3种数字化技术在前牙美学区种植中的精度分析  

Accuracy analysis of 3 digital techniques in the implantation surgery in anterior dental aesthetic area

作　　者：张维丹 汪婷 刘玉洁 林海燕 吴慧 贾洪宇 ZHANG Weidan;WANG Ting;LIU Yujie;LIN Haiyan;WU Hui;JIA Hongyu(Hangzhou Stomatology Hospital,China,310000;Stomatology College of Zhejiang Chinese Medicine University,Hangzhou;Stomatological Hospital Affiliated to Hangzhou Medical College)

机构地区：[1]杭州口腔医院,310000 [2]浙江中医药大学口腔医学院 [3]杭州医学院附属口腔医院

出　　处：《实用口腔医学杂志》2024年第5期691-697,共7页Journal of Practical Stomatology

基　　金：浙江省医药卫生科技项目(编号:2020ZH006)。

摘　　要：目的:比较全程动态导航、全程静态导板与先锋钻导板在前牙美学区种植中的精度。方法:纳入前牙美学区单颗牙种植修复的患者45例,随机分为3组(n=15)。A组采用易植美全程动态导航下进行种植手术,对B组和C组患者3D打印制作牙支持式种植导板,B组应用ASTRA EV全程静态导板辅助外科植入植体,C组制作先锋钻导板,半程导板辅助植入,测量术前设计和术后结果之间的偏差。术前、术后拍摄CBCT,导航组将数据直接导入自带软件,导板组导入3shape软件进行三维重建,与术前设计进行配准拟合,测量分析各个位点的偏差。数据采用SPSS 25.0软件分析。数据为定量资料,S-W检验显著性;数据方差齐性,采用±s进行描述性分析,3组间结果两两比较采用单因素方差分析(ANOVA)。结果:数据均呈正态分布,A组种植体顶部中心点距离偏差为(0.571±0.196)mm、水平向偏差为(0.405±0.222)mm、种植体底部中心点距离偏差为(0.449±0.267)mm、垂直向偏差为(0.312±0.223)mm、两中心点连线角度偏差为2.257°±0.989°;B组5项数据分别为(0.520±0.242)mm、(0.219±0.201)mm、(0.643±0.284)mm、(0.464±0.292)mm、1.272°±0.951°;C组5项数据分别为(1.179±0.365)mm、(0.667±0.276)mm、(1.518±0.566)mm、(0.967±0.444)mm、2.568°±0.632°。A组和B组5项偏差均显著小于C组(P<0.05);B组在两中心连线角度的偏差显著小于A组(P<0.05),其他4项偏差A组和B组无显著性差异(P>0.05);结论:全程动态导航、全程静态导板的精度显著高于先锋钻导板,全程动态与全程静态导板导航的精度无显著差异。Objective:To compare the accuracy of dynamic navigation system,fully-guided and Pilot-drill guided implant surgery in anterior dental aesthetic area.Methods:45 patients underwent single tooth implantation in anterior dental aesthetic area were randomly divided into 3 groups(n=15).Dynamic navigation system imlanting(A),3D printing fully-guided template with ASTRA EV assisted orthopedic implantation(B)and Pilot-drill guided implantation(C)were respectively used for the patients in group A,B and C.The deviation between the preoperative design and actual results were measured by CBCT and/or 3D reconstruction with navigation design software or 3SHAPE software.SPSS 25.0 software package was used and±s was used for descriptive analysis,results were pairwise compared among the 3 groups using ANOVA.Results:Data were normally distributed and the variance of the data was homogeneous.In group A,the distance deviation of implant top center was(0.571±0.196)mm,the horizontal deviation was(0.405±0.222)mm,the distance deviation of implant apical center was(0.449±0.267)mm,the vertical deviation was(0.312±0.223)mm,the deviation of the connection angle between the two centers was 2.257°±0.989°.In group B,those were(0.520±0.242)mm,(0.219±0.201)mm,(0.643±0.284)mm,(0.464±0.292)mm and 1.272°±0.951°respectively.In group C those were(1.179±0.365)mm,(0.667±0.276)mm,(1.518±0.566)mm,(0.967±0.444)mm and 2.568°±0.632°.The deviation of all the measurments of group A and B was lower than those of group C(P<0.05).The deviation of the connection angle between the 2 centers of group B was less than that of group A(P<0.05),but no statistical significance(P>0.05)was found in other 4 measured items.Conslusion:The accuracy of the dynamic navigation system and the fully-guided implantation is significantly higher than that of the Pilot-drill guided implantation,but is not statistically significant between dynamic navigation and the fully-guided system.

关 键 词：全程动态导航 全程静态导板 先锋钻导板 美学区 精度 

分 类 号：R783.5[医药卫生—口腔医学] TP3[医药卫生—临床医学] P1.73[自动化与计算机技术—计算机科学与技术]