Dental support surgical template for implant placement in the aesthetic area of maxillary anterior region
-
摘要:
目的 对比简易导板以及数字化外科导板植入种植体的角度和位置的不同，分析影响种植体植入精准性的因素。 方法 选取2019年1月—2020年1月在蚌埠医学院第一附属医院口腔科开展种植手术的30例患者，按照随机数字表分为A、B 2组，各15例。手术前全部进行锥形束CT(CBCT)拍摄，选择以Tooth Implant软件设计种植相关位点，A组手术选择数字化导板，B组手术选择简易导板，完成手术后二次拍摄CBCT，而后配准种植手术前后的相应位点，对比位置设计与实际情况的不同，主要包括角度差异、深度差异、根尖差异以及顶部差异。术后6个月修复并采用红、白色美学评分。 结果 30例患者总计植入51枚种植体，其中B组有25枚。测量偏差：A组顶部为(0.57±0.11)mm，根尖部为(0.78±0.35)mm，深度为(0.36±0.19)mm，角度为(2.37±1.13)°；B组顶部为(1.32±0.23)mm，根尖部为(1.04±0.15)mm，深度为(0.86±0.35)mm，角度为(7.24±1.37)°；2组测量偏差比较差异有统计学意义(均P＜0.05)。术后6个月A组红色美学评分[(9.19±0.74)分]与B组[(7.95±0.76)分]比较差异有统计学意义(P＜0.05)。 结论 通过数字化外科导板开展种植手术能够显著提升植入种植体的准确性，同时起到保障美学修复的作用。 Abstract:Objective To research the accuracy and position of implant placement between the and the simple template, and analyse the factors which affect the accuracy of implant placement. Methods Thirty patients were selected from January 2019 to January 2020 in the First Affiliated Hospital of Bengbu Medical College, who were randomly divided into groups A and B (15 patients in each group). Cone beam computed tomography (CBCT) images were taken before surgery, and Tooth Implant software was used to design the pre-operative plan. Implants were placed in group A using the digital surgical template, and implants were placed in group B using the simple template. All patients in the two groups were subjected to CBCT after the operation. Pre-operative and post-operative CBCT images were matched, and the deviations between the placed position and the planned were measured, including shoulder deviation, apical deviation, depth deviation and angle deviation. Final repair work was performed after 6 months, and the pink esthetic score (PES) and white aesthetic scores were given. Results We placed 51 implants in the 30 patients. Patients in group B received 25 implants. The deviation in group A was (0.57±0.11) mm in the shoulder, (0.78±0.35) mm in the apex, (0.36±0.19) mm in depth and (2.37±1.13)° in angle. The deviation in group B was (1.32±0.23) mm in the shoulder, (1.04±0.15) mm in the apex, (0.86±0.35) mm in depth and (7.24±1.37)° in angle. A significant difference in deviation index was found between the two groups (all P < 0.05). The PES in group A [(9.19±0.74) points] was significantly different from that in group B [(7.95±0.76) points] after 6 months (P < 0.05). Conclusion The digital surgical template for implant surgery may improve the precision of implantation in the anterior maxilla and the aesthetic restoration result. digital surgical template for implant surgery. -
Key words:
- Surgical template /
- Oral implant /
- Deviation /
- Aesthetic restoration
-
图 1 A组患者手术采用数字化导板种植
Figure 1. The patients in Group A were operatedwith digital guide plate
图 2 B组患者手术采用简易导板种植
Figure 2. The patients in Group B were operatedwith simple guide plate
表 1 2组行种植手术患者术前设计与实际种植体测量偏差比较(x±s)
Table 1. Preoperative design and actual implant positiondeviation of two groups of patients (x±s)
组别 例数 顶部偏差
(mm)根尖部偏差
(mm)深度偏差
(mm)角度偏差
(°)A组 26 0.57±0.11 0.78±0.35 0.36±0.19 2.37±1.13 B组 25 1.32±0.23 1.04±0.15 0.86±0.35 7.24±1.37 t值 -4.032 -2.613 -3.053 -6.383 P值 0.001 0.026 0.012 0.001 
