中国口腔种植学杂志 ›› 2021, Vol. 26 ›› Issue (5): 306-312.DOI: 10.12337/zgkqzzxzz.2021.10.007

• 论著·典型病例分析 • 上一篇    下一篇

“榫卯”连接式全程数字化组合导板在全口种植手术中的临床应用

李岩, 杨清然, 徐光宙   

  1. 国家口腔疾病临床医学研究中心 上海市口腔医学重点实验室 上海交通大学医学院附属第九人民医院口腔外科 200011
  • 收稿日期:2020-08-04 出版日期:2021-10-30 发布日期:2021-11-12
  • 通讯作者: 徐光宙,Email: xgzmy@163.com,电话:021-23271699-5945
  • 作者简介:李岩,口腔医学博士、副教授、硕士研究生导师,研究方向:仿生生物医用材料、microRNA基因修饰技术与血管-骨组织工程的基础研究与临床研究;徐光宙,口腔医学博士、教授、主任医师、研究生导师,研究方向:微创牙槽外科及牙种植修复的临床和基础研究

Clinical application of “tenon-mortise” based whole-process digital combined guide plate in complete-mouth implant surgery.

Li Yan, Yang Qingran, Xu Guangzhou   

  1. National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Department of Oral Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
  • Received:2020-08-04 Online:2021-10-30 Published:2021-11-12
  • Contact: Xu Guangzhou, Email: xgzmy@163.com, Tel: 0086-21-23271699-5945

摘要: 目的 本项研究旨在探索榫卯连接式全程数字化组合导板在全口种植外科手术中应用的临床效果。方法 本项研究选取一位由于重度牙周炎导致全口上下颌牙槽骨吸收至根尖1/3,全口上下颌牙齿松动III度,要求全口种植修复的患者为研究对象。运用一项自主设计研发的榫卯连接式全程数字化组合导板,该导板利用榫卯式的连接,将定位导板、截骨导板、种植导板之间实现互相组合。利用牙支持式定位导板组合截骨导板实现截骨导板的精确定位并固定,截骨导板能够有效地指导骨面修整,实现以修复为导向的全程数字化种植外科。结果 通过术后锥形束CT将种植体植入位点与术前设计对比,发现该导板系统精确度较高,总体角度偏差为2.27°,总体种植体尖端偏差值为1.93 mm,种植体颈部偏差值为1.77 mm,病例即刻修复效果较为理想。结论 自主设计研发的榫卯连接组合式全程数字化导板,作为一种改良的组合式数字化导板,为真正实现针对无牙颌病例的全程数字化种植外科提供了新的选择,减少了全口无牙颌种植手术的难度和时间,提高了种植位点与角度的精确度,但其临床效果仍然需要未来更大样本量、更长随访期的研究支持。

关键词: 全程数字化种植, 榫卯结构, 组合式, 数字化种植外科导板, 全口修复

Abstract: Objective This study was to conduct a preliminary investigation of the efficacy of “tenon-mortise” based combined digital whole-process surgical templates to assist in diagnosis, plan, and facilitate proper positioning for edentulous patients. Methods This clinical case analysis was to report the treatment of one case with advanced periodontitis, which in turn leads to loosening of teeth. Because of the advanced periodontitis, the remaining teeth were severely loose. A self-designed “tenon-mortise” based combined digital whole-process surgical templates were applied to guide the placement of the implant. The combined surgical templates include positioning plate, osteotomy plate, and implant plate. The connection between the two plates is based on the tenon-mortise joint, which facilitates implant surgery for edentulous patients. In addition, for the irregular alveolar ridge, the osteotomy plate, as one of the combined guided surgical templates, could be used to guide cutting and trimming the alveolar ridge. Using the self-designed “tenon-mortise” based combined digital guided surgical templates could successfully guide the entire surgical process. Results When comparing the planned and placed implant by CBCT, it was found that high accuracy was achieved by using the self-designed “tenon-mortise” based combined digital whole-process surgical templates. The mean angular deviation was 2.27°. The mean value of deviation at the shoulder and apex was 1.77 mm and 1.93 mm, respectively. The outcome of the immediate restoration was satisfying. Conclusion This self-designed template system provides a novel technique to guide whole-process digital implant surgery for edentulous patients. But the efficacy needs further investigation in clinical trials with larger sample sizes and longer follow-up periods.

Key words: Full digital implant, Tenon-mortise joint structure, Combination, Digital implant surgical guide, Complete mouth repairment