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基于锥形束计算机断层扫描的实验室手术模板在部分无牙颌患者中的准确性评估。

Accuracy assessment of cone beam computed tomography-derived laboratory-based surgical templates on partially edentulous patients.

机构信息

Department of Oral Surgery, University of Mainz, Mainz, GermanyDepartment of Prosthetic Dentistry, University of Mainz, Mainz, Germany.

出版信息

Clin Oral Implants Res. 2012 Feb;23(2):137-143. doi: 10.1111/j.1600-0501.2011.02176.x. Epub 2011 Mar 28.

Abstract

OBJECTIVES

The aim of the present prospective clinical study was to evaluate the match between the positions and axes of the virtually planned and the placed implants using laboratory-based surgical guides generated from cone beam computed tomography (CBCT).

MATERIALS AND METHODS

A total of 132 implants were placed with the aid of 3D-based transfer templates in 52 consecutive partially edentulous patients between April 2008 and March 2010. After individual adaptation of the scan templates and CBCT scanning, the acquired data for virtual implant planning and simulation were processed using the med3D software program. After finalizing the virtual placement of the implants the radiographic templates were converted into operative guides containing titanium sleeves for cavity preparation. Preoperative planning was merged with postoperative CBCT data to identify linear and angular deviations between virtually planned and placed implants.

RESULTS

Compared with the planned implants the installed implants showed linear deviations in the median at the neck and apex of 0.27 mm (range 0.01-0.97 mm), and of 0.46 mm (range 0.03-1.38 mm), respectively. The angle deviation was 1.84° in median, with a range of 0.07-6.26°. The extent of deviation depends on the size of the tooth gap and the distribution of the remaining teeth.

CONCLUSION

The results of this study suggested that laboratory-fabricated surgical guides using CBCT data may be reliable in implant placement under prosthodontic considerations in partial edentulism.

摘要

目的

本前瞻性临床研究的目的是评估基于实验室的锥形束 CT(CBCT)制作的手术导板虚拟规划和实际植入的种植体位置和轴之间的匹配程度。

材料与方法

2008 年 4 月至 2010 年 3 月期间,52 例连续部分缺牙患者在 3D 转移模板的辅助下共植入 132 枚种植体。扫描模板和 CBCT 扫描个体化适配后,使用 med3D 软件程序处理获取的虚拟种植体规划和模拟数据。完成虚拟种植体放置后,将放射学模板转换为含有钛套管的手术导板,用于准备种植体腔。将术前规划与术后 CBCT 数据融合,以确定虚拟规划和实际植入种植体之间的线性和角度偏差。

结果

与计划种植体相比,安装的种植体在颈部和根尖的中位数处的线性偏差分别为 0.27mm(范围 0.01-0.97mm)和 0.46mm(范围 0.03-1.38mm)。角度偏差中位数为 1.84°,范围为 0.07-6.26°。偏差程度取决于牙齿间隙的大小和剩余牙齿的分布。

结论

本研究结果表明,基于 CBCT 数据制作的实验室手术导板在部分缺牙的修复考虑下植入种植体时可能具有可靠性。

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