Faculty of Dentistry, Oral and Maxillofacial Surgery Department, British University of Egypt, Cairo, Egypt.
Faculty of Oral and Dental Medicine, Oral and Maxillofacial Surgery Department, Cairo University, Cairo, Egypt.
Clin Implant Dent Relat Res. 2018 Aug;20(4):501-506. doi: 10.1111/cid.12610. Epub 2018 Apr 23.
The introduction of CAD/CAM technology allowed clinicians to carry out complex procedures with a high level of precision and reproducibility and minimize the risk of injury during the procedure.
The aim of the present study is to evaluate the efficacy of the CAD/CAM surgical guide during chin harvesting procedures in reducing the risk of neurosensory damage and patient morbidity compared with the standard technique.
About 20 cases of autogenous block chin harvest were randomly into two groups. The first group received computer-guided chin block harvest while the second group received autogenous block chin harvest using the standard approach.
In the guided group, out of the 10 subjects, 2 subjects presented with wound dehiscence which resolved within 1 month. No teeth showed any negative pulp sensitivity results. The pointed-Blunt test and 2 point discrimination tests showed a single case of neurodeficits at 1 week follow-up appointment which resolved within 1 month. In the nonguided group, out of the 10 subjects, 1 case presented with wound dehiscence that resolved completely within 1 month. Pulp vitality test showed negative results in 29.4% of the involved teeth at 1 week which decreased to 9.8% and 3.9% at 1 and 6 months follow-up, respectively. The pointed blunt test revealed 3 subjects with neurodeficits at 1 week, out of which 2 subjects showed persisting symptoms at 6 months follow-up. The 2 point discrimination test showed 3 subjects with neurodeficits, out of which two subjects showed persistent symptoms with no resolution at the 6 months follow-up.
Within the limits of this study, computer-guided chin harvest shows promising results in the reduction of neurosensory complications following harvesting procedures and presents as a safe alternative to the standard technique.
CAD/CAM 技术的引入使临床医生能够以高精度和可重复性进行复杂的手术，并最大限度地降低手术过程中的损伤风险。
本研究旨在评估 CAD/CAM 手术导板在减少神经感觉损伤风险和患者发病率方面的效果，与标准技术相比，在颏部取骨手术中。
大约 20 例自体颏部骨块采集被随机分为两组。第一组接受计算机引导的颏骨块采集，而第二组接受标准方法的自体颏骨块采集。
在引导组中，10 名受试者中有 2 名出现伤口裂开，1 个月内愈合。没有牙齿出现任何负面牙髓敏感结果。尖钝测试和 2 点辨别测试显示，在 1 周随访时，有 1 例神经缺损，1 个月内愈合。在非引导组中，10 名受试者中有 1 例出现伤口裂开，1 个月内完全愈合。牙髓活力测试显示，1 周时有 29.4%的受累牙齿呈阴性结果，1 个月时降至 9.8%，6 个月时降至 3.9%。尖钝测试显示 1 周时有 3 例神经缺损，其中 2 例在 6 个月随访时仍有症状。2 点辨别测试显示 3 例神经缺损，其中 2 例在 6 个月随访时仍有症状，无缓解。
在本研究范围内，计算机引导的颏部采集在减少采集术后神经感觉并发症方面显示出有前景的结果，并作为标准技术的安全替代方法。
