Department of Diagnostic Imaging, School of Medicine, Federal University of São Paulo, São Paulo, Brazil.
J Periodontol. 2012 Apr;83(4):410-9. doi: 10.1902/jop.2011.110115. Epub 2011 Aug 5.
Computer-aided dental implant placement seems to be useful for placing implants by using a flapless approach. However, evidence supporting such applications is scarce. The aim of this study is to evaluate the accuracy of and complications that arise from the use of selective laser sintering surgical guides for flapless dental implant placement and immediate definitive prosthesis installation.
Sixty implants and 12 prostheses were installed in 12 patients (four males and eight females; age range: 41 to 71 years). Lateral (coronal and apical) and angular deviations between virtually planned and placed implants were measured. The patients were followed up for 30 months, and surgical and prosthetic complications were documented.
The mean ± SD angular, coronal, and apical deviations were 6.53° ± 4.31°, 1.35 ± 0.65 mm, and 1.79 ± 1.01 mm, respectively. Coronal and apical deviations of <2 mm were observed in 82.67% and 58.33% of the implants, respectively. The total complication rate was 34.41%; this rate pertained to complications such as pulling of the soft tissue from the lingual surface during drilling, insertion of an implant that was wider than planned, implant instability, prolonged pain, midline deviation of the prosthesis, and prosthesis fracture. The cumulative survival rates for implants and prostheses were 98.33% and 91.66%, respectively.
The mean lateral deviation was <1.8 mm, and the mean angular deviation was 6.53°. However, 41.67% of the implants had apical deviation >2 mm. The complication rate was 34.4%. Hence, computer-aided dental implant surgery still requires improvement and should be considered as in the developmental stage.
计算机辅助牙种植似乎可以通过无瓣技术来放置种植体，从而提高种植体放置的准确性。然而，支持这种应用的证据还很缺乏。本研究旨在评估无瓣牙种植术中使用选择性激光烧结（selective laser sintering，SLS）手术导板的准确性及相关并发症，以及即刻修复体安装的效果。
12 名患者（4 名男性，8 名女性；年龄 41~71 岁）共植入 60 颗种植体并安装 12 个修复体。测量虚拟设计与实际植入种植体之间的侧向（冠向和根尖向）和角度偏差。随访 30 个月，记录手术和修复体并发症。
平均±标准差的角度、冠向和根尖向偏差分别为 6.53°±4.31°、1.35±0.65mm 和 1.79±1.01mm。82.67%和 58.33%的种植体冠向和根尖向偏差<2mm。总的并发症发生率为 34.41%，主要包括在种植体植入过程中舌侧软组织被牵拉、植入体比计划的更宽、种植体稳定性差、疼痛持续时间长、修复体中线偏离、修复体折断等。种植体和修复体的累积存活率分别为 98.33%和 91.66%。
平均侧向偏差<1.8mm，平均角度偏差 6.53°。然而，41.67%的种植体根尖向偏差>2mm。并发症发生率为 34.4%。因此，计算机辅助牙种植手术仍需改进，目前尚处于发展阶段。
