Vinci R, Manacorda M, Abundo R, Lucchina A G, Scarano A, Crocetta C, Muzio L Lo, Gherlone E F, Mastrangelo F
Dental Clinic, Ateneo Vita Salute, 20019 San Raffale Milan, Italy.
Private Practice, 20021 Milan, Italy.
J Clin Med. 2020 Mar 12;9(3):774. doi: 10.3390/jcm9030774.
To evaluate the accuracy of computer-aided dental implant positions obtained with mucosal-supported templates as compared to Three-Dimensional (3D) planning.
One-hundred implants were inserted into 14 edentulous patients using the All-on-4/6 protocol after surgical virtual planning with RealGUIDE, 3DIEMME, and Geomagic software. After 6 months, three-dimensional neck (V) and apex (S) spatial coordinates of implants and angle inclination displacements as compared to virtual plans were evaluated.
The S maxilla coordinates revealed a significant discrepancy between clinical and virtual implant positions (-value = 0.091). The V coordinates showed no significant differences (-value = 0.71). The S (-value = 0.017) and V (-value = 0.038) mandible coordinates showed significant discrepancies between the clinical and virtual positions of the screws. Implant evaluation showed a 1-mm of the horizontal deviation in the V point and a 1.6-mm deviation in the S point. A mean 5° angular global deviation was detected. The multivariate permutation test of the S (-value = 0.02) confirmed the difference. Greater errors in the mandible were detected as compared to the maxilla, and a higher S discrepancy was found in the posterior jaw compared to the anterior section of both the mandible and maxilla.
Computer-aided surgery with mucosal-supported templates is a predictable procedure for implant placement. Data showed a discrepancy between the actual dental implant position as compared to the virtual plan, but this was not statistically significant. However, the horizontal and angle deviations detected indicated that flap surgery should be used to prevent implant positioning errors due to poor sensitivity and accuracy in cases of severe jaw atrophy.
评估与三维（3D）规划相比，使用黏膜支持模板获得的计算机辅助牙种植体位置的准确性。
在使用RealGUIDE、3DIEMME和Geomagic软件进行手术虚拟规划后，采用All-on-4/6方案将100颗种植体植入14例无牙患者。6个月后，评估种植体的三维颈部（V）和根尖（S）空间坐标以及与虚拟规划相比的角度倾斜位移。
上颌骨S坐标显示临床种植体位置与虚拟位置之间存在显著差异（P值 = 0.091）。V坐标无显著差异（P值 = 0.71）。下颌骨S（P值 = 0.017）和V（P值 = 0.038）坐标显示螺钉的临床位置与虚拟位置之间存在显著差异。种植体评估显示V点水平偏差为1mm，S点偏差为1.6mm。检测到平均5°的整体角度偏差。S的多变量排列检验（P值 = 0.02）证实了差异。与上颌骨相比，下颌骨检测到的误差更大，并且与下颌骨和上颌骨前部相比，后牙区的S差异更高。
使用黏膜支持模板的计算机辅助手术是一种可预测的种植体植入程序。数据显示实际牙种植体位置与虚拟规划之间存在差异，但在统计学上不显著。然而，检测到的水平和角度偏差表明，在严重颌骨萎缩的情况下，由于敏感性和准确性较差，应采用翻瓣手术以防止种植体定位错误。
