Department of Periodontology and Oral Implantology, Dental School, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium.
Clin Implant Dent Relat Res. 2012 Apr;14(2):293-303. doi: 10.1111/j.1708-8208.2009.00255.x. Epub 2009 Nov 10.
Flapless implant placement using guided surgery is widespread, although clinical publications on the precision are lacking.
The purpose of this study was to evaluate the accuracy of mucosal-supported stereolithographic guides in the edentulous maxillae.
Seventy-eight OsseoSpeed™ implants (Astra Tech AB, Mölndal, Sweden) of 3.5 to 5 mm width and 8 to 15 mm length were installed consecutively in 13 patients. Implants were functionally loaded on the day of surgery, and implant location was assessed with a computed tomography scan. Mimics 9.0 software (Materialise N.V., Leuven, Belgium) was used to fuse the images of the virtually planned and actually placed implants, and the locations, axes, and interimplant distances were compared.
One implant was lost shortly after insertion because of abscess formation caused by remnants of impression material. Seventy-seven implant locations were analyzed. The deviation at the entrance point ranged between 0.29 mm and 2.45 mm (SD: 0.44 mm), with a mean of 0.91 mm. Average angle deviation was 2.60° (range 0.16-8.86°; SD: 1.61°). At the apical point, the deviation ranged between 0.32 mm and 3.01 mm, with a mean of 1.13 mm (SD: 0.52 mm). The mean deviation of the coronal and apical interimplant distance was respectively 0.18 mm (range 0.07-0.32 mm; SD: 0.15) and 0.33 mm (range 0.12-0.69 mm; SD: 0.28). These deviations are lower than the global coronal and apical deviations.
The present study is the first to investigate the accuracy of stereolithographic, full, mucosally supported surgical guides in the treatment of fully edentulous maxillae. Clinicians should be warned that angular and linear deviations are to be expected. Short implants show significantly lower apical deviations compared with longer ones. Reasons for implant deviations are multifactorial; however, it is unlikely that the production process of the guide has a major impact on the total accuracy of a mucosal-supported stereolithographic guide.
无瓣种植体使用导板引导植入已广泛应用，尽管临床文献对其精度缺乏报道。
本研究旨在评估无牙颌牙槽嵴黏膜支持式立体光刻导板的准确性。
连续将 78 颗 OsseoSpeed™种植体（AstraTech AB，Mölndal，瑞典）植入 13 名患者的无牙颌中，种植体宽度 3.5-5mm，长度 8-15mm。术中即刻负载种植体，术后即刻行 CT 扫描评估种植体位置。使用 Mimics 9.0 软件（Materialise NV，Leuven，比利时）融合虚拟规划和实际植入种植体的图像，并比较种植体的位置、轴位和种植体间距离。
1 颗种植体植入后不久因残留印模材料导致脓肿形成而脱落。共分析了 77 个种植体位置。入口处的偏差范围为 0.29-2.45mm（标准差：0.44mm），平均为 0.91mm。平均角度偏差为 2.60°（范围 0.16-8.86°；标准差：1.61°）。在根尖处，偏差范围为 0.32-3.01mm，平均为 1.13mm（标准差：0.52mm）。冠根和根尖种植体间距离的平均偏差分别为 0.18mm（范围 0.07-0.32mm；标准差：0.15mm）和 0.33mm（范围 0.12-0.69mm；标准差：0.28mm）。这些偏差低于整体冠根和根尖偏差。
本研究首次评估了全牙列无牙颌牙槽嵴黏膜支持式立体光刻导板的准确性。临床医生应注意到会存在角度和线性偏差。短种植体的根尖偏差明显低于长种植体。种植体偏差的原因是多因素的；然而，导板制作过程不太可能对黏膜支持式立体光刻导板的整体精度产生重大影响。
