Comparison between computer-guided and freehand dental implant placement surgery: A systematic review and meta-analysis

The purpose of this systematic review was to compare computer-guided (fully guided) and freehand implant placement surgery in terms of marginal bone loss, complications, and implant survival. This review followed the PRISMA guidelines and was registered in the PROSPERO database (CRD42019135893). Two independent investigators performed the search of the PubMed/MEDLINE, Scopus, and Cochrane Library databases for studies published up to April 2020 and identified 1508 references. After a detailed review, only four studies were considered eligible. These studies involved a total of 154 patients with 597 dental implants and a mean follow-up period of 2.25 years. There was no difference between computer-guided surgery and freehand surgery in terms of the marginal bone loss (mean difference ?0.11 mm, 95% confidence interval (CI) ?0.27 to 0.04 mm; P = 0.16), mechanical complications (risk ratio (RR) 0.85, 95% CI 0.36–2.04; P = 0.72), biological complications (RR 1.56, 95% CI 0.42–5.74; P = 0.51), and implant survival rate (RR 0.53, 95% CI 0.11–2.43; P = 0.41). This meta-analysis demonstrated that both computer-guided and freehand surgeries yielded similar results for marginal bone loss, mechanical and biological complications, and implant survival rate.     

Verification of the usability of a navigation method in dental implant surgery: In vitro comparison with the stereolithographic surgical guide template method

ObjectiveThis study investigates the usefulness of a navigation method using a reference frame directly fixed to the mandible compared to the stereolithographic (STL) surgical guide template method in dental implant surgery.Materials and methodsTwenty rapid prototyping (RP) mandibular models were divided into two groups. Simulation surgery was performed using SimPlant software for both groups. The actual dental implants were placed in the RP models using a real-time navigation system or the surgical guide template, which was fabricated based on STL data by a 3-dimensional printer. Positional implantation errors were measured by comparing the simulation surgery implant positions to the actual postoperative implant positions.ResultsThe vertical distance error of the top surface area in the first molar region was not significantly different between groups. Otherwise, the implantation method using real-time navigation showed greater errors except for the horizontal and vertical errors in the apical area of the canine region.ConclusionThe STL surgical guide template was associated with fewer errors than the real-time navigation method in dental implant surgery.     

利用数字化导板取出骨内折断种植体的临床效果研究

目的 研究利用数字化导板取出骨内折断种植体的临床效果.方法 选取2010年1月至2020年1月于中国医科大学附属口腔医院种植中心完成骨内折断种植体取出术患者11例行回顾性分析,其中利用数字化导板取出的患者5例(导板组),利用常规环钻取出的患者6例(常规组).比较两组的手术时间、种植体完整性、并发症发生情况及患者疼痛程度...     

正颌外科术后患者的满意度调查

本文通过问卷回顾性地调查了126位正颌外科术后1年以上患者的满意度。93．6%的患者对手术后容貌的改变满意;849%的患者愿意向有类似畸形的亲朋好友推荐正颌外科手术;74.8％的患者愿意再选择手术;64.3％以上的患者术后感觉自信心提高,与他人交往更自如,幸福感增强。     

基于3D打印技术新型金属镂空式种植外科导板的临床应用

目的：探讨基于3D打印技术制作的新型金属镂空式种植外科导板在种植手术中的效果及其精确性。方法牙缺失患者23例,利用新型金属镂空式种植外科导板辅助植入52枚种植体,观测其种植体颈部偏移距离（植入位点）和种植体1年存活率。结果48枚种植体进入预定位置,仅4枚种植体颈部出现偏移,偏移范围在2 mm内,颈部偏移的平均距离为（1.08±0.24） mm。所有种植体均顺利修复。种植体1年存活率为100％。结论新型金属镂空式种植外科导板辅助植入技术具有操作简便、术中冷却效果良好和手术视野开阔等优点,且精确度较高。     

