Jorba-García A, Figueiredo R, González-Barnadas A, Camps-Font O, Valmaseda-Castellón E
Facultat de medicina i ciències de la salut, Campus de Bellvitge, Universitat de Barcelona (UB), Pavelló de Govern; 2a planta, Despatx 2.9, C/ Feixa Llarga s/n, E-08907 L'Hospitalet de Llobregat, Spain,
Med Oral Patol Oral Cir Bucal. 2019 Jan 1;24(1):e76-e83. doi: 10.4317/medoral.22785.
BACKGROUND: To compare the accuracy of implant placement using the conventional freehand method and a dynamic navigation system; to assess the role of the surgeon's experience in implant placement using these two methods. MATERIAL AND METHODS: A randomized in-vitro study was conducted. Six resin mandible models and 36 implants were used. Two researchers with differing clinical experience (novice and experienced) placed implants using either the Navident dynamic navigation system (navigation group) or the conventional freehand method (freehand group). Accuracy was measured by overlaying the real position in the postoperative CBCT on the virtual presurgical placement of the implant in a CBCT image. Descriptive and bivariate analyses of the data were performed. RESULTS: The navigation group showed significantly higher accuracy for all the variables studied except 3D entry and depth deviation. This system significantly enhanced the accuracy of the novice professional in several outcome variables in comparison with the freehand implant placement method. However, when the implants were placed by the experienced clinician the dynamic navigation system only improved angulation deviation. Significant differences were found between the 2 professionals when the freehand method was employed. Similar deviations were observed for the implants placed with the navigation system. CONCLUSIONS: Dynamic computer assisted surgery systems allow more accurate implant placement in comparison with the conventional freehand method, regardless of the surgeon's experience. However, this system seems to offer more advantages to novice professionals, since it allows them to reduce their deviations significantly and achieve similar results to those of experienced clinicians.
背景:比较使用传统徒手方法和动态导航系统进行种植体植入的准确性;评估外科医生的经验在使用这两种方法进行种植体植入中的作用。 材料与方法:进行了一项随机体外研究。使用了六个树脂下颌骨模型和36颗种植体。两名临床经验不同的研究人员(新手和有经验的)分别使用Navident动态导航系统(导航组)或传统徒手方法(徒手组)植入种植体。通过将术后CBCT中的实际位置与CBCT图像中种植体的虚拟术前放置位置进行叠加来测量准确性。对数据进行了描述性和双变量分析。 结果:除三维入口和深度偏差外,导航组在所有研究变量上均显示出显著更高的准确性。与徒手种植体植入方法相比,该系统在几个结果变量上显著提高了新手专业人员的准确性。然而,当由经验丰富的临床医生植入种植体时,动态导航系统仅改善了角度偏差。采用徒手方法时,两名专业人员之间存在显著差异。使用导航系统植入的种植体观察到类似的偏差。 结论:与传统徒手方法相比,动态计算机辅助手术系统可实现更准确的种植体植入,无论外科医生的经验如何。然而,该系统似乎为新手专业人员提供了更多优势,因为它使他们能够显著减少偏差并取得与经验丰富的临床医生相似的结果。
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