动态实时导航与数字化导板导航牙种植精确度的比较

doi:10.12016/j.issn.2096-1456.2021.03.006

口腔疾病防治 ›› 2021, Vol. 29 ›› Issue (3): 178-183.DOI: 10.12016/j.issn.2096-1456.2021.03.006

动态实时导航与数字化导板导航牙种植精确度的比较

赵娅琴^1,²(),刘艾芃¹(),岑峰³,杨凯文¹,李艳芳¹,邓文正¹()

1.梧州市红十字会医院口腔科,广西梧州（543002）
2.右江民族医学院口腔医学院,广西百色（533000）
3.梧州市红十字会医院医学影像科,广西梧州（543002）

收稿日期:2020-06-19 修回日期:2020-08-26 出版日期:2021-03-20 发布日期:2021-01-12
通讯作者: 邓文正
作者简介:赵娅琴,住院医师,硕士研究生在读,Email：dentist-zhao@qq.com|刘艾芃,主治医师,硕士,Emai：331408727@qq.com
基金资助:
广西医学高层次骨干人才培养“139”计划培养项目资助(G201903057)

Research on the accuracy of dynamic real-time navigation and digital guide navigation implanting techniques

ZHAO Yaqin^1,²(),LIU Aipeng¹(),CEN Feng³,YANG Kaiwen¹,LI Yanfang¹,DENG Wenzheng¹()

1. Department of Stomatology, Wuzhou Red Cross Hospital, Wuzhou 543002, China
2. School of Stomatology, Youjiang Medical University for Nationalities, Baise 533000, China
3. Department of Medical Imaging, Wuzhou Red Cross Hospital, Wuzhou 543002, China

Received:2020-06-19 Revised:2020-08-26 Online:2021-03-20 Published:2021-01-12
Contact: Wenzheng DENG
Supported by:
‘139’ Plan Training Project for Guangxi Medical High-level Backbone Talents(G201903057)

摘要/Abstract

摘要：

目的比较采用动态实时导航与数字化导板导航牙种植术植入种植体的精确度,为临床实施精准牙种植提供参考。方法选择2018年4月到2019年12月梧州市红十字会医院口腔科收治的46例（70颗牙）牙缺失患者,随机分两组（每组35颗牙）分别行动态实时导航和数字化导板导航牙种植术,比较两组种植体术前设计位置和术后实际种植位置的颈部、尖部、深度和角度偏差。运用SPSS 21.0软件对数据进行统计学分析。结果两组患者种植手术均顺利进行并完成种植体的成功植入。动态实时导航组种植体尖部、深度和角度的偏差均小于数字化导板导航组的偏差,差异具有统计学意义（P < 0.05）,动态实时导航组和数字化导板导航组在颈部中心点的偏差无统计学意义（P > 0.05）。结论动态实时导航与数字化导板导航种植手术均有较好的临床效果,前者的精度高于后者。

关键词: 牙缺失, 牙种植手术, 动态导航, 实时导航, 数字化导板, 精确度, 误差分析, 3D打印

Abstract:

Objective To compare the accuracies of implants with dynamic real-time navigation versus digital guide navigation to provide a reference for clinical precision dental implants. Methods Forty-six cases (seventy teeth) with missing teeth admitted to the Department of Stomatology, Wuzhou Red Cross Hospital from April 2018 to December 2019 were randomly divided into two groups (thirty-five teeth in each group) for dynamic real-time navigation and digital guide navigation implantation techniques. To compare the entry point, apex point, depth and angle deviation of the preoperative and postoperative position of implants in the two groups. SPSS 21.0 software was used for statistical analysis. Results Dental implants were successfully placed in both groups. The deviations of apex point, depth and angle in the dynamic real-time navigation group were all smaller than those in the digital guide navigation group, and the differences were statistically significant (P < 0.05). There was no statistically significant deviation in the entry point between the two groups (P > 0.05). Conclusion In this study, both techniques had good clinical effects. The accuracy of dynamic real-time navigation was higher than that of digital guidance.

