CAD/CAM导板在后牙区种植精度的体外研究

›› 2019, Vol. 39 ›› Issue (1): 15-19.

CAD/CAM导板在后牙区种植精度的体外研究

张莹莹¹,张志宏¹,刘红红²,陈佳¹,芮茜¹,蒋晔¹

1. 安徽医科大学附属省立医院
2. 安徽省立医院

收稿日期:2018-05-31 修回日期:2018-06-23 出版日期:2019-01-28 发布日期:2019-01-28
通讯作者: 张莹莹 E-mail:yasmine1208@126.com
基金资助:
安徽省2013-2014科技攻关计划项目

An in vitro study of the precision of CAD/CAM guides in the posterior area

Received:2018-05-31 Revised:2018-06-23 Online:2019-01-28 Published:2019-01-28

摘要/Abstract

摘要： 目的后牙区利用计算机辅助设计和制作（computer aided design and computer aided manufacture，CAD/CAM）导板种植时，比较翻瓣与不翻瓣两种术式的精度。方法选取20名后牙种植患者的锥形束CT（cone beam CT，CBCT）资料和石膏模型，采用3D打印技术制作翻瓣与不翻瓣树脂模型，运用导板在两种模型上模拟牙种植术，分别计算术前术后种植体位置偏差进而比较两种术式的精度。结果 CAD/CAM导板在后牙区辅助种植时，翻瓣与不翻瓣术式种植体顶端偏差分别为（0.95±0.36）mm、（1.33±0.43）mm；底端偏差分别为（1.53±0.56）mm、（1.94±0.30）mm；角度偏差分别为3.45°±1.10°、3.31°±1.55°；深度偏差分别为（0.75±0.47）mm、（1.43±0.41）mm。翻瓣与不翻瓣两种术式在种植体距离偏差上有统计学差异，角度偏差上没有统计学差异。结论 CAD/CAM导板引导的种植翻瓣术式比不翻瓣术式在种植体距离偏差上更准确。

关键词: [关键词] CAD/CAM导板, 精度, 翻瓣, 不翻瓣

Abstract: Objective To compare the accuracy of two methods of flap and flaplss in the posterior region when using the CAD/CAM template. Methods Cone Beam CT data and plaster models were selected from 20 patients with posterior teeth implantation. The flap and flapless resin models were fabricated by 3D printing technique. The surgical guides were used to simulate dental implant placement on the two kinds of models, respectively. The preoperative and postoperative implant position deviations were calculated and then accuracies of the two surgical procedures were compared. Results The top deviations of the flap and the flapless way were（0.95±0.36）mm，（1.33±0.43）mm, respectively. The bottom deviations were（1.53±0.56）mm,（1.94±0.30）mm, respectively. The angle deviations were（3.45±1.10）°，（3.31±1.55）°, respectively. The depth deviations were（0.75±0.47）mm，（1.43±0.41）mm, respectively. Conclusion There is a statistically significant difference in the deviation of the implant between flap and flapless methods, while there is no statistical difference in angle deviation. CAD/CAM guided implant flap approach is more accurate than the flapless procedure in distance deviation.

Key words: [Key words] CAD / CAM template, accuracy, flap, flapless

中图分类号:

R783.4

张莹莹张志宏刘红红陈佳芮茜蒋晔. CAD/CAM导板在后牙区种植精度的体外研究[J]. , 2019, 39(1): 15-19.

参考文献

[1].参考文献
[2]Yunus N, Masood M, Saub R, et al.Impact of mandibular implant prostheses on the oral health-related quality of life in partially and completely edentulous patients[J].Clinical Oral Implants Research, 2015, 27(7):904-909
[3] Singh D, Singh S, Sharma R, Lakhani S, Pal A.Dental Implants: Future of Prosthetic Dentistry. Int J Res Health Allied Sci 2017; 3(4):68-70.
[4]Moragas J S M, Oth O, Büttner M, et al.Journal of Cranio-Maxillo-Facial Surgery[J].Journal of cranio-maxillo-facial surgery: official publication of the European Association for Cranio-Maxillo-Facial Surgery, 2015, 43(1):1-
[5] Inbarajan A, Banu F, Tv P, et al.Pre-surgical Provisional Prosthesis for Immediate Non-occlusal-loaded Flapless Implant.[J]. 2017, 9(6).
[6] Eleni N, Alexander S, Frank W.Accuracy of computer-assisted implant placement with insertion templates:[J]. Gms Interdisciplinary Plastic & Reconstructive Surgery Dgpw, 2016, 5.
[7] Nguyen M, Doan N, Du Z, et al.A Measure of Clinical Outcomes in Dental Implant Surgery Flapless Surgery versus Flap Technique in Posterior Maxilla of Post Menopause Women[M]// 5th International Conference on Biomedical Engineering in Vietnam. Springer International Publishing, 2015:133-136.
[8]Llamas-Monteagudo O, Girbes-Ballester P, Vina-Almunia J, et al.Clinical parameters of implants placed in healed sites using flapped and flapless techniques: A systematic review[J].Medicina Oral Patología Oral Y Cirugía Bucal, 2017, 28(5):e572-e581
[9]Lin G H, Chan H L, Bashutski J D, et al.The effect of flapless surgery on implant survival and marginal bone level: a systematic review and meta-analysis[J].Journal of Periodontology, 2014, 85(5):e91-
[10]Geng W, Liu C, Su Y, et al.Accuracy of different types of computer-aided designcomputer-aided manufacturing surgical guides for dental implant placement[J].International Journal of Clinical & Experimental Medicine, 2015, 8(6):8442-9
[11]Cristache C M, Gurbanescu S.Accuracy Evaluation of a Stereolithographic Surgical Template for Dental Implant Insertion Using 3D Superimposition Protocol:[J]. International Journal of Dentistry, 2017, (2017-5-7), 2017, 2017:4292081.
[12]Shen P, Zhao J, Fan L, et al.Accuracy evaluation of computer-designed surgical guide template in oral implantology[J].Journal of Cranio-Maxillofacial Surgery, 2015, 43(10):2189-2194
[13]Beretta M, Poli P P, Maiorana C.Accuracy of computer-aided template-guided oral implant placement: a prospective clinical study[J].J Periodontal Implant Sci, 2014, 44(4):184-193
[14]Vasak C, Strbac G D, Huber C D, et al.Evaluation of three different validation procedures regarding the accuracy of template-guided implant placement: an in vitro study[J].Clin Implant Dent Relat Res, 2015, 17(1):142-149
[15]Matta R E, Bergauer B, Adler W, et al.The impact of the fabrication method on the three-dimensional accuracy of an implant surgery template[J].Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery, 2017, 45(6):804-
[16]Park S J, Leesungbok R, Cui T, et al.Reliability of a CADCAM Surgical Guide for Implant Placement: An In Vitro Comparison of Surgeons' Experience Levels and Implant Sites[J].International Journal of Prosthodontics, 2017, 30(4):367-169
[17] Raico Gallardo Y N, Da S O I, Mukai E, et al.Accuracy comparison of guided surgery for dental implants according to the tissue of support: a systematic review and meta-analysis.[J]. Clinical Oral Implants Research, 2016.