Department of Periodontics, School of Dentistry, Virginia Commonwealth University, Richmond, Virginia, USA.
Department of General Practice, School of Dentistry, Virginia Commonwealth University, Richmond, Virginia, USA.
Eur J Dent Educ. 2019 Nov;23(4):415-423. doi: 10.1111/eje.12447. Epub 2019 Jun 13.
INTRODUCTION: Recent computer-guided dynamic navigation systems promise a novel training approach for implant surgery. This study aimed to examine learning progress in placement of dental implants among dental students using dynamic navigation on a simulation model. MATERIALS AND METHODS: Senior students with no implant placement experience were randomly assigned five implant placement attempts involving either three maxillary or four mandibular implants distributed in the anterior/posterior, and left/right segments. Implant placement was planned using a Navident Dynamic Guidance system. Surgical time was recorded. Horizontal, vertical and angulation discrepancies between the planned and placed implant positions were measured using superimposed CBCT scans. Data were analysed with repeated measures regression with Tukey's adjusted pairwise comparisons (α = 0.05). RESULTS: Fourteen students participated, with a mean age of 26.1 years and equal males and females. Mean time for implant placement was associated with attempt number (P < 0.001), implant site (P = 0.010) and marginally related to gender (P = 0.061). Students had a significant reduction in time from their first attempt to their second (10.6 vs 7.6 minutes; adjusted P < 0.001) then plateaued. Overall 3D angulation (P < 0.001) and 2D vertical apex deviation (P = 0.014) improved with each attempt, but changes in lateral 2D (P = 0.513) and overall 3D apex deviations (P = 0.784) were not statistically significant. Implant sites were associated with lateral 2D, 2D vertical and overall 3D apex deviation (P < 0.001). DISCUSSION: Males were marginally faster than females, had slightly lower overall 3D angulation, and reported higher proficiency with video games. Novice operators improved significantly in speed and angulation deviation within the first three attempts of placing implants using dynamic navigation. CONCLUSION: Computer-aided dynamic implant navigation systems can improve implant surgical training in novice population.
引言:最近的计算机引导动态导航系统为种植手术提供了一种新的培训方法。本研究旨在检查使用动态导航在模拟模型上进行牙种植体放置的牙科学生的学习进展。
材料与方法:没有种植体放置经验的高年级学生被随机分配五次种植体放置尝试,涉及三个上颌或四个下颌种植体,分布在前/后和左/右部位。使用 Navident 动态引导系统计划种植体放置。记录手术时间。使用重叠 CBCT 扫描测量计划和放置的种植体位置之间的水平、垂直和角度偏差。使用重复测量回归分析和 Tukey 调整后的成对比较进行数据分析(α=0.05)。
结果:14 名学生参与了研究,平均年龄为 26.1 岁,男女比例相等。种植体放置时间与尝试次数相关(P<0.001),与种植体部位相关(P=0.010),与性别相关(P=0.061)。学生从第一次尝试到第二次尝试的时间显著减少(10.6 分钟对 7.6 分钟;调整后 P<0.001),然后趋于平稳。总体 3D 角度(P<0.001)和 2D 垂直根尖偏差(P=0.014)随着每次尝试而改善,但侧向 2D(P=0.513)和总体 3D 根尖偏差(P=0.784)的变化没有统计学意义。种植体部位与侧向 2D、2D 垂直和总体 3D 根尖偏差相关(P<0.001)。
讨论:男性略快于女性,总体 3D 角度略低,并且报告对视频游戏的熟练程度更高。在使用动态导航进行种植体放置的前三次尝试中,新手操作员在速度和角度偏差方面显著提高。
结论:计算机辅助动态种植导航系统可以提高新手人群的种植手术培训效果。
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