Key words: tooth loss, dental implant, dynamic navigation, real-time navigation, digital guide, accuracy, error analysis, 3D printing

中图分类号:

赵娅琴,刘艾芃,岑峰,杨凯文,李艳芳,邓文正. 动态实时导航与数字化导板导航牙种植精确度的比较[J]. 口腔疾病防治, 2021, 29(3): 178-183.

ZHAO Yaqin,LIU Aipeng,CEN Feng,YANG Kaiwen,LI Yanfang,DENG Wenzheng. Research on the accuracy of dynamic real-time navigation and digital guide navigation implanting techniques[J]. Journal of Prevention and Treatment for Stomatological Diseases, 2021, 29(3): 178-183.

图/表 5

图1 动态实时导航种植手术过程

Figure 1 Dynamic real- time navigation of the implant procedure a: 3D view of borehole preparation under the guidance of the dynamic navigation system; b: registration process; c: prepare the borehole under the guidance of the dynamic navigation system.

图2 数字化导板导航种植手术过程

Figure 2 Digital guide of the implant procedure a-c: design of digital guide template with 6D Dental Implant Design Software; a: side view of digital guide design; b: elevation view of digital guide design; c: guide template; d: try-in digital guide; e: prepare the borehole under the guidance of digital guide

图3 测量模型图和测量指标

Figure 3 Model of measurement and deviation parameters Grey represents the design position; yellow represents the actual position; a: entry point deviation (mm); b: apex point deviation (mm); c: depth deviation (mm); d: angle deviation (°)

表1 两组患者植牙区牙位分布资料分析

Table 1 Comparison of positions forimplanteeth data between two groups n=35

Group	Anterior	Premolar	Molar	χ²	P
Dynamic real-time navigation	9	12	14	2.853	0.240
Digital guide navigation	15	7	13	2.853	0.240

表2 两组种植体偏离程度相关指标比较

Table 2 Comparison of various parameters of the accuracies between two groups x ± s

Parameter	Dynamic real-time navigation	Digital guide navigation	t	P
Entry point deviation (mm)	0.79 ± 0.24	0.84 ± 0.19	-0.965	0.338
Apex point deviation (mm)	1.03 ± 0.34	1.23 ± 0.17	-3.142	0.002
Depth deviation (mm)	0.58 ± 0.15	0.71 ± 0.13	-3.879	0.000
Angle deviation (°)	2.41 ± 0.48	3.48 ± 0.64	-7.943	0.000

