上海口腔医学

上海口腔医学 ›› 2020, Vol. 29 ›› Issue (5): 504-508.doi: 10.19439/j.sjos.2020.05.011

• 论著 • 上一篇    下一篇

国产六维导板辅助无牙颌种植手术的精度分析

涂业颖1, 周健1, 于艳春2, 樊明星3, 泮海松3, 林海燕1,2   

  1. 1.浙江中医药大学 口腔医学院,浙江 杭州 310053;
    2.杭州口腔医院,浙江 杭州 310000;
    3.杭州六维齿科医疗技术有限公司,浙江 杭州 310023
  • 收稿日期:2019-10-10 修回日期:2020-05-04 出版日期:2020-10-25 发布日期:2020-11-02
  • 通讯作者: 林海燕,E-mail：lhaiyanlily@163.com
  • 作者简介:涂业颖（1995-）,在读硕士研究生,住院医师,E-mail：1269612095@qq.com
  • 基金资助:
    浙江省医药卫生科技项目(2020374061)

Accuracy of 6D computed-derived implant guides made in China for dental implant surgery in edentulous patients

TU Ye-ying1, ZHOU Jian1, YU Yan-chun2, FAN Ming-xing3, PAN Hai-song3, LIN Hai-yan1,2   

  1. 1. Stomatological College of Zhejiang Chinese Medicine University. Hangzhou 310053;
    2. Hangzhou Stomatology Hospital. Hangzhou 310000;
    3. Hangzhou 6D Dental Medical Technology Co, Ltd. Hangzhou 310023, Zhejiang Province, China
  • Received:2019-10-10 Revised:2020-05-04 Online:2020-10-25 Published:2020-11-02

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摘要： 目的：评估国产六维数字化种植导板的精度,为临床应用提供减小偏差的方法和依据。方法：采用3D打印制作种植导板,应用于无牙颌患者,辅助外科植入,测量种植体术前设计和术后实际位置之间的偏差。选择16例无牙颌患者,测量172个植入位点。其中,10例患者上颌骨植入6颗植体,下颌骨植入4颗植体;6例患者上、下颌骨各均植入6颗植体;14例患者、28颗植体为倾斜植入。将术前锥形束CT（CBCT）数据导入国产六维齿科牙种植设计软件,设计和制作导板;应用数字化导板辅助植入手术;术后拍摄CBCT并导入六维软件进行三维重建,并与术前设计进行配准;将配准模型导出到Geomagic Studio软件进行分析,得出术前设计和植入后种植体的位置偏差,分析导板辅助下种植手术精度。采用SPSS 25.0软件包对样本进行配对t检验及单因素方差分析。结果：种植体顶部中心点距离偏差为（0.83±0.27） mm,水平向偏差为（0.60±0.21） mm;种植体底部中心点距离偏差为 （1.11±0.35） mm,垂直向偏差为（0.45±0.19） mm;角度偏差为（3.16±1.73）°。结论：六维数字化导板能够显著提高无牙颌患者种植手术精度和效率,并获得较好的远期临床效果。临床设计时须考虑偏差,规避风险和并发症。

关键词: 国产六维导板, 无牙颌, 种植, 精度, 偏差, 锥形束CT

Abstract: PURPOSE: To evaluate the accuracy of 6D computed-derived implant guides made in China, in order to provide methods and basis for reducing deviation. METHODS: 3D rapid prototyping technique was used to fabricate implant guides for auxiliary surgical implantation in edentulous patients, and the position deviation between the preoperative design and the actual implant was measured. Sixteen edentulous patients with 172 implantation sites were measured. In 10 patients, six implants were implanted in the maxilla, 4 implants in the mandible, and 6 implants were implanted both in the maxilla and mandible of 6 patients. A total of 28 implants were tilted implant in 14 patients. Preoperative cone-beam CT(CBCT) data were imported into the 6D Dental Planning Software to design and make the implant guides. Digital guides were used to assist implant placement. Preoperative design and postoperative CBCT were imported into the software for 3D reconstruction and registration, and then exported to Geomagic Studio software for analysis to obtain the deviation between the preoperative design and the implantation, so as to analyze the accuracy of the guides. The differences were analyzed by SPSS 25.0 software package with paired t-test and single factor analysis of variance. RESULTS: The distance deviation of implant neck center point was (0.83±0.27) mm and the horizontal deviation was (0.60±0.21) mm. The distance deviation of implant bottom center point was (1.11±0.35) mm, and the vertical deviation was (0.45±0.19) mm. The angle deviation was (3.16±1.73)°. CONCLUSIONS: The 6D computed-derived implant guides made in China can improve the accuracy and efficiency of implant surgery for edentulous patients and obtain a better long-term clinical effect to meet clinical requirements well. Since the deviation is similar to other implant guide plate systems that reported aborad, it must be taken into account in the process of clinical design, in order to avoid risks and unnecessary complications. This method is worthy of wide clinical application.

Key words: 6D computed-derived implant guides made in China, Edentulous jaw, Dental implant, Accuracy, Deviation, Cone-beam CT

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