下载: 导出CSV
表 2 2组行种植手术患者完成修复12个月后WES、PES评分比较(x±s, 分)
Table 2. WES and PES scores were compared between the two groups 12 months after implant repair (x±s, points)
组别 例数 PES总分 近中龈乳头 远中龈乳头 唇侧龈缘曲度 唇侧龈缘高度 软组织的质地及颜色/根部凸度 A组 26 9.19±0.74 1.70±0.28 1.81±0.11 1.86±0.13 1.87±0.12 1.88±0.10 B组 25 7.95±0.76 1.70±0.22 1.68±0.13 1.62±0.11 1.54±0.12 1.41±0.18 t值 2.607 0.785 2.563 4.231 8.523 11.476 P值 0.026 0.257 0.034 0.017 ＜0.001 ＜0.001 组别 例数 WES总分 牙冠形态 牙冠外形轮廓 牙冠颜色 牙冠表面质地 透明度/个性化 A组 26 8.95±0.58 1.88±0.09 1.82±0.13 1.78±0.06 1.75±0.09 1.72±0.21 B组 25 8.93±0.47 1.87±0.05 1.78±0.12 1.74±0.03 1.73±0.14 1.81±0.13 t值 1.023 1.487 1.692 1.563 1.265 3.908 P值 0.134 0.095 0.037 0.054 0.119 0.014
下载: 导出CSV
-
[1] 金杭颖, 吴英浩, 徐继文, 等. 国产数字化导板辅助上前牙种植手术的精准度研究[J]. 实用口腔医学杂志, 2018, 34(5): 644-647. doi: 10.3969/j.issn.1001-3733.2018.05.015JIN H Y, WU Y H, XU J W, et al. Precision evaluation of domestic digital guide assisting in the implantation of maxillary anterior teeth[J]. Journal of Practical Stomatology, 2018, 34(5): 644-647. doi: 10.3969/j.issn.1001-3733.2018.05.015 [2] GEDRIMIENE A, ADASKEVICIUS R, RUTKUNAS V. Accuracy of digital and conventional dental implant impressions for fixed partial dentures: A comparative clinical study[J]. J Adv Prosthodont, 2019, 11(5): 271-279. doi: 10.4047/jap.2019.11.5.271 [3] 张婷婷, 胡建. 数字化导板与动态导航在口腔种植应用中的研究进展[J]. 国际口腔医学杂志, 2019, 46(1): 99-104. https://www.cnki.com.cn/Article/CJFDTOTAL-GWKQ201901022.htmZHANG T T, HU J. Research progress on the application of surgical template and dynamic navigation system in implant dentistry[J]. International Journal of Stomatology, 2019, 46(1): 99-104. https://www.cnki.com.cn/Article/CJFDTOTAL-GWKQ201901022.htm [4] SONICK M, HWANG D, DWORKIN J. Implants in the aesthetic zone: Clinical guidelines[J]. Dent Today, 2017, 36(1): 91-92, 95. [5] 沈琳, 彭国光, 夏炜, 等. 红、白美学评价氧化锆个性化基台在前牙种植美学区的应用[J]. 中国口腔种植学杂志, 2017, 22(3): 124-127. doi: 10.3969/j.issn.1007-3957.2017.03.007SHEN L, PENG G G, XIA W, et al. The clinical application of WES and PES assessing the zirconium custom abutments in the anterior implant esthetics area[J]. Chinese Journal of Oral Implantology, 2017, 22(3): 124-127. doi: 10.3969/j.issn.1007-3957.2017.03.007 [6] 吴哲, 丁烨. 数字化技术在口腔修复中的应用[J]. 中华口腔医学研究杂志(电子版), 2019, 13(4): 200-203. doi: 10.3877/cma.j.issn.1674-1366.2019.04.002WU Z, DING Y. The application of digital technology in oral prosthesis[J]. Chinese Journal of Stomatological Research (Electronic Edition), 2019, 13(4): 200-203. doi: 10.3877/cma.j.issn.1674-1366.2019.04.002 [7] CHANG R J, CHEN H L, HUANG L G, et al. Accuracy of implant placement with a computer-aided fabricated surgical template with guided parallel pins: A pilot study[J]. J Clin Med Assoc, 2018, 81(11): 970-976. doi: 10.1016/j.jcma.2018.04.004 [8] CUCCHI A, CHIERICO A, FONTANA F, et al. Statements and recommendations for guided bone regeneration: Consensus report of the guided bond regeneration symposium held in Bologna, October 15 to 16, 2016[J]. Implant Dent, 2019, 28(4): 388-399. doi: 10.1097/ID.0000000000000909 [9] 袁治, 陈一晖. 数字化快速成型牙种植导板辅助修复上前牙种植: 12个月随访[J]. 