Pettersson Andreas, Kero Timo, Söderberg Rikard, Näsström Karin
Research Fellow, Department of Dental Medicine, Division of Image and Functional Odontology, Karolinska Institute, Huddinge, Sweden.
Research Fellow, Department of Product and Production Development, Chalmers University of Technology, Göteborg, Sweden.
J Prosthet Dent. 2014 Dec;112(6):1472-8. doi: 10.1016/j.prosdent.2014.01.029. Epub 2014 Jun 30.
Studies of guided implant surgery have identified various methods that could influence accuracy. The present investigation was designed to limit the factors contributing to accuracy and to compare the results for 5 different surgeons.
The purpose of this study was to evaluate any deviation between virtually planned and actually placed implants by 5 surgeons performing computer-aided design/computer-aided manufacturing (CAD/CAM)-guided implant surgery on duplicate plastic models.
Five surgeons participated in the study, and each received 5 plastic maxillary jaw models. Thus, 25 models were used for implant placement with CAD/CAM-fabricated surgical templates. Each model contained 6 implants; therefore, a total of 150 implants were placed. The virtually planned and actually placed implant positions were compared for the apex, hexagon, depth, and angle with 2 computed tomography scans that were matched with voxel-based registration software. In addition, any differences in the 4 parameters among the surgeons were statistically tested. The data were analyzed with the t test, ANOVA, and Scheffé test (α=.05).
A statistically significant difference between the virtually planned and actually placed implant positions was observed for 3 of the 4 outcome variables (the apex, hexagon, and depth; P<.05). A statistically significant difference was also noted among all surgeons regarding the positions of the apex, depth, and angle.
The results of this study provide a better understanding of the differences in accuracy between surgeons when using a CAD/CAM surgical technique. There was a significant difference between the virtually planned and actually placed implant positions and between the surgeons for some of the variable parameters analyzed. The null hypothesis was thus rejected.
引导式种植手术的研究已经确定了各种可能影响准确性的方法。本研究旨在限制影响准确性的因素，并比较5位不同外科医生的手术结果。
本研究的目的是评估5位外科医生在复制塑料模型上进行计算机辅助设计/计算机辅助制造（CAD/CAM）引导式种植手术时，虚拟计划植入位置与实际植入位置之间的任何偏差。
5位外科医生参与了本研究，每人接收5个塑料上颌颌骨模型。因此，共使用25个模型通过CAD/CAM制作的手术导板进行种植体植入。每个模型包含6个种植体；因此，总共植入了150个种植体。通过与基于体素的配准软件匹配的2次计算机断层扫描，比较虚拟计划植入位置与实际植入位置在根尖、六边形、深度和角度方面的差异。此外，还对医生之间4个参数的任何差异进行了统计学检验。数据采用t检验、方差分析和谢费检验（α=0.05）进行分析。
在4个结果变量中的3个（根尖、六边形和深度；P<0.05）观察到虚拟计划植入位置与实际植入位置之间存在统计学显著差异。在所有医生之间，根尖、深度和角度的位置也存在统计学显著差异。
本研究结果有助于更好地理解使用CAD/CAM手术技术时医生之间准确性的差异。在分析的一些可变参数方面，虚拟计划植入位置与实际植入位置之间以及医生之间存在显著差异。因此，原假设被拒绝。
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