Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland.
Department of Oral Medicine, Infection and Immunity, School of Dental Medicine, Harvard University.
Clin Implant Dent Relat Res. 2019 Feb;21(1):101-107. doi: 10.1111/cid.12705. Epub 2018 Dec 27.
The aim of this study was to evaluate the effect of guided sleeve height, drilling distance, and guided key height on accuracy of static Computer-Assisted Implant Surgery (sCAIS).
Pre and post-operative positions of implants placed in duplicate dental models were compared and recorded after placement of implants according to a standardized treatment planning and execution sCAIS protocol. Guided sleeve heights: 2 mm, 4 mm, 6 mm and guided key heights: 1 mm and 3 mm were equally randomized in six test groups with varying implant lengths (10-16 mm) and surgical drilling protocols. The mean crestal and apical three-dimensional (3D) deviation, as well as the angular deviation were calculated for each group. Data was analyzed using multivariate analysis anova. P values less than .05 were considered statistically significant. All P values of post-hoc tests were corrected for multiple testing using Bonferroni-Holm's adjustment method.
3D implant positioning accuracy was not significantly affected by the difference in sleeve height alone or by the implant length alone (P > .05). However, 3D and angular deviation values became significantly higher as the total drilling distance below the guided sleeve increased and significantly became lower as the guided key height above the sleeve increased. 18 mm drilling distance resulted in a significantly higher deviation, when compared to 14 mm or 16 mm drilling distances, irrespective of sleeve height or implant length (P < .01). 3 mm key height resulted in significantly less 3D deviation than 1 mm key height (P < .01).
Decreasing the drilling distance below the guided sleeve, by using shorter sleeve heights or shorter implants can significantly increase the accuracy of sCAIS.
本研究旨在评估引导套管高度、钻孔距离和引导键高度对静态计算机辅助种植手术(sCAIS)精度的影响。
在按照标准化治疗计划和执行 sCAIS 方案放置种植体后,比较并记录重复牙模中种植体的术前和术后位置。引导套管高度:2mm、4mm、6mm 和引导键高度:1mm 和 3mm 在具有不同种植体长度(10-16mm)和手术钻孔方案的六个测试组中随机等分配。计算每组的平均牙槽嵴和根尖三维(3D)偏差以及角度偏差。使用多元方差分析对数据进行分析。P 值小于.05 被认为具有统计学意义。后验检验的所有 P 值均使用 Bonferroni-Holm 调整方法进行了多重检验校正。
3D 种植体定位精度不受套管高度差异或种植体长度差异的显著影响(P >.05)。然而,随着引导套管下方总钻孔距离的增加,3D 和角度偏差值显著升高,随着套管上方引导键高度的增加,偏差值显著降低。与 14mm 或 16mm 钻孔距离相比,18mm 钻孔距离导致的偏差显著更高,而与套管高度或种植体长度无关(P <.01)。3mm 键高度导致的 3D 偏差显著小于 1mm 键高度(P <.01)。
通过使用较短的套管高度或较短的种植体来减少引导套管下方的钻孔距离,可以显著提高 sCAIS 的精度。