Huh Young-June, Choi Bo-Ram, Huh Kyung-Hoe, Yi Won-Jin, Heo Min-Suk, Lee Sam-Sun, Choi Soon-Chul
Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea.
Imaging Sci Dent. 2012 Sep;42(3):139-46. doi: 10.5624/isd.2012.42.3.139. Epub 2012 Sep 21.
An individual surgical stent fabricated from computed tomography (CT) data, called a CT-guided stent, would be useful for accurate installation of implants. The purpose of the present study was to introduce a newly developed CT-guided stent with a simple design and evaluate the accuracy of the stent placement.
A resin template was fabricated from a hog mandible and a specially designed plastic plate, with 4 metal balls inserted in it for radiographic recognition, was attached to the occlusal surface of the template. With the surgical stent applied, CT images were taken, and virtual implants were placed using software. The spatial positions of the virtually positioned implants were acquired and implant guiding holes were drilled into the surgical stent using a specially designed 5-axis drilling machine. The surgical stent was placed on the mandible and CT images were taken again. The discrepancy between the central axis of the drilled holes on the second CT images and the virtually installed implants on the first CT images was evaluated.
The deviation of the entry point and angulation of the central axis in the reference plane were 0.47±0.27 mm, 0.57±0.23 mm, and 0.64±0.16°, 0.57±0.15°, respectively. However, for the two different angulations in each group, the 20° angulation showed a greater error in the deviation of the entry point than did the 10° angulation.
The CT-guided template proposed in this study was highly accurate. It could replace existing implant guide systems to reduce costs and effort.
由计算机断层扫描(CT)数据制作的个体化手术导板,即CT引导导板,有助于准确植入种植体。本研究的目的是介绍一种新开发的设计简单的CT引导导板,并评估导板放置的准确性。
用猪下颌骨制作树脂模板,并将一块特别设计的塑料板附着在模板的咬合面上,塑料板内插入4个金属球用于放射影像识别。应用手术导板后进行CT扫描,并使用软件植入虚拟种植体。获取虚拟种植体的空间位置,并用一台特别设计的五轴钻孔机在手术导板上钻出种植体引导孔。将手术导板放置在下颌骨上,再次进行CT扫描。评估第二次CT图像上钻孔中心轴与第一次CT图像上虚拟植入种植体之间的差异。
参考平面内进针点偏差和中心轴角度偏差分别为0.47±0.27mm、0.57±0.23mm和0.64±0.16°、0.57±0.15°。然而,在每组的两种不同角度中,20°角度的进针点偏差误差比10°角度更大。
本研究提出的CT引导模板具有很高的准确性。它可以替代现有的种植体导向系统,以降低成本和工作量。