种植牙手术的导向模板定向法临床研究

本文介绍了用于人工牙根种植手术的一种导向模板定向法。该导向模板由圆柱形金属定向杆、导向钛管、负压成型的塑料牙列套及自凝塑料增强基托组成。临床应用35例.效果满意。     

疼痛管理对口腔种植围术期患者的影响

目的:探讨口腔种植患者围术期疼痛管理方法,提高对口腔门诊种植手术患者的护理水平.方法:纳入100例口腔门诊种植手术患者,以随机抽签方式分为管理组和对照组,管理组采用疼痛管理干预手段进行护理,对照组仅采用传统常规护理,对2组患者的术后疼痛及满意度进行比较.采用SPSS 16.0软件包对评价结果进行x2检验.结果:在2组紧张程度相同的情况下,管理组患者的疼痛率降低,满意率高,与对照组之间差异显著(P＜0.05).结论:通过对口腔种植患者进行围术期疼痛管理,可有效减轻不适感,提高患者的满意度,有利于及早康复.     

老年患者种植修复成功率与满意度的随访研究

目的评估老年人种植修复的成功率和满意度,探讨可能影响种植体成功率的危险因素。 方法本研究以2015—2018年在南京医科大学附属口腔医院特诊科就诊并进行种植牙修复治疗的老年患者（≥60岁）为研究对象。种植体植入时的平均年龄为（67.47 ± 6.57）岁,共101例病例、241颗种植体。在种植修复完成后的3年内对其进行随访,记录种植体的成功率和牙周情况,并分析影响种植体成功率的危险因素。同时采用问卷调查的方法,调查患者对种植牙的满意度。采用线性回归模型及t检验来对数据进行统计分析。 结果种植体总成功率为96%,失败率为4%（10颗种植体）,3年随访期间,出血指数、菌斑指数、牙龈指数均有改善。种植体的成功率与多种因素有关,尤其是患者的牙周状态、吸烟程度以及咬合力大小等。231颗种植体在3个月、6个月、1年、2年、3年的平均边缘骨吸收量为（0.45 ± 0.61）、（0.51 ± 0.55）、（0.54 ± 0.48）、（0.60 ± 0.06）和（0.67 ± 0.25）mm,种植体周围平均探诊深度为（2.60 ± 1.42）mm,平均边缘骨吸收（0.55 ± 0.16）mm。线性回归分析结果显示,r = -0.81、SE = 0.75、R² = 0.50、P = 0.78,种植体周围牙周袋深度越大,种植体边缘骨丢失越多。患者对种植修复的总体满意度为（9.20 ± 0.94）分。 结论在满足种植适应证的前提下,术后避免咬合力过大、尽量减少吸烟及注意牙周的维护对老年缺牙患者进行种植修复的成功率很高,且患者满意度较高,可以获得良好的修复效果。     

CAD/CAM fabrication and clinical application of surgical template and bone model in oral implant surgery

Objectives: A novel implant surgery support system with computer simulation for implant insertion and fabrication of a surgical template that helps in drilling bone was developed. A virtual reality haptic device that gives the sense of touch was used for simulation and a surgical template was fabricated by CAD/CAM method. Surgical guides were applied for two clinical cases.
Material and methods: Three-dimensional (3D) jaw bone images transferred from DICOM data filmed by CT scanner were fed to the software and manipulated using the haptic device. The site for implant insertion was determined after evaluating the quality of bone and position of the mandibular canal. The surgical template was designed with ease using the free design CAD function of haptic device. The surgical template and bone model were fabricated by a fused deposit modeling machine. Two clinical cases were applied using the present system.
Results: Simulation to determine the site of implant insertion and fabrication of the surgical bone templates were successfully done in two clinical cases, one for three implant insertion in lower right jaw and the other is for seven implant insertion in lower edentulous jaw, respectively. During surgery, the templates could be firmly adapted on the bone and drilling was successfully performed in both cases.
Conclusion: The present simulation and drilling support using the surgical template may help to perform safe and accurate implant surgery.     

