非引导种植术种植体三维位置精确度分析

目的：分析简单种植病例非引导植入种植体的位置偏差。方法：筛选3名医师治疗的68例简单种植牙患者,共97颗种植体,术后利用CBCT软件测量种植体颈部、尖部、角度偏差。比较3名不同医师、左右后牙与前牙区、游离端与非游离端种植体在颈部、尖部、角度偏差方面的差异。采用SPSS 22.0软件包进行统计学分析。结果：97颗种植体颈部、尖部、角度偏差平均值为（0.76±0.57）mm、（1.41±0.90）mm、（4.76±3.68）°。医师间比较颈部、尖部、角度偏差,差异有统计学意义（P<0.05）。左右后牙组间比较,3项偏差差异无统计学意义（P>0.05）,左侧后牙与前牙相比,3项偏差差异有统计学意义（P<0.05）;右侧后牙与前牙组相比,3项偏差差异无统计学意义（P>0.05）。游离端与非游离端比较,颈部偏差差异有统计学意义(P<0.05),尖部、角度偏差差异无统计学意义(P>0.05)。结论：简单病例非引导种植的总偏差与计算机导板相仿,偏差与医师经验相关,前牙组偏差小于双侧后牙组,非游离端颈部偏差小于游离端。

Analysis of implant placement accuracy using freehand in 68 consecutive patients with 97 implants

PURPOSE: To analyze the accuracy of implant position in simple cases by freehand. METHODS: Ninety-seven implants of 68 patients from 3 surgeons were selected.After operation,the deviations of implant position at shoulder apex and angle were measured using cone-beam CT(CBCT).The mean of three parameters were calculated with SPSS 22.0 software package, and the differences were analyzed between three surgeons,three operation areas,free-end missing and non free-end missing. RESULTS: The deviations of 97 implants were (0.76±0.57)mm,(1.41±0.90)mm,(4.76±3.68)° at shoulder, apex and angle.The deviation of shoulder apex and angle between three surgeons was significantly different(P<0.05). The deviations between left and right group were not significantly different (P>0.05); the deviations between anterior group and left group were significantly different(P<0.05); the deviations between anterior group and right group were not significantly different(P>0.05). The deviation of shoulder between free-end missing area and non free-end missing area was significantly different(P<0.05),other parameters between the two groups were not significantly different(P>0.05).CONCLUSIONS: The deviation of implant placement between surgical guide and mental guide were similar in simple cases. The experience of surgeon was important during freehand implant placement. The deviations were lower when missing tooth is in anterior area than in posterior area, whereas the same at shoulder in non free-end missing area than in free-end missing area.