Journal of Prevention and Treatment for Stomatological Diseases ›› 2018, Vol. 26 ›› Issue (8): 508-513.doi: 10.12016/j.issn.2096-1456.2018.08.006

• Cinical Study • Previous Articles     Next Articles

Clinical application of a digital whole-process surgical guide plate for immediate implant placement in the molar area

Shaobing LI(), Jia NI(), Xueyang ZHANG(), Yanhong HUANG, Mingdeng RONG, Haibin LU   

  1. Department of Periodontal Implantology, Stomatological Hospital, Southern Medical University, Guangzhou 510280, China
  • Received:2018-05-06 Revised:2018-06-15 Online:2018-08-20 Published:2018-08-30

Abstract:

Objective To evaluate the clinical effect of a digital whole-process surgical guide for immediate implantation in the molar area. Methods Twenty-six patients with molar extraction plans were accepted for preoperative CBCT and model construction. Computer software was used to design the ideal three-dimensional position of the implant. The control group of 13 patients underwent immediate implantation with a free hand operation, whereas the experimental group of 13 patients underwent preparation and implant insertion under the guidance of a surgical guide. Bone grafting was performed, and a good initial stability was achieved. After 5 to 6 months, osseointegration was achieved, and the final restoration was delivered. After surgery, the accuracy of the three-dimensional position of the implants was measured, and at the 6 month return visit, the modified Plaque Index (mPLI), modified Sulcular Bleeding Index (mSBI) and probing depth (PD) were measured. Results In the control group and experimental group, the vertical errors at the top of the implants were 1.246 ± 0.072 mm and 0.628 ± 0.046 mm (t = 26.078, P < 0.001), respectively, and the horizontal errors were 1.563 ± 0.086 mm and 0.546 ± 0.056 mm (t = 35.813, P < 0.001), respectively; and the vertical errors at the root of the implants were 1.352 ± 0.042 mm and 0.532 ± 0.030 mm (t = 57.021, P < 0.001), respectively, and the horizontal errors were 1.645 ± 0.076 mm and 0.625 ± 0.072 mm (t = 35.086, P < 0.001), respectively. For the experimental group, the mPLI value was 0.923 ± 0.760, the mSBI value was 0.846 ± 0.689, and the PD value was 3.460 ± 0.713 mm, which were significantly lower than those of the control group. For the control group, the mPLI value was 1.769 ± 0.927 (t = 2.546, P = 0.018), the mSBI value was 1.692 ± 0.947 (t = 22.605, P = 0.016) and the PD value was (4.579 ± 0.475) mm (t = 4.709, P < 0.001). Conclusion A digital surgical guide plate can increase the precision of immediate implantation and the peri-implant health in the molar area.

Key words: Immediate implant placement, Molar area, Digital surgical guide, Three-dimensional position, Accuracy, Modified plaque index, Modified sulcular bleeding index, Probing depth

CLC Number: 

  • R783.6

Figure 1

Software-designed 3D position of the implant and digital surgical guide plate"

Figure 2

Digital guide plate used in immediate implant placement after minimally invasive tooth extraction"

Figure 3

Software matching between the preoperative and postoperative CBCT images and measurement of the deviation between the planned implant placement and the actual implant placement"

Table 1

Inspection of the accuracy of the 3D positioning of the implants $\bar{x}$ ± s,mm"

位置 对照组 试验组 t P
顶端垂直向误差 1.246 ± 0.072 0.628 ± 0.046 26.078 < 0.001
顶端水平向误差 1.563 ± 0.086 0.546 ± 0.056 35.813 < 0.001
根端垂直向误差 1.352 ± 0.042 0.532 ± 0.030 57.021 < 0.001
根端水平向误差 1.645 ± 0.076 0.625 ± 0.072 35.086 < 0.001

Table 2

Comparison of the modified plaque index, modified bleeding index and probing depth for the implantation restorations $\bar{x}$± s"

指标 对照组 试验组 t P
mPLI 1.769 ± 0.927 0.923 ± 0.760 2.546 0.018
mSBI 1.692 ± 0.947 0.846 ± 0.689 2.605 0.016
PD(mm) 4.579 ± 0.475 3.460 ± 0.713 4.709 < 0.001
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