 males and 9 females,aged(17.11±6.28)years.Before surgery,the medical digital imaging and communication(DICOM)file of cone beam CT(CBCT)and the STL file scanned by the model were imported into the 3 Shape Dental System software.Relevant data fitting and matching operations needed to be processed to design the 3D guide plate.Assist implantation method was used intraoperatively,and postoperative CT was used to evaluate the position and implantation angle of micro-implant anchorage.Compared with the original design,paired t test was used.Results The feasibility of precise implantation method of micro-implant anchorage guided by 3D guide plate was determined,and the production process was designed.CBCT data before and after microimplant implantation were compared;the meandeviations of neck and root from the original design were(0.13±0.40)mm and(0.21±0.60)mm,respectively,and the mean deviation of angle was(1.15±3.21)°in the mesial-distal direction and(1.25±3.71)°in the buccal-lingual direction respectively,showing no statistically significant differences(all P>0.05).There were 26 gradeⅠmicroimplants and 4 gradeⅡmicroimplants,without gradeⅢmicroimplant.No loosening of microimplants was recorded 1 and 3 months after surgery.Conclusions Microimplant implantation is more accurate under the guidance of 3D guide plate.This technology can achieve accurate positioning,thus ensuring the safety,stability,and success rate after implantation.

关 键 词：微种植支抗 3D导板 精准 助攻 

分 类 号：R783.6[医药卫生—口腔医学]