参考文献 17

[1]	Sirida A, Soontra P, Atiphan P. The stability of augmented bone between two different membranes used for guided bone regeneration simultaneous with dental implant placement in the esthetic zone[J]. Int J Oral Maxillofac Implants, 2018,33(1):206-216. doi: 10.11607/jomi.5492. DOI URL PMID
[2]	刘子燕, 戴群, 肖芳数字化种植导板在口腔种植修复中的应用[J]. 口腔疾病防治, 2019,27(5):337-340. doi: 10.12016/j.issn.2096-1456.2019.05.013.
	Liu ZY, Dai Q, Xiao F. Application of digital implant guide plate in oral implant restoration[J]. J Prev Treat Stomatol Dis, 2019,27(5):337-340. doi: 10.12016/j.issn.2096-1456.2019.05.013.
[3]	Aydemir CA, Arısan V. Accuracy of dental implant placement via dynamic navigation or the freehand method: a split-mouth randomized controlled clinical trial[J]. Clin Oral Implants Res, 2020,31(3):255-263. doi: 10.1111/clr.13563. URL PMID
[4]	Gargallo-Albiol J, Barootchi S, Salomó-Coll O, et al. Advantages and disadvantages of implant navigation surgery. A systematic review[J]. Ann Anat, 2019,225:1-10. doi: 10.1016/j.aanat. 2019. 04.005. DOI URL PMID
[5]	Block MS, Emery RW, Cullum DR, et al. Implant placement is more accurate using dynamic navigation[J]. J Oral Maxillofac Surg, 2017,75(7):1377-1386. doi: 10.1016/j.joms.2017.02.026. DOI URL PMID
[6]	Herklotz I, Beuer F, Kunz A, et al. Navigation in implantology[J]. Int J Comput Dent, 2017,20(1):9-19. URL PMID
[7]	Alterman M, Rushinek H, Lavi A, et al. Computerized navigation for minimal invasive retrieval of displaced dental implants in the lower jaw[J]. Oral Maxillofac Surg Clin North Am, 2019,31(3):447-455. doi: 10.1016/j.coms.2019.03.007. DOI URL PMID
[8]	满毅, 周楠, 杨醒眉动态实时导航在口腔种植领域中的临床应用及新进展[J]. 口腔疾病防治, 2020,28(6):341-348. doi: 10.12016/j.issn.2096-1456.2020.06.001.
	Man Y, Zhou N, Yang XM. Clinical application and new progress of dynamic navigation system in the field of oral implantology[J]. J Prev Treat Stomatol Dis, 2020,28(6):341-348. doi: 10.12016/j.issn.2096-1456.2020.06.001.
[9]	Chen YT, Chiu YW, Peng CY. Preservation of inferior alveolar nerve using the dynamic dental implant navigation system[J]. J Oral Maxillofac Surg, 2020,78(5):678-679. doi: 10.1016/j.joms.2020.01.007. DOI URL PMID
[10]	Kaewsiri D, Panmekiate S, Subbalekha K, et al. The accuracy of static vs. dynamic computer-assisted implant surgery in single tooth space: a randomized controlled trial[J]. Clin Oral Implants Res, 2019,30(6):505-514. doi: 10.1111/clr.13435. URL PMID
[11]	Sun TM, Lee HE, Lan TH. Comparing accuracy of implant installation with a navigation system (NS), a laboratory guide (LG), NS with LG, and freehand drilling[J]. Int J Environ Res Public Health, 2020,17(6). doi: 10.3390/ijerph17062107. DOI URL PMID
[12]	Tahmaseb A, Wismeijer D, Coucke W, et al. Computer technology applications in surgical implant dentistry: a systematic review[J]. Int J Oral Maxillofac Implants, 2014,29Suppl: 25-42. doi: 10.11607/jomi.2014suppl.g1.2.
[13]	Van Assche N, Vercruyssen M, Coucke W, et al. Accuracy of computer-aided implant placement[J]. Clin Oral Implants Res, 2012,23 Suppl 6: 112-123. doi: 10.1111/j.1600-0501.2012.02552.x.
[14]	Somogyi-Ganss E, Holmes HI, Jokstad A. Accuracy of a novel prototype dynamic computer-assisted surgery system[J]. Clin Oral Implants Res, 2015,26(8):882-890. doi: 10.1111/clr.12414. DOI URL PMID
[15]	Mandelaris George A, Stefanelli Luigi V, DeGroot Bradley S. Dynamic navigation for surgical implant placement: overview of technology, key concepts, a case report[J]. Compend Contin Educ Dent, 2018, 39(9): 614-621; quiz 622. URL PMID
[16]	Bencharit S, Staffen A, Yeung M, et al. In vivo tooth-supported implant surgical guides fabricated with desktop stereolithographic printers: fully guided surgery is more accurate than partially guided surgery[J]. J Oral Maxillofac Surg, 2018,76(7):1431-1439. doi: 10.1016/j.joms.2018.02.010. URL PMID
[17]	邓文正, 刘艾芃, 钟凌, 等. 数字化种植手术导板技术在上颌前后牙区植入精确度差异的研究[J]. 临床口腔医学杂志, 2018,34(1):41-43. doi: 10.3969/j.issn.1003-1634.2018.01.013.
	Deng WZ, Liu AF, Zhong L, et al. Accuracy research for the implant placements in anterior regions or in molar regions of maxilla by using computer-assisted guide template navigation[J]. J Clin Stomatol, 2018,34(1):41-43. doi: 10.3969/j.issn.1003-1634.2018. 01.013.

