Beretta Mario, Poli Pier Paolo, Maiorana Carlo
Department of Dental Implants, U.O.C. Maxillofacial Surgery and Odontostomatology, Fondazione IRCCS Cà Granda, State University of Milan, Milan, Italy.
J Periodontal Implant Sci. 2014 Aug;44(4):184-93. doi: 10.5051/jpis.2014.44.4.184. Epub 2014 Aug 28.
The aim of the present study was to evaluate the in vivo accuracy of flapless, computer-aided implant placement by comparing the three-dimensional (3D) position of planned and placed implants through an analysis of linear and angular deviations.
Implant position was virtually planned using 3D planning software based on the functional and aesthetic requirements of the final restorations. Computer-aided design/computer-assisted manufacture technology was used to transfer the virtual plan to the surgical environment. The 3D position of the planned and placed implants, in terms of the linear deviations of the implant head and apex and the angular deviations of the implant axis, was compared by overlapping the pre- and postoperative computed tomography scans using dedicated software.
The comparison of 14 implants showed a mean linear deviation of the implant head of 0.56 mm (standard deviation [SD], 0.23), a mean linear deviation of the implant apex of 0.64 mm (SD, 0.29), and a mean angular deviation of the long axis of 2.42° (SD, 1.02).
In the present study, computer-aided flapless implant surgery seemed to provide several advantages to the clinicians as compared to the standard procedure; however, linear and angular deviations are to be expected. Therefore, accurate presurgical planning taking into account anatomical limitations and prosthetic demands is mandatory to ensure a predictable treatment, without incurring possible intra- and postoperative complications.
本研究的目的是通过分析线性和角度偏差,比较计划植入和实际植入种植体的三维(3D)位置,以评估无瓣计算机辅助种植体植入的体内准确性。
根据最终修复体的功能和美学要求,使用3D规划软件对种植体位置进行虚拟规划。采用计算机辅助设计/计算机辅助制造技术将虚拟规划转移到手术环境中。通过使用专用软件重叠术前和术后的计算机断层扫描,比较计划植入和实际植入种植体的3D位置,包括种植体头部和根尖的线性偏差以及种植体长轴的角度偏差。
对14枚种植体的比较显示,种植体头部的平均线性偏差为0.56毫米(标准差[SD],0.23),种植体根尖的平均线性偏差为0.64毫米(SD,0.29),长轴的平均角度偏差为2.42°(SD,1.02)。
在本研究中,与标准手术相比,计算机辅助无瓣种植手术似乎为临床医生提供了几个优势;然而,线性和角度偏差是可以预期的。因此,必须进行精确的术前规划,考虑解剖学限制和修复需求,以确保可预测的治疗效果,避免可能的术中及术后并发症。