骨质情况对计算机辅助设计种植导板应用精确性的影响分析

doi:10.13591/j.cnki.kqyx.2024.07.005

Abstract

Abstract:

Objective To explore the influence of different bone quality around the implant on the implantation accuracy, the computer-aided design of implant guide plate was used for patients with poor bone quality to evaluate its accuracy. Methods Retrospective analysis of relevant clinical data from 29 single-tooth implant patients with relatively poor bone quality meeting inclusion criteria was conducted. Using 3Shape Implant Studio software, implant plans were designed and fully guided digital templates were fabricated before surgery. Implantation was guided by the templates throughout, with torque and ISQ values recorded to evaluate the initial stability of the implant. Postoperative implant positions were reconstructed using CBCT images, and the three-dimensional deviation of implant placement was evaluated in conjunction with the preoperative design. Bone quality around the implants was also recorded and analyzed before and after surgery. Results In this study, digital guide plates were used in patients with poor bone quality, and the initial stability of implants was ≥ 20 N·cm except for three cases. In cases of poor bone quality, the accuracy of the fully guided digital templates was as follows: cervix deviation (0.94±0.59)mm, apex deviation (1.40±0.81)mm and angle deviation 4.10°±2.99°. Bone quality had a greater impact on angle deviation (P<0.05). The higher the proportion of D3 bone was around the implant body 1/3, the smaller the deviation of neck, apex and angle was, while the higher the proportion of D5 bone, the greater the deviation of implantation. Conclusion For patients with poor bone quality, under the premise of restoration-oriented, the proportion of D3 bone around the implant can be increased by computer-aided design, and the initial stability of the implant can be improved by guiding the implantation with digital guide plate. Attention should be paid to the influence of bone on the angle deviation of implant during the application of guide plate.

Key words: dental implant, computer-assisted design and fabrication, precision, surgical template

CLC Number:

R783.4

QIAN Yuxin, LI Jian, ZHANG Jianlan, ZHANG Shixuan, GU Yangqian, LU Mengmeng, TANG Chunbo. Analysis of the impact of bone quality on the accuracy of computer-aided design of implant guide plate[J]. Stomatology, 2024, 44(7): 508-514.

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References 28

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项目	骨质分类		P
项目	D4、D3b(HU<600)	D2(颈部D4)	P
位置			0.030
上颌	11	0
下颌	10	8
性别			0.257
男	9	6
女	12	2
植入扭矩/(N·cm)	25.24±5.63	28.13±3.91	0.196
ISQ	63.80±7.80	67.46±6.06	0.243

种植体尺寸 (直径×长度)	种植体数量	植入扭矩/(N·cm)	ISQ
4.0 mm×8.5 mm	1	23.00	57.70
4.0 mm×10.0 mm	3	25±5.57	60.67±2.52
4.0 mm×11.5 mm	1	30.00	63.90
4.5 mm×7.0 mm	5	17.80±4.38	58.28±8.02
4.5 mm×8.5 mm	9	28.56±1.94	68.41±6.42
4.5 mm×10.0 mm	9	28.11±4.37	67.32±7.57
5.0 mm×7.0 mm	1	28.00	62.80

差异源	植入扭矩		ISQ
差异源	F	P	F	P
直径	2.279	0.126	2.190	0.136
长度	4.280	0.016	2.607	0.077

骨质分类	颈部偏差/mm	根尖部偏差/mm	角度偏差/°
D4、D3b(HU<600)	0.99±0.60	1.53±0.82	4.74±2.27
D2(颈部D4)	0.80±0.60	1.05±0.67	2.27±1.08
P	0.467	0.150	0.045

种植体尺寸 (直径×长度)	颈部偏差/mm	根尖部偏差/mm	角度偏差/°
4.0 mm×8.5 mm	0.51	1.17	4.61
4.0 mm×10.0 mm	1.08±0.32	2.64±0.54	9.16±2.14
4.0 mm×11.5 mm	0.77	0.84	1.86
4.5 mm×7.0 mm	1.40±1.08	1.60±1.10	5.72±4.34
4.5 mm×8.5 mm	1.02±0.48	1.37±0.59	3.06±1.47
4.5 mm×10.0 mm	0.67±0.34	1.09±0.62	2.91±1.86
5.0 mm×7.0 mm	0.49	0.50	2.46

Analysis of the impact of bone quality on the accuracy of computer-aided design of implant guide plate

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差异源	颈部偏差		根尖部偏差		角度偏差
差异源	F	P	F	P	F	P
直径	1.006	0.382	2.083	0.148	4.065	0.031
长度	1.182	0.339	1.805	0.176	3.960	0.021

不同部位骨质	颈部偏差		根尖部偏差		角度偏差
不同部位骨质	皮尔逊相关系数	P	皮尔逊相关系数	P	皮尔逊相关系数	P
颈部D1	-0.368	0.051	-0.382	0.044^*	-0.353	0.058
颈部D2	-0.383	0.043^*	-0.336	0.068	-0.264	0.123
颈部D3	-0.324	0.076	-0.352	0.059	-0.417	0.030^*
颈部D4	0.278	0.112	0.051	0.414	0.088	0.353
颈部D5	0.355	0.057	0.497	0.011^*	0.510	0.009^*
体部D1	-0.107	0.323	0.094	0.342	0.126	0.293
体部D2	-0.276	0.113	-0.116	0.308	-0.013	0.477
体部D3	-0.418	0.030^*	-0.431	0.026^*	-0.520	0.008^*
体部D4	0.230	0.158	0.098	0.336	0.138	0.275
体部D5	0.638	0.001^*	0.605	0.002^*	0.606	0.002^*
根部D1	-0.108	0.321	0.134	0.281	0.151	0.256
根部D2	-0.224	0.165	-0.087	0.354	-0.033	0.443
根部D3	-0.364	0.053	-0.379	0.045^*	-0.316	0.082
根部D4	-0.006	0.490	0.031	0.447	0.215	0.175
根部D5	-0.515	0.008^*	0.376	0.046^*	0.171	0.229

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