中国组织工程研究, 2016, 20(7): 987-992. https://www.cnki.com.cn/Article/CJFDTOTAL-XDKF201607012.htmYUAN Z, CHEN Y H. Digital rapid prototyping implant template assists anterior tooth restoration in maxillary esthetic zone: A follow-up of 12 months[J]. Chinese Journal of Tissue Engineering Research, 2016, 20(7): 987-992. https://www.cnki.com.cn/Article/CJFDTOTAL-XDKF201607012.htm [10] 吕晶, 邓天政, 杨捷绯. 探讨上前牙区延期即刻种植修复的美学效果及对种植体周围软组织的影响[J]. 空军医学杂志, 2019, 35(1): 80-82, 93. https://www.cnki.com.cn/Article/CJFDTOTAL-ZJZY201901025.htmLYU J, DENG T Z, YANG J F. Aesthetic effect and soft tissue around implant in the uppe ranterior tooth area after immediate-delayed implantation[J]. Medical Journal of Air Force, 2019, 35(1): 80-82, 93. https://www.cnki.com.cn/Article/CJFDTOTAL-ZJZY201901025.htm [11] EDELMANN A R, HOSSEINI B, BYRD W C, et al. Exploring effectiveness of computer-aided planning in implant positioning for a single immediate implant placement[J]. J Oral Implantol, 2016, 42(3): 233-239. doi: 10.1563/AAID-JOI-D-15-00056 [12] AL A M D, KELLESARIAN S V, ABDULJABBAR T S, et al. Comparison of peri-implant soft tissue parameters and crestal bone loss around immediately loaded and delayed loaded implants in smokers and non-smokers: 5-year follow-up results[J]. J Periodontol, 2017, 88(1): 3-9. doi: 10.1902/jop.2016.160427 [13] SATO D, KANAZAWA M, KIM Y, et al. Immediate loading of two freestanding implants placed by computer-guided flapless surgery supporting a mandibular overdenture with magnetic attachments[J]. J Prosthodont Res, 2016, 60(1): 54-62. doi: 10.1016/j.jpor.2015.09.002 [14] YU T, YANG X, ZHAO L, et al. Length and width-to-length ratio of clinical crown of Chinese Han adults in Wuhan[J]. J Oral Sci Res, 2018, 34(9): 1003-1006. [15] 谢华德, 孙海鹏, 姜健, 等. 数字化种植外科导板精确性的影响因素[J]. 口腔疾病防治, 2018, 26(10): 669-672. doi: 10.12016/j.issn.2096-1456.2018.10.011XIE H D, SUN H P, JIANG J, et al. Influencing factors of the accuracy of digital surgical implant-guide plate[J]. Journal of Dental Prevention & Treatment, 2018, 26(10): 669-672. doi: 10.12016/j.issn.2096-1456.2018.10.011 [16] MARLIÉRE D, DEMÉTRIO M, PICININI L, et al. Accuracy of computer-guided surgery for dental implant placement in fully edentulous patients: A systematic review[J]. Eur J Dent, 2018, 12(1): 153-160. doi: 10.4103/ejd.ejd_249_17 [17] SUN T M, LAN T H, PAN C Y, et al. Dental implant navigation system guide the surgery future[J]. Kaohsiung J Med Sci, 2018, 34(1): 56-64. doi: 10.1016/j.kjms.2017.08.011 [18] HARADA T, ISOMURA E, UCHIHASHI T, et al. Aspergillosis associated with migration of a dental implant into the maxillary sinus: A case report[J]. J Oral Maxillofac Surg Med Pathol, 2017, 29(5): 448-451. https://www.sciencedirect.com/science/article/pii/S2212555817300790 [19] BLOCK M, EMERY R, CULLUM D, et al. Implant placement is more accurate using dynamic navigation[J]. J Oral Maxillofac Surg, 2017, 75(7): 1377-1386. https://www.sciencedirect.com/science/article/pii/S0278239117302525 [20] BLOCK M S, EMERY R W, LANK K, et al. Implant placement accurary using dynamic navigation[J]. Int J Oral Maxillofac Implants, 2017, 32(1): 92-99. https://pubmed.ncbi.nlm.nih.gov/27643585/ -
点击查看大图
图(4) / 表(2)
计量
- 文章访问数: 246
- HTML全文浏览量: 112
- PDF下载量: 3
- 被引次数: 0