动态实时导航与数字化导板导航牙种植精确度的比较

Research on the accuracy of dynamic real-time navigation and digital guide navigation implanting techniques

RichHTML

PDF

可视化

摘要/Abstract

引用本文

使用本文

图/表 5

参考文献 17

相关文章 15

编辑推荐

Metrics

[1]	张威龙,吴婉淇,廖珊华,邹俊斌,詹栩铮,林捷. 椅旁四面体定位技术制作导板拆除纤维桩1例及文献复习[J]. 口腔疾病防治, 2021, 29(7): 479-484.
[2]	谭国忠,江千舟. 3D打印技术在牙髓再生领域的研究进展[J]. 口腔疾病防治, 2021, 29(4): 279-283.
[3]	张凯,刘小元,李蕾,李君,韩祥祯,何惠宇. 细胞膜片复合3D打印马鹿角粉/丝素蛋白/聚乙烯醇支架对羊下颌骨缺损的修复效果[J]. 口腔疾病防治, 2021, 29(10): 669-676.
[4]	李玉姣,钱飞,张倩霞,王丹,王艺蓉,田宇. 3D打印在微创牙髓治疗中应用的研究进展[J]. 口腔疾病防治, 2021, 29(10): 716-720.
[5]	徐鸿玮,韩冰. 颌骨组织工程支架材料机械强度增强方法研究进展[J]. 口腔疾病防治, 2020, 28(9): 600-606.
[6]	满毅,周楠,杨醒眉. 动态实时导航在口腔种植领域中的临床应用及新进展[J]. 口腔疾病防治, 2020, 28(6): 341-348.
[7]	任立志,孙睿. 引导骨再生屏障膜材料临床应用进展[J]. 口腔疾病防治, 2020, 28(6): 404-408.
[8]	王亚敏,周震,刀俊峰,陈祈月,刘文静,宋光保. 浓缩生长因子应用于上颌前牙区骨缺损引导骨再生的效果评价[J]. 口腔疾病防治, 2020, 28(4): 236-240.
[9]	顾新华. 萎缩无牙颌患者数字化种植即刻修复工作流程[J]. 口腔疾病防治, 2020, 28(12): 749-758.
[10]	王易维,夏文君,唐子圣,卞小禾,漆正楠,詹灵女,邹岩,林皓逸,董敏俊,朱凌. 运用小视野CBCT及计算机辅助技术对3D打印椭圆形根管的预备效果评价[J]. 口腔疾病防治, 2020, 28(11): 710-713.
[11]	吴玉琼,阮雅烨,明佳俊,程蕙娟,焦婷. 数字化技术在小口畸形牙列缺损修复中的应用[J]. 口腔疾病防治, 2020, 28(10): 651-656.
[12]	王春林,兰泽栋,毛琴,林地福,徐婵娟,刘从华. 个性化微支抗钉辅助快速扩弓器扩展成人腭中缝的疗效[J]. 口腔疾病防治, 2020, 28(10): 657-663.
[13]	刘燕菲,李运峰,祝颂松. 虚拟手术设计在双颌正颌手术中的精准性研究[J]. 口腔疾病防治, 2020, 28(1): 30-35.
[14]	陈圣恺,毛渤淳,陈奕霖,周佳琦,毛靖宁,石冰,李精韬. 二维及三维摄影应用于单侧唇裂患者面部测量的精确性比较[J]. 口腔疾病防治, 2020, 28(1): 41-46.
[15]	刘小元,张凯,韩祥祯,左新慧,李君,何惠宇. 3D打印复合PVA骨组织工程支架研究现状[J]. 口腔疾病防治, 2020, 28(1): 52-55.