数字化导板在口腔种植临床应用中的精确度评价

中国口腔颌面外科杂志 ›› 2015, Vol. 13 ›› Issue (6): 508-514.

数字化导板在口腔种植临床应用中的精确度评价

赵璟阳¹#，樊林峰²#，王艳辉¹，张善勇³*，赵保东¹*

1.青岛大学附属医院口腔种植中心，山东青岛 266100；
2.上海交通大学医学院附属第九人民医院放射科，上海 200011；
3.上海交通大学医学院附属第九人民医院?口腔医学院口腔外科，上海市口腔医学重点实验室，上海 200011

收稿日期:2014-12-17 出版日期:2015-11-20 发布日期:2015-12-03
作者简介:赵璟阳（1987-），男，在读硕士研究生，E-mail:jingy87@126.com；樊林峰（1980-），男，技师，E-mail:22643155@qq.com。
基金资助:
Supported by Western Medicine Leading Project of Science and Technology Committee of Shanghai Municipality (134119a5400) and Natural Science Foundation of Shandong Province(zr2010hm036).

Accuracy evaluation of computer-designed stereolithographic surgical guide in dental implantology

ZHAO Jing-yang¹, FAN Lin-feng², WANG Yan-hui¹, ZHANG Shan-yong³, ZHAO Bao-dong¹.

1. Center of Oral Implantology, The Affiliated Hospital of Qingdao University Medical College. Qingdao 266100, Shandong Province;
2.Department of Radiology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine.Shanghai 200011;
3. Department of Oral Surgery,Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology. Shanghai 200011, China

Received:2014-12-17 Online:2015-11-20 Published:2015-12-03
Contact: 2013年上海市科学技术委员会西医引导类项目（134119a5400）；山东省自然科学基金 (zr2010hm036)

摘要/Abstract

摘要： 目的：评估利用数字化导板进行种植手术的精确度，探讨其在口腔种植中的优势和临床应用价值。方法：选择2013年2月—2013年12月在上海交通大学医学院附属第九人民医院口腔外科行种植手术的60例牙列缺损患者，随机分为Ⅰ、Ⅱ2组，每组30例。术前均拍摄口腔颌面部锥形束CT，并利用Simplant软件规划手术方案。其中I组采用无种植导板辅助植入种植体；Ⅱ组利用快速成型技术制作数字化导板，辅助植入种植体。术后2组均拍摄口腔颌面部锥形束CT，利用Simplant软件将术前图像与术后图像进行配准融合，测量比较种植体实际位置与术前设计的差异。所得数据采用SPSS 18.0软件包进行统计学分析。结果：Ⅰ组共植入52颗种植体，测量偏差为：顶部(2.07±0.51) mm（1.33～2.79 mm），根尖部(2.89±1.02) mm（1.51～4.43 mm），深度(0.78±0.33) mm（0.30～1.28 mm）和角度(8.84±4.64)°（3.29～16.21°）；Ⅱ组共植入57颗种植体，测量偏差为：顶部(1.18±0.72) mm（0.12～2.35 mm），根尖部(1.43±0.74) mm(0.20～2.66 mm)，深度(0.54±0.29) mm（0.20～1.07 mm）和角度(4.21±1.91)°（0.82～7.79°）。种植体植入的精确度在顶部、根尖部和角度有显著差异（P<0.01），而深度偏差无显著差异（P>0.05）。结论：利用数字化导板辅助种植手术，可以更好地控制种植体植入的精确度，具有良好的应用前景。

关键词: 口腔种植, 计算机辅助设计, 种植导板, 精确度

Abstract: PURPOSE :To assess the accuracy of implant placement using digitized guide templates, with emphasis on the advantage and clinical value in oral implantology. METHODS : From February 2013 to December 2013, Sixty patients diagnosed with dentition defect were randomly selected in the Department of Oral Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, who were equally divided into 2 groups. Pre-operative cone-beam computed tomography (CBCT) was taken, and operation plan was designed with Simplant software. Implants were placed in group I without being assisted by surgical guide templates; implants were placed in group Ⅱ assisted by digitized guide templates using rapid prototyping technology. Postoperative CBCT was taken in 2 groups. Pre- and post-operative CBCT was matched and integrated using Simplant software, the deviation of implant between actual position and preoperative design was measured and compared using SPSS 18.0 software package. RESULTS : Totally 52 implants was placed in groupⅠ, the recorded deviation was as follows: the implant shoulder (2.07±0.51) mm (1.33-2.79 mm), apex (2.89±1.02) mm (1.51～4.43 mm), depth(0.78±0.33) mm (0.30～1.28 mm) and angle(8.84±4.64)° (3.29-16.21°); totally 57 implants were placed in group Ⅱ, measured deviation was as follows: the implant shoulder (1.18±0.72) mm (0.12 -2.35 mm)，apex (1.43±0.74) mm (0.20-2.66 mm), depth (0.54±0.29) mm（0.20-1.07 mm） and angle (4.21±1.91)° (0.82-7.79°). There was significant difference in implant shoulder, apex and angle （P<0.01）between the 2 groups, while there was no significant difference of depth bias between the 2 groups (P>0.05). CONCLUSIONS : Accuracy of implant placed was better controlled using digitized guide templates, which was favorable application prospect.

Key words: Dental implantation, Computer aided design, Surgical guide templates, Accuracy

中图分类号:

R782.05.1

赵璟阳#，樊林峰#，王艳辉，张善勇*，赵保东*. 数字化导板在口腔种植临床应用中的精确度评价[J]. 中国口腔颌面外科杂志, 2015, 13(6): 508-514.

ZHAO Jing-yang, FAN Lin-feng, WANG Yan-hui, ZHANG Shan-yong, ZHAO Bao-dong.. Accuracy evaluation of computer-designed stereolithographic surgical guide in dental implantology[J]. China J Oral Maxillofac Surg, 2015, 13(6): 508-514.

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