三维CT指导下口腔种植模板的制作与应用

目的：介绍一种实用简单的口腔种植模板制作方法,用于指导牙种植手术,以获得准确的定位和修复效果。方法：首先制取缺牙区牙列模型,排牙,制作透明树脂模板,在石膏模型上选取植入点,然后按照预计种植方向放置导向用套管,光固化树脂固定,患者戴入口内后拍摄CT,根据三维CT信息计算是否需要修改以及修改的量,然后对导向套管进行修改使之成为最终种植模板,以此模板进行种植手术。结果：以三维CT信息引导下的种植模板为种植体的植入和修复提供了客观依据,取得了较好的种植效果。结论：含有三维CT信息的口腔种植模板制作简单,定位精确,值得临床推广使用。     

CAD/CAM全程手术导板结合改良根盾技术在前牙区即刻种植中的应用

目的 探讨CAD/CAM全程手术导板结合改良根盾技术在美学区即刻种植的临床效果,以期为CAD/CAM全程手术导板和改良根盾技术在临床应用提供借鉴.方法 对1例左侧上前牙外伤的病例进行即刻种植,应用改良根盾技术保存唇侧牙片,CAD/CAM全程手术导板引导种植体植入.结果 通过CAD/CAM全程手术导板引导即刻种植体植入和...     

计算机种植导板在重度吸收上颌窦患者进行种植提升手术的应用

目的:了解计算机种植导板在重度吸收上颌窦患者进行种植提升手术的应用情况。方法:2007年1月至2009年3月之间,通过常规上下颌骨CT扫描,经计算机辅助制作软件建模,12例上颌窦区域骨质重度吸收的患者,共19颗牙植体,利用快速成型技术加工出个体化种植模板,并按照轴向垂直载荷的力学原则进行了反咬合设计,应用于上颌窦的种植术中。结果:在计算机种植导板的辅助下,种植体植入术前设计位置实现了种植体的精确植入,能够在修复时与对颌牙形成良好的咬合关系,完全实现了手术前进行的反咬合设计方案。术中未出现并发症。结论:利用计算机种植导板技术,在进行上颌窦植牙时,尤其是在上颌窦颊侧壁重度吸收的情况下,对于非常规的反咬合设计,可以很好的完成上颌窦种植术的定位及导向功能。     

Patient satisfaction with two designs of implant supported removable overdentures; ball attachment and magnets

Objective: The aim of this study was to compare ball and magnet attachments within implant-supported mandibular overdentures (ISMOD) using patient centred outcome measures. Our a priori hypothesis was that there is no difference in patient satisfaction between the two attachment types.
Material and methods: In this within-subject crossover randomised clinical trial, edentulous patients were recruited to the study and completed a denture satisfaction questionnaire before having two implants placed in the intraforaminal region of the mandible. They were randomly assigned to receive an ISMOD retained by either ball or magnetic attachment. After 3 months satisfaction questionnaires were repeated before attachments were changed to the alternative design. After a further 3 months patients completed final questionnaires. Patients were asked to choose their preferred prostheses and record the most influential factors in their final choice. The outcome variables of patient satisfaction were compared between baseline and the two attachment types using non-parametric two-related sample tests (Wilcoxon's signed rank).
Results and discussion: Sixteen patients completed the study. Patient satisfaction improved significantly between baseline and the new prosthesis with each attachment type for all domains of satisfaction ( P <0.05). Ball attachments provided greater satisfaction in the domains of general satisfaction, stability and ability to chew ( P <0.05). Patients' general satisfaction with ball attachment retained overdentures was greater than that for magnetic attachments; however, both designs provide significantly greater satisfaction than conventional dentures. In this study, the majority preferred to retain the ball attachment although one-third of patients actively chose the magnetic attachment.     

