一种新型助攻型微种植体支抗3D导板的研制和应用  

Development and application of a new type of assisted micro implant anchorage 3D guide plate

作　　者：高宇峰 马宇 陈志飞 许艳华 朱房勇 吴祥冰[4] 侯德强[1] Gao Yufeng;Ma Yu;Chen Zhifei;Xu Yanhua;Zhu Fangyong;Wu Xiangbing;Hou Deqiang(Department of Stomatology,Affiliated Hospital of Jiangnan University,Wuxi 214021,China;Department of Stomatology,Suzhou Mingji Hospital,Suzhou 215000,China;Department of Orthodontics,Yunnan Stomatological Hospital,Kunming 650101,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]苏州明基医院口腔科,苏州215000 [3]云南省口腔医院正畸科,昆明月650101 [4]无锡市人民医院口腔科,无锡214021

出　　处：《中国医师杂志》2023年第9期1325-1328,共4页Journal of Chinese Physician

基　　金：国家自然科学基金面上项目(81960195);无锡市双百医疗卫生拔尖人才(HB2020045);无锡市卫生健康委科研项目(M202240);江南大学附属医院临床研究与转化医学研究项目(LCYJ202223)。

摘　　要：目的建立微种植体支抗精准植入的计算机辅助设计和3D打印系统,准确标定微种植体植入的位置和方向。方法回顾性选取2019年11月至2021年11月在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(17.1±6.3)岁。术前患者拍摄锥形束CT(CBCT),输出采集的DICOM数据格式。对患者术前分析模型进行3D扫描,获取模型扫描的STL文件。通过3Shape Implant Studio软件将CBCT数据和模型数据拟合匹配处理,对导板的厚度、倒凹补偿的量、关键部件套环尺寸等进行设计。使用3D打印机调整尺寸后进行打印。采用助攻法植入微种植体,术后拍摄CBCT,将术前设计与术后结果进行对比。结果将术后CBCT与设计微种植体的CBCT拟合发现,微种植体与术前设计一致,与邻牙牙根保持安全距离且平行,不损伤上颌窦等部位,术后1、3个月未见微种植体支抗脱落。应用助攻型微种植体支抗3D导板可靠,植入的位置和方向准确,可植入口腔内绝大多数部位。结论采用计算机辅助设计和3D打印系统制作助攻型微种植体支抗3D导板,可以精准定位微种植体的位置和方向,值得临床推广应用。Objective To establish a computer-aided design and 3D printing system for precise implantation of micro implant anchorage,and accurately calibrate the position and direction of micro implant implantation.Methods A retrospective selection was conducted on 15 patients(30 in total)who underwent micro implant implantation surgery from the Department of Stomatology,the Affiliated Hospital of Jiangnan University from November 2019 to November 2021,including 6 males and 9 females,aged(17.1±6.3)years old.The preoperative patient was photographed with cone beam computed tomography(CBCT)and the collected DICOM data format was output.A 3D scan was performed on the patient′s preoperative analysis model to obtain the STL file of the model scan.The CBCT data and model data were fitted and matched using 3Shape Implant Studio software,and the thickness of the guide plate,the amount of undercut compensation,and the size of the key component collar were designed.The 3D printer was used for printing after resizing.Using the assist method to implant micro implants,CBCT was taken postoperatively to compare the preoperative design with the postoperative results.Results After fitting the postoperative CBCT with the designed CBCT of the micro implant,it was found that the micro implant was consistent with the preoperative design,maintained a safe distance and parallel to the adjacent tooth root,and did not damage the maxillary sinus and other areas.No detachment of the micro implant anchorage was observed 1 or 3 months after surgery.The application of assisted micro implant anchorage 3D guide plate was reliable,with accurate implantation position and direction,and can be implanted in most parts of the oral cavity.Conclusions The use of computer-aided design and 3D printing system to create an assistive micro implant anchorage 3D guide plate can accurately locate the position and direction of the micro implant,which is worthy of clinical promotion and application.

关 键 词：牙种植 微种植支抗 3D导板 精准种植 

分 类 号：R783.6[医药卫生—口腔医学]