Wang Q F, He Z D, Yu H Y, Qiu X H, Wang Y Y, Han J, Yang J, Sun X D, Li X B, Li Z Y, Fan H, Zhang J
Department of Oral Implantology, Tianjin Stomatological Hospital & Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin 300041, China.
College of Health Science and Environmental Engineering, Shenzhen Technology University, Shenzhen Key Laboratory of Laser Intelligent Manufacturing in Digtal Dentistry, Shenzhen 518118, China.
Zhonghua Kou Qiang Yi Xue Za Zhi. 2020 Nov 9;55(11):902-907. doi: 10.3760/cma.j.cn112144-20200621-00357.
To evaluate the influence of the sleeve lengths and implant lengths on accuracy of static computer-assisted implant surgery (sCAIS). Twenty-eight models of bilateral mandibular single tooth loss were included. Fifty-five implants were placed under the guidance of sCAIS (Straumann Bone Level 4.1 mm×10 mm). According to the height of metal sleeve of static guide plate, 55 implants were divided into 11 groups (free hand group, 1 mm group, 2 mm group, 3 mm group, 4 mm group, 5 mm group, 6 mm group, 7 mm group, 8 mm group, 9 mm group, 10 mm group), with 5 implants in each group. Eight research models were included. Group with 5 mm sleeve guides were used to place implants of different length, (Straumann Bone Level width 4.1 mm, height was 8 mm, 10 mm and 14 mm), 5 implants in each group. Eighteen patients with mandibular single tooth loss were included in the Department of Oral Implantology, Tianjin Stomatological Hospital from October 2018 to June 2019. There were 10 males and 8 females, 18-46(33.7±7.9) years old. A total of 18 implants were implanted and divided into 3 groups (free hand group, 3 mm group and 5 mm group) with 6 implants in each group. Digital software was used to compare the implant positions before and after implantation. Non-parametric Kruskal-Wallis test or one-way ANOVA were used to analyze the results. There was no significant difference in implant vertical deviation between different sleeve height groups (1-10 mm) and free hand group, but the neck deviation in free hand group[(1.04±0.13) mm] was significantly higher than that in different sleeve height groups (1-10 mm) (<0.05). The tip deviations of free hand group, 1 mm group and 2 mm group [(1.32±0.43), (0.83±0.10) and (0.78±0.11) mm, respectively] was significantly higher than that of 10 mm group [(0.31±0.14) mm](<0.05). The angle deviation of free hand group and 1 mm group (3.99°±0.85° and 2.59°±0.69°), respectively] was significantly higher than that of 10 mm group (0.61°±0.03°) (<0.05). The tip deviations of implants in the 14 mm group [(0.83±0.22) mm] was significantly higher than that in the 8 mm and 10 mm groups [(0.44±0.07) and (0.49±0.06) mm, respectively]. Clinical studies showed that there was no significant difference in neck deviation, tip deviation and angle deviation between 3 mm group and 5 mm group (>0.05), but deviations were significantly lower than those in free hand group (<0.05). The length of the sleeves has significant influence on the accuracy of the surgical guide. There was no significant difference in accuracy of the implant guide with 3 mm or 5 mm metal sleeves. The vitro study has some limitations and needs further systematic research.
评估套筒长度和种植体长度对静态计算机辅助种植手术(sCAIS)准确性的影响。纳入28例双侧下颌单颗牙缺失模型。在sCAIS(士卓曼骨水平4.1mm×10mm)引导下植入55颗种植体。根据静态导板金属套筒高度,将55颗种植体分为11组(徒手组、1mm组、2mm组、3mm组、4mm组、5mm组、6mm组、7mm组、8mm组、9mm组、10mm组),每组5颗种植体。纳入8个研究模型。使用5mm套筒导板的组用于植入不同长度的种植体(士卓曼骨水平宽度4.1mm,高度分别为8mm、10mm和14mm),每组5颗种植体。2018年10月至2019年6月,天津市口腔医院口腔种植科纳入18例下颌单颗牙缺失患者。其中男性10例,女性8例,年龄18 - 46(33.7±7.9)岁。共植入18颗种植体,分为3组(徒手组、3mm组和5mm组),每组6颗种植体。使用数字软件比较种植前后种植体位置。采用非参数Kruskal - Wallis检验或单因素方差分析进行结果分析。不同套筒高度组(1 - 10mm)与徒手组种植体垂直偏差无显著差异,但徒手组颈部偏差[(1.04±0.13)mm]显著高于不同套筒高度组(1 - 10mm)(P<0.05)。徒手组、1mm组和2mm组的根尖偏差[分别为(1.32±0.43)、(0.83±0.10)和(0.78±0.11)mm]显著高于10mm组[(0.31±0.14)mm](P<0.05)。徒手组和1mm组的角度偏差[分别为(3.99°±0.85°)和(2.59°±0.69°)]显著高于10mm组(0.61°±0.03°)(P<0.05)。14mm组种植体的根尖偏差[(0.83±0.22)mm]显著高于8mm组和10mm组[分别为(0.44±0.07)和(0.49±0.06)mm]。临床研究表明,3mm组和5mm组在颈部偏差、根尖偏差和角度偏差方面无显著差异(P>0.05),但偏差显著低于徒手组(P<0.05)。套筒长度对手术导板的准确性有显著影响。3mm或5mm金属套筒的种植导板准确性无显著差异。体外研究存在一定局限性,需要进一步系统研究。