术前牙科焦虑症对口腔种植手术相关疼痛及满意度的影响

目的:调查口腔种植患者人群牙科焦虑的发生情况,分析患者术前的牙科焦虑对口腔种植术中疼痛及手术满意度的影响.方法:通过问卷调查的方式对某段时期在上海地区某三甲医院接受口腔种植手术的全部患者进行知情同意后开展调查,收集调查对象的人口学信息、术前牙科焦虑评分、术中疼痛评分以及对手术的满意度评分等资料进行统计描述与数据分析.结...     

微创拔牙即刻种植的牙龈美学效果观察

目的探讨微创拔牙即刻种植技术的临床特点及修复后的牙龈美学效果。方法21例上前牙单个缺失病例，行不翻瓣微创拔牙同期23颗种植体即刻植入，并且同期安装愈合基台直接暴露于口腔，即非埋入式种植术式，种植体愈合6个月后进行永久修复。种植永久修复后观察时间平均27．6个月（13～51个月）。根据Jemt牙龈乳头指数（papilla index score，PIS）观察种植体永久修复12个月后的近远中牙龈乳头状况，根据Flirhauser的改良红色美学指数观察种植体永久修复1年后与相邻天然牙唇侧龈缘位置的协调性；唇侧软组织与相邻天然牙唇侧牙龈色泽协调性。结果23颗种植体均获得良好的骨结合；种植修复体近远中PIS均为Ⅱ级以上。种植修复体与相邻天然牙唇侧牙龈缘水平位置协调性一致的15颗，8颗不协调；唇侧软组织色泽与相邻天然牙协调一致的18个牙位，5个牙位有轻度差异。结论微创拔牙即刻种植术是一项要求较高的技术，多因素影响软组织美学效果，严格掌控适应证，才能获得理想修复效果。     

种植外科导板临床应用及改良的研究进展

计算机技术广泛应用于口腔种植领域,数字化技术辅助下的种植修复治疗不仅能提高种植体植入的准确度,而且能实现微创、修复导向的治疗目标,保证最终修复体的美学、功能效果。本文将对数字化导板在前牙区、后牙区和无牙颌种植修复中的临床应用情况,以及种植导板改良的研究进展进行分析总结。     

Factors affecting utilization of dental health services and satisfaction among adolescent females in Riyadh City

Objectives

This study was conducted to determine factors affecting utilization of dental health services among intermediate female school students in Riyadh. In addition to assessing their satisfaction with the dental care received during the last dental visit.

Subjects and methods

Self-administered questionnaires were distributed among students attending eight public and four private schools. These schools were selected randomly to represent the four different administrative zones in Riyadh.

Results

Of 600 questionnaires distributed, 531 were complete and suitable for analysis. Nearly three quarters of the students visited the dentist more than once during the last 2 years. A bout 75% had their treatment in private dental clinics and 63% made their visits for routine treatment. The quality of dental care was found to be the most encouraging factor for utilization of dental services, whereas, far geographic location of the dental clinics was the most discouraging factor. For those who received treatment in the government clinics, the most discouraging factor was post operative complications (P < 0.0001), while the most encouraging factor was the availability of friendly staff (P < 0.0001). The high cost of dental care was the most discouraging factor for utilizing the dental services for those who visited private clinics (P < 0.0001), while the high quality of dental care was the most encouraging factor (P < 0.009). Students who made their visits because of pain highly considered modern clinics and those recommended by friends as highly encouraging factors (P < 0.002), while they considered the high cost of dental care as discouraging factor for using dental services (P < 0.038). Students who visited the dentist for routine treatment gave the quality of dental care as encouraging for the use of dental clinics (P < 0.0001). Satisfaction with dental care was found to be significantly associated with high quality of dental care, convenient appointment, friendly staff, modern dental clinics and clinics recommended by friends.

Conclusion

Quality of dental care, reasonable fees for dental services and close location of dental clinics to students’ homes are encouraging factors for utilization of dental services.