上颌后牙区数字化导板引导下倾斜种植精确性研究

目的 评估上颌后牙区使用数字化外科导板引导进行倾斜种植的精确性.方法 上颌后牙缺失伴垂直骨量不足病例14例,术前拍摄锥形束CT(cone beam computed tomography,CBCT)获得颌骨数据,扫描上颌石膏模型获得上颌数字化模型,将数据输入种植设计软件后完成导板的设计,再通过快速成型技术完成导板的制作.在导板的引导下完成手术,术后拍摄CBCT,将CBCT数据导入种植设计软件,与术前种植设计数据进行匹配整合后测量种植体设计位置与实际位置的差异.结果 纳入研究的14例患者在数字化外科手术导板引导下共植入26枚种植体.种植体计划植入位置尖端与种植体实际植入位置尖端的平均距离是(0.820±0.208)mm,两尖端水平向平均距离是(0.509±0.139)mm,垂直向平均距离是(0.638±0.178)mm.种植体计划植入位置的顶端与种植体实际植入位置顶端的平均距离是(0.625±0.183)mm,两顶端水平向平均距离是(0.314±0.070)mm,垂直向平均距离是(0.538±0.178)mm.结论 上颌后牙区倾斜种植技术能降低手术风险及创伤,使用数字化外科导板能降低手术难度、减少手术时间,但该技术仍存在一定误差.

Accuracy evaluation of digital surgical template in angled implantation in the maxillary posterior region

Objective To evaluate the accuracy of digital surgical guide in tilted implant in the maxillary posterior re-gion. Methods Jaw data from 14 patients were scanned using cone beam computed tomography (CBCT), and digital models were acquired by scanning maxillary plaster models. Implant software was employed to process jaw data and digi-tal models in order to design the surgical template. Then the stereolithographic (SLA) surgical template was created to guide the surgery. After that CBCT data was collected again and compared with the data collected before. Deviations be-tween the actual implant position and the planned implant position were analyzed. Results Central deviation at the hex and apex between the actual implant and the planned implant was almost constant with a mean of (0.625 ± 0.183) mm and (0.820 ± 0.208) mm. Mean value of horizontal deviation at the hex was (0.314 ± 0.070) mm, horizontal deviation at the apex was (0.509 ± 0.139) mm, vertical deviation at the hex was (0.538 ± 0.178) mm, vertical deviation at the apex was (0.638 ± 0.178) mm. Conclusion Angled implantation in the maxillary posterior region can reduce risks and trauma as well as the difficulties and duration of surgery. However, our data suggested that significant deviations existed in the actu-al implant position and the planned implant position.