计算机辅助种植技术在颧种植中的应用研究进展  

Progress of research on clincal application of computer-assisted implant placement techniques for zygomatic implant placement

作　　者：郑悦 张森林 ZHENG Yue;ZHANG Senlin(Department of Stomatology,Affiliated Jiangning Hospital of Nanjing Medical University,Nanjing 211100,China)

机构地区：[1]南京医科大学附属江宁医院口腔科,江苏南京211100

出　　处：《口腔医学》2024年第12期957-960,共4页Stomatology

摘　　要：目前有两种计算机辅助种植技术:静态导板和动态导航。使用静态导板可大大提高颧种植的精准度、减少术中和术后并发症。特制的颧钻头导板可全程引导颧种植的备洞,增加种植精准度。黏膜和骨联合支持式导板有助于将颧种植体精准植入至预定位置。但存在着一些不足之处:静态导板难以在上颌骨缺损的病例获得稳定的固位;静态导板引导下颧种植的入路困难,尤其是在使用长钻头和张口受限时。动态导航引导下颧种植在术中可实时可视化追踪种植钻针和种植体植入的方向,精准度高、创伤小,可避免静态导板引导下种植存在的不足,适用于张口受限或有上颌骨缺损患者,适用于在1侧植入1颗以上颧种植体。动态导航引导下无翻瓣颧种植可进一步提高精准度和安全性。计算机辅助种植技术可显著提高颧种植精准度、降低并发症,适用于严重萎缩上颌骨或上颌骨缺损的修复重建。There are two different types of computer-assisted implant placement techniques:static guide systems and dynamic navigation systems.There is greater accuracy and drastically reduced risk of perioperative/postoperative complications using the static guide compared to the freehand placement of implants.A zygoma drill guide can increase the precision of zygomatic implant placement.A combined bone-and mucosa-supported static guide can facilitate optimal zygomatic implant position.Using static guide systems for zygomatic implant placement faces several shortcomings.First,the use of static guides depends largely on the accurate positioning of surgical guides on the underlying tissue,and static guides do not have adequate underlying tissue to stabilize the surgical guides in a severely compromised defected maxilla.A second major concern with static guides is inadequate access for the drills,especially when using long twist drills with limitation in mouth opening.The dynamic navigation systems with actively tracked surgical drills have been proposed to provide real-time control of the drill position and achieve a precise zygomatic implant placement with minimal invasiveness,and challenges with static guides can be overcome.It is especially useful in patients with mouth opening limitation or extensive maxillary defect.The dynamic navigation technology has been recommended for placing more than one zygomatic implant on one side.Flapless placement of zygomatic implants guided by dynamic navigation has satisfactory safety and accuracy.Computer-assisted implant placement techniques can improve the accuracy and avoid complications of zygomatic implant placement for the reconstruction of severe maxillary atrophy and maxillary defects.

关 键 词：计算机辅助种植技术 静态导板 动态导航 颧种植体 精准度 安全性 

分 类 号：R782.13[医药卫生—口腔医学]