Oral and Maxillofacial Surgery Department, Universitat Internacional de Catalunya, Spain; Department of Periodontics and Oral Medicine, University of Michigan, School of Dentistry, Ann Arbor, MI, United States.
Department of Periodontics and Oral Medicine, University of Michigan, School of Dentistry, Ann Arbor, MI, United States.
Ann Anat. 2019 Sep;225:1-10. doi: 10.1016/j.aanat.2019.04.005. Epub 2019 May 4.
This review elucidates the advantages and disadvantages of the different implant navigation methods to assist the precise surgical placement of dental implants. Implant navigation surgery can be classified into: dynamic and static navigation, and static navigation can further be divided into full (FG)- and half-guided (HG) implant surgery. The HG implant placement includes the drilling-guided, pilot-drill guided, and the non-computed guided approaches. In dynamic navigation, the bone drilling and the implant placement are completely tracked with a specific software; while the static navigation refers to the use of static surgical templates. The FG associated with flapless surgery and teeth/crown supported guides has demonstrated the highest accuracy, followed by the drilling and pilot HG surgery that may provide comparable results, while the non-computer HG and FH implant placement provide the least accuracy in transmitting the implant positioning from the pre-surgical planning to the patient. Additionally, flapless implant surgery is related to reduced pain, less analgesic consumption, less swelling, shorter chair-time, and reduced risk of hemorrhage while achieving greater patient satisfaction. Nevertheless, other methods such as non-computer HG and FH implant surgery procedures require more surgical experience to overcome their limitations. There is still limited evidence to support dynamic surgery, and further investigations are needed.
本文阐述了不同种植体导航方法在辅助精确种植体手术中的优缺点。种植体导航手术可分为：动态和静态导航，而静态导航可进一步分为完全（FG）和半（HG）引导种植体手术。HG 种植体植入包括钻孔引导、导钻引导和非计算机引导方法。在动态导航中，骨钻和种植体的放置都通过特定软件进行完全跟踪；而静态导航是指使用静态手术模板。无瓣手术和牙/冠支持导板的 FG 导航具有最高的准确性，其次是钻孔和导钻 HG 手术，其结果可能相当，而非计算机 HG 和 FH 种植体植入在将种植体定位从术前规划传输到患者方面准确性最低。此外，无瓣种植手术与减轻疼痛、减少镇痛药消耗、减少肿胀、缩短椅旁时间和降低出血风险有关，同时患者满意度更高。然而，非计算机 HG 和 FH 种植体手术等其他方法需要更多的手术经验来克服其局限性。目前还没有足够的证据支持动态手术，需要进一步的研究。
