Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, Ohio, USA.
Private Practice Limited to Periodontology and Implant Surgery, Athens, Greece.
Periodontol 2000. 2019 Oct;81(1):194-208. doi: 10.1111/prd.12292.
Ideal implant placement may reduce surgical complications, such as nerve injury and lingual cortical plate perforation, and minimize the likelihood of functional and prosthetic compromises. Guided implant surgery (GIS) has been used as the means to achieve ideal implant placement. GIS refers to the process of digital planning, custom-guide fabrication, and implant placement using the custom guide and an implant system-specific guided surgery kit. GIS includes numerous additional steps beyond the initial prosthetic diagnosis, treatment planning, and fabrication of surgical guide. Substantial errors can occur at each of these individual steps and can accumulate, significantly impacting the final accuracy of the process with potentially disastrous deviations from proper implant placement. Pertinent overall strategies to reduce or eliminate these risks can be summarized as follows: complete understanding of the possible risks is fundamental; knowledge of the systems and tools used is essential; consistent verification of both diagnostic and surgical procedures after each step is crucial; proper training and surgical experience are critical. This review article summarizes information on the accuracy and efficacy of GIS, provides insight on the potential risks and problems associated with each procedural step, and offers clinically relevant recommendations to minimize or eliminate these risks.
理想的种植体植入位置可以减少手术并发症，如神经损伤和舌侧皮质板穿孔，并最大限度地减少功能和修复体妥协的可能性。引导式种植手术（GIS）已被用作实现理想种植体植入位置的手段。GIS 是指使用数字规划、定制导板制作以及使用定制导板和种植体系统专用引导手术套件进行种植体植入的过程。GIS 包括初始修复诊断、治疗计划和手术导板制作之外的许多其他步骤。在这些单独的步骤中，都会出现大量的误差，这些误差会累积，从而严重影响整个过程的最终准确性，导致种植体的位置出现灾难性的偏差。减少或消除这些风险的相关总体策略可以总结如下：完全了解可能存在的风险是基础；了解使用的系统和工具至关重要；在每个步骤之后，始终如一地验证诊断和手术过程至关重要；适当的培训和手术经验是关键。本文综述了 GIS 的准确性和有效性信息，深入了解了每个程序步骤相关的潜在风险和问题，并提供了临床相关建议，以最小化或消除这些风险。
