Altieri Federica, Padalino Gabriella, Guarnieri Rosanna, Barbato Ersilia, Cassetta Michele
Int J Comput Dent. 2020;23(3):219-224.
To present a minimally invasive approach to solve the impaction of palatal canines using computer-guided orthodontic miniscrews.
Miniscrew-supported appliances for palatal canine disimpaction are performed with CAD/CAM technology. With adequate software, it is possible to match the STL files of the dental arch with the DICOM images of the maxilla, previously transformed into STL files. The ideal points for miniscrew insertion can be identified on the STL 3D model file on the basis of the width and thickness of the palatal vault. A software application allows for the design of the surgical guide, which is printed using a 3D printer. The virtual position of the planned miniscrews is transferred onto a printed dental cast on which the orthodontic device is realized. On the day of surgery, both the surgical guide and the orthodontic appliance are ready for use.
Miniscrew insertion and palatal canine disimpaction can be achieved in one surgical procedure.
The use of computer-guided skeletal anchorage allows for both the reduction of the biomechanical side effects typical of conventional treatment and the risk of damaging adjacent anatomical structures, increasing the effectiveness of treatment. Controlled clinical trials are necessary to evaluate more fully any advantages of this minimally invasive technique.
介绍一种使用计算机引导的正畸微螺钉解决腭侧尖牙阻生的微创方法。
采用CAD/CAM技术制作用于腭侧尖牙解阻的微螺钉支持矫治器。借助适当的软件，可将牙弓的STL文件与先前转换为STL文件的上颌骨DICOM图像进行匹配。基于腭穹窿的宽度和厚度，可在STL 3D模型文件上确定微螺钉植入的理想点。一款软件应用程序可用于设计手术导板，该导板使用3D打印机打印。将计划植入的微螺钉的虚拟位置转移到已制作好正畸装置的打印牙模上。手术当天，手术导板和正畸矫治器均可投入使用。
一次外科手术即可完成微螺钉植入和腭侧尖牙解阻。
使用计算机引导的骨锚固技术，既能减少传统治疗典型的生物力学副作用，又能降低损伤相邻解剖结构的风险，提高治疗效果。有必要进行对照临床试验，以更全面地评估这种微创技术的任何优势。
