数字化导板辅助种植6颗平行种植体精确度分析

doi:10.12337/zgkqzzxzz.2022.06.003

摘要/Abstract

摘要： 目的通过对比3种数字化测量方法,评估静态导板辅助种植的精确度并探讨同一导板辅助种植多颗种植体的影响误差及种植体之间的平行情况。方法随机抽取3名下颌无牙颌患者的CBCT数据,数据提取后通过Straumann P20+ 3D打印机仿形态各打印10个模型,共30个下颌无牙颌树脂模型。按照无牙颌固定修复在46位点、44位点、42位点、32位点、34位点、36位点常规植入6颗平行种植体,并设计手术导板。由1名种植医生从46位点开始依次顺序种植6颗种植体,共180颗种植体,术后分别用3种测量方法评估植入种植体的3D距离偏差及轴向角度偏差。结果术后种植体合计平均角度偏差为1.89°±0.87°,平均3D距离偏差颈部为（0.46±0.19）mm、根方为（0.58±0.21）mm;扫描杆&Qualify、扫描杆&coDiagnostiX和CBCT&coDiagnostiX 3种测量方法的测量数据轴向角度偏差分别为1.96°（1.26°）、1.82°（1.15°）和1.60°（1.12°）,颈部3D距离偏差分别为0.37 mm（0.23 mm）、0.41 mm（0.15 mm）和0.6 mm（0.28 mm）,根方3D距离偏差分别为0.47 mm（0.26 mm）、0.55 mm（0.22 mm）和0.69 mm（0.29 mm）;扫描杆&Qualify测量术后实际任意两种植体之间平均夹角为1.65°±0.87°,最小0.02°,最大5.54°。结论 CBCT测量在角度偏差上比扫描杆测量准确度高,在3D距离偏差上准确性要低;数字化导板辅助种植多颗种植体有较好的精确性和平行度,其手术过程中偏差没有累加或递减趋势,偏差与种植位点有关。

关键词: 口腔种植, 数字化种植导板, 测量方式, 精确度, 平行度

Abstract: Objective To compare the effects of three digital measurement methods on the accuracy evaluation of implants placed with the static surgical guide, and to explore the influence of surgical procedure on the accuracy and parallelism of multiple implants assisted by the same guide plate. Methods CBCT data of three patients with mandibular edentulous were randomly selected. After data extraction, 10 models of each were printed by Straumann P20+ 3D printer and a total of 30 resin models of mandibular edentulous were made. Surgical guide plates were designed according to the routine implantation of parallel implants at tooth positions 46, 44, 42, 32, 34, and 36 in edentulous fixed restoration. Six implants were planted from left to right by an implant doctor according to the surgical guidelines of digital guide assisted implantation technology, with a total of 180 implants. Three measurements were used to evaluate the 3D deviation and parallelism of the implants. Results The mean Angle deviation of all implants was 1.89°±0.87°, and the mean 3D distance deviation of implants was (0.46±0.19) mm at the implant's neck and (0.58±0.21) mm at the implants root apex. The actual postoperative average angle between any two implants was 1.65°±0.87°, with a minimum of 0.02° and a maximum of 5.54°. Scan-body&Qualify, Scan-body&coDiagnostiX, and CBCT&coDiagnostiX three measurement methods, the three sets of data axial angle deviations are 1.96°（1.26°）, 1.82°（1.15°）and 1.60°（1.12°）, the 3D distance deviations of the neck are 0.37 mm（0.23 mm）, 0.41 mm（0.15 mm）and 0.6 mm（0.28 mm）, respectively. The 3D distance deviations of the root apex are 0.47 mm（0.26 mm）, 0.55 mm（0.22 mm）, and (0.69±0.22) mm, respectively. Conclusions CBCT measurements are more accurate than the scan-body method in angular deviation and less accurate in 3D distance deviation. The accuracy and parallelism of multiple implants assisted by the same guide plate are good. The deviation does not accumulate or decrease during the operation and is related to the implant site.

Key words: Dental implant, Digital implant surgical guide, Measurement method, Accuracy, Parallelism

倪婷,张亮,韩泽奎,等. 数字化导板辅助种植6颗平行种植体精确度分析[J]. 中国口腔种植学杂志, 2022, 27(3): 140-146. DOI: 10.12337/zgkqzzxzz.2022.06.003

Ni Ting, Zhang Liang, Han Zekui, Wang Xinyu, Duan Feng. Digital measurement methods on accuracy evaluation of six implants placed paralleled with the static surgical guide[J].Chinese Journal of Oral Implantology, 2022, 27(3): 140-146.DOI: 10.12337/zgkqzzxzz.2022.06.003.

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