中国口腔种植学杂志 ›› 2023, Vol. 28 ›› Issue (4): 223-228.DOI: 10.12337/zgkqzzxzz.2023.08.003

• 无牙颌种植治疗重点栏目 • 上一篇    下一篇

无牙颌金属种植导板精度分析的病例系列

骆泯润1, 白雪莹1, 祝雨茜1, 吴涛1,2, 周毅1,2   

  1. 1湖北省口腔基础医学重点实验室 省部共建国家重点实验室培育基地 武汉大学口腔生物医学教育部重点实验室武汉大学口腔医(学)院 430079;
    2武汉大学口腔医院光谷分院种植和修复中心 430079
  • 收稿日期:2023-07-19 出版日期:2023-08-30 发布日期:2023-09-05
  • 通讯作者: 周毅,Email:dryizhou@whu.edu.cn,电话:0278-7686220
  • 作者简介:骆泯润,口腔医学5+3年制本硕连读生,研究方向:数字化口腔种植精度研究;周毅,副教授、主任医师、硕士研究生导师,研究方向:数字化口腔种植

A case series on accuracy analysis of metal implant guides in edentulism

Luo Minrun1, Bai Xueying1, Zhu Yuxi1, Wu Tao1,2, Zhou Yi1,2   

  1. 1The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China;
    2Department of Prosthodontics and Implant Dentistry, Guanggu Branch Hospital of Stomatology, Wuhan University, Wuhan 430079, China
  • Received:2023-07-19 Online:2023-08-30 Published:2023-09-05
  • Contact: Zhou Yi, Email: dryizhou@whu.edu.cn, Tel: 0086-278-7686220

摘要: 目的 通过系列病例分析金属导板引导的无牙颌种植中种植体的植入精度。方法 术前拍摄CBCT获取三维数据,在设计软件内拟合数据后进行种植导板设计,通过三维打印的方式制作钛金属导板,试戴后引导种植手术。对比5例全口或半口无牙颌种植的35颗种植体术前设计与术后实际位置的偏差,分析金属导板的精度。结果 排除5颗半程引导、1颗颧种植、4颗上颌窦底提升部位种植的种植体后,最终纳入25颗种植体。所有病例未发生导板折裂,种植体均愈合良好,未见骨灼伤等情况。精度分析结果显示:在近远中向上,种植体尖端水平位移0.91(0.28-1.35)mm,颈部水平位移0.46(0.23-0.83)mm,尖端垂直位移0.57(0.29-0.80)mm,角度偏差1.93°(1.02°-3.40°);在颊舌向上,种植体尖端水平位移0.84(0.43-1.51)mm,颈部水平位移0.77(0.32-1.05)mm,尖端垂直位移0.52(0.30-0.88)mm,角度偏差2.77°(2.09°-4.21°)。结论 在本研究有限的无牙颌种植手术病例系列中,金属导板得到了与树脂导板相似的精度和临床效果。

关键词: 无牙颌, 种植体, 外科导板, 数字化, 计算机辅助设计/计算机辅助制造

Abstract: Objective This study analyzed the accuracy of implant placement in edentulism implant surgeries guided by metal guides through a case series. Methods Five cases of full or partial edentulism implant surgeries with a total of 35 implants were included. Preoperative cone beam computed tomography (CBCT) was performed to obtain three-dimensional data, which was then used to design the implant guide within software. Titanium metal guides were 3D-printed and used for guided implant placement. The accuracy of the metal guides was analyzed by comparing the planned implant positions with the postoperative positions. Results After excluding 5 partially guided implants, 1 zygomatic implant, and 4 maxillary sinus elevation implants, a total of 25 implants were included in the analysis. No guide fractures or thermal osteonecrosis were observed, and all implants achieved successful healing. In the mesiodistal direction, the average apex horizontal displacement was 0.91 (0.28-1.35) mm, neck horizontal displacement was 0.46 (0.23-0.83) mm, apex vertical displacement was 0.57 (0.29-0.80) mm, and angular deviation was 1.93° (1.02°-3.40°). In the buccolingual direction, the average apex horizontal displacement was 0.84 (0.43-1.51) mm, neck horizontal displacement was 0.77 (0.32-1.05) mm, apex vertical displacement was 0.52 (0.30-0.88) mm, and angular deviation was 2.77° (2.09°-4.21°). Conclusion In this limited case series of edentulism implant surgeries, metal guide plates have shown similar accuracy and clinical outcomes to those of resin guide plates.

Key words: Edentulism, Implant, Surgical guide, Digitalization, CAD/CAM