Widmann Gerlig, Widmann Roland, Widmann Ekkehard, Jaschke Werner, Bale Reto
Interdisciplinary Stereotactic Intervention and Planning Laboratory Innsbruck (SIP-Lab), Innsbruck Medical University, Department of Radiology, Clinical Division of Diagnostic Radiology I, Austria.
Int J Oral Maxillofac Implants. 2007 Jan-Feb;22(1):72-8.
The purpose of this study was to evaluate in vitro the accuracy of 2 methods for computerized tomography (CT)-guided template production via a surgical navigation system.
Oral implants were planned on CT scans of standard dental stone casts with integrated target pellets. Method 1 used the aiming device of the navigation system for direct positioning of 2-mm surgical bur tubes on the dental stone casts. In method 2, the aiming device was used to guide drillings into the dental stone casts, and the surgical bur tubes were indirectly positioned by metal rods inserted in the drill holes. In both methods the bur tubes were affixed in a resin template. The accuracy of the obtained templates was evaluated by postoperative CT scans using descriptive statistics and the Student t test (P < .05 considered significant).
The mean accuracy (normal deviation from the defined targets) of method 1 was 0.5 +/- 0.3 mm (max 1.2 mm; n = 56). Mean accuracy for method 2 was 0.6 +/- 0.3 mm (max 1.4 mm; n = 56). No significant difference was found between the maxillary and mandibular templates.
Conventional navigation systems already installed in many hospitals may be used for surgical template production. In contrast to intraoperative tool tracking, there is no need for patient tracking, and the planned implant axis can be rigidly secured as precisely as technically feasible with the help of an aiming device.
Both methods of bur tube positioning may represent a precise means for CT-guided template production.
本研究旨在体外评估通过手术导航系统进行计算机断层扫描（CT）引导模板制作的两种方法的准确性。
在带有集成靶丸的标准牙石模型的CT扫描上规划口腔种植体。方法1使用导航系统的瞄准装置将2毫米手术钻针管直接定位在牙石模型上。在方法2中，使用瞄准装置引导钻入牙石模型，手术钻针管通过插入钻孔中的金属棒间接定位。在两种方法中，钻针管都固定在树脂模板中。使用描述性统计和学生t检验（P <.05认为具有显著性）通过术后CT扫描评估获得的模板的准确性。
方法1的平均准确性（与定义目标的正常偏差）为0.5 +/- 0.3毫米（最大1.2毫米；n = 56）。方法2的平均准确性为0.6 +/- 0.3毫米（最大1.4毫米；n = 56）。在上颌和下颌模板之间未发现显著差异。
许多医院已经安装的传统导航系统可用于手术模板制作。与术中工具跟踪不同，无需患者跟踪，并且借助瞄准装置可以在技术可行的情况下尽可能精确地牢固固定计划的种植体轴。
两种钻针管定位方法都可能是CT引导模板制作的精确方法。
