Vercruyssen Marjolein, Cox Catherine, Naert Ignace, Jacobs Reinhilde, Teughels Wim, Quirynen Marc
Department of Oral Health Sciences, Periodontology, Faculty of Medicine, Catholic University Leuven, University Hospitals Leuven, Leuven, Belgium.
Department of Oral Health Sciences, Prosthetic Dentistry, Faculty of Medicine, Catholic University Leuven, University Hospitals Leuven, Leuven, Belgium.
Clin Oral Implants Res. 2016 Apr;27(4):427-32. doi: 10.1111/clr.12583. Epub 2015 Mar 28.
To assess the accuracy and patient-centered outcome of a novel guided surgery system for placing implants in an edentulous maxilla.
Fifteen consecutive patients with sufficient bone to place six implants in the maxilla were randomly assigned to the immediate loading (with delivery of the final prosthesis within 24 h) or the delayed loading treatment group. Accuracy was assessed by matching the planning CT with a postoperative CBCT. Patient-centered outcome measures were the Dutch version of the McGill Pain Questionnaire (MPQ-DLV), the health-related quality of life instrument (HRQOL), visual analog scales (VAS), the duration of the procedure, and the analgesic doses taken each day.
A mean deviation was found at the entry point of 0.9 mm (range: 0.1-4.5, median 0.8) and of 1.2 mm (range: 0.2-4.9, median 1.1) at the apex, and an angular deviation of 2.7° (range: 0.0-6.6°, median 2.3) was observed. The mean vertical deviation was 0.5 mm (range: 0.0-3.2, median 0.4), and in a horizontal direction, this was 0.7 mm (range: 0.1-3.1, median 0.6). The mean deviation in mesio-distal direction was 0.5 mm (range: 0.0-2.3, median 0.4) and in bucco-lingual direction 0.5 mm ± 0.4 (range: 0.0-2.2, median 0.3). No statistical differences could be shown between treatment groups on pain response (MPQ-DLV), treatment perception (VAS), number or kind of pain killers, or for the HRQOLI instrument.
The accuracy of a novel CT-based guide is comparable to the accuracy data of other systems. Within the limitations of this study, no difference could be found in patient-centered outcome variables after immediate or delayed loading.
评估一种用于在上颌无牙区植入种植体的新型导向手术系统的准确性及以患者为中心的治疗效果。
连续纳入15例上颌骨有足够骨量可植入6枚种植体的患者，随机分为即刻负重（在24小时内戴入最终修复体）或延期负重治疗组。通过将术前规划CT与术后CBCT进行匹配来评估准确性。以患者为中心的治疗效果指标包括荷兰版麦吉尔疼痛问卷（MPQ-DLV）、健康相关生活质量量表（HRQOL）、视觉模拟量表（VAS）、手术时长以及每日服用的镇痛药物剂量。
发现种植体植入点的平均偏差为0.9毫米（范围：0.1 - 4.5，中位数0.8），根尖处平均偏差为1.2毫米（范围：0.2 - 4.9，中位数1.1），观察到的角度偏差为2.7°（范围：0.0 - 6.6°，中位数2.3）。平均垂直偏差为0.5毫米（范围：0.0 - 3.2，中位数0.4），水平方向为0.7毫米（范围：0.1 - 3.1，中位数0.6）。近远中方向的平均偏差为0.5毫米（范围：0.0 - 2.3，中位数0.4），颊舌方向为0.5毫米±0.4（范围：0.0 - 2.2，中位数0.3）。治疗组之间在疼痛反应（MPQ-DLV）、治疗感受（VAS）、止痛药物的数量或种类以及HRQOLI量表方面均未显示出统计学差异。
一种新型基于CT的导向系统的准确性与其他系统的准确性数据相当。在本研究的局限性范围内，即刻负重或延期负重后，以患者为中心的治疗效果变量未发现差异。
