牙种植定位导向模板的计算机辅助设计和制作

背景:目前国内广泛使用的种植模板是在石膏模型上制作完成,由于无法明确植入区颌骨的三维结构,因此不能准确地指导种植体植入,容易导致植体植入并发症。目的:利用CT技术、计算机辅助设计/计算机辅助制作技术设计制作口腔种植模板,以准确定位种植体植入的位置和方向。方法:CT扫描带有定位标记的上颌游离缺失石膏模型。在软件MIMICS中进行三维重建和种植模拟。根据受植区颌骨的解剖结构兼顾修复学和美学的要求设计种植方案,并将虚拟种植体放置在理想的位置上。设计模板形态同时将虚拟种植体位置角度信息转移到模板上,导入快速成型设备制作树脂模板。在模型上完成种植然后评价模板的精度。结果与结论:种植体植入后顶端偏差为.(0.87±0.21)mm,底端偏差为(0.82±0.16)mm。种植体在垂直方向上的偏差较颊舌向和近远中向略大。采用此方法可以将种植前设计准确地转移到种植模板中,从而更有效地指导种植,有助于提高种植的安全性、准确性和成功率。

Computer aided design and computer aided manufacture of templates in dental implantation

BACKGROUND: Currently, the templates widely used in implant surgery in China were prepared on plaster model. As the three-dimensional structure of the jaw is unclear, accurate implanting is difficult and complications of implantation are prone to exist. OBJECTIVE: To prepare oral implant templates with CT and computer aided design (CAD)/computer aided manufacture (CAM) in order to locate implants in the right position and direction. METHODS: Plaster models of maxillary edentulous with location marker were scanned with CT. The MIMICS software was used to reconstruct three-dimensional model and simulate implantation. Simulated implant was located in the ideal position based on the anatomical structure of the implanted jaw and the implanted methods according to prosthetic and aesthetic requests. The information of position angle of the simulated implant was transferred to the template while it was prepared. The data were input rapid prototyping equipment to prepare resin template. The accuracy of the template was tested after implantation in it. RESULTS AND CONCLUSION: The top deviation of the implant was (0.87±0.21) mm and the bottom deviation was (0.82± 0.16) mm after implantation. The deviation of the implant in the vertical direction was slightly bigger than those in the buccolingual direction and mesiodistal direction. The implant design can be accurately transferred to the template before operation. Implantation can be well guided using this, and it can improve the safety, accuracy and the successful rate.