Department of Oral Implantology, The Affiliated Stomatology Hospital of Southwest Medical University, Luzhou, China.
Department of Oral and Maxillofacial Surgery, The Affiliated Stomatology Hospital of Southwest Medical University, Luzhou, China.
Clin Implant Dent Relat Res. 2021 Feb;23(1):117-130. doi: 10.1111/cid.12980. Epub 2021 Feb 2.
To study the accuracy of partially guided and fully guided templates applied to implant surgery of anterior teeth.
Sixty patients who were scheduled to receive dental implant treatment in the anterior region were enrolled and randomly assigned to one of the following study groups (n = 20 each): routine implant-supported restoration treatment (control group, 30 implants), implant-supported restoration treatment using a partially guided template (test group 1, 36 implants), and implant-supported restoration treatment using a fully guided template (test group 2, 33 implants). The depth of implant was controlled for fully guided template. After implantation, planned implants and placed implants were superimposed using digital software, and the deviations (angular, coronal, apical, depth) were analyzed. Esthetic parameters were assessed at baseline, 6 months, and 1 year after the final restoration. Pink esthetic score (PES) and white esthetic score (WES) were respectively used to evaluate the soft tissue and restoration esthetic outcome. Each parameter of PES and WES is assessed with a 0-1-2 score with 2 being the best and 0 being the worst score.
There were significant differences in all of the deviation parameters between the control group, test group 1, and test group 2 (p < 0.001). Mean angular, coronal, apical and depth deviations were all the highest in the control group (6.61 ± 1.09°, 1.05 ± 0.17 mm, 1.36 ± 0.13 mm, and 1.02 ± 0.13 mm, respectively), and lowest in test group 2 (2.05 ± 0.45°, 0.39 ± 0.12 mm, 0.28 ± 0.09 mm, and 0.24 ± 0.06 mm, respectively). At 1 year after the final restoration, the analysis revealed mean PES values of 7.09 ± 0.56 (control group), 8.39 ± 0.54 (test group 1), and 9.04 ± 0.35 (test group 2). The WES values were 7.24 ± 0.54 (control group), 8.47 ± 0.44 (test group 1), and 8.97 ± 0.38 (test group 2). At all examinations, the mean PES and WES values were both the highest in test group 2 and lowest in the control group. The PES and WES values recorded in the control group at baseline, 6 months, and 1 year after final restoration were significantly lower than those in test groups (p < 0.001). Moreover, the PES and WES values recorded in the test group 1 at baseline, 6 months, and 1 year after final restoration were significantly lower than those in test group 2 (p < 0.05).
Digital surgical guides can improve the accuracy of the three-dimensional position of implants in the maxillary esthetic zone, the fully guided template has higher precision than that of the partially guided template, and plays an important role in obtaining the ideal esthetic outcome for maxillary anterior teeth.
研究部分引导和完全引导模板在前牙种植术中的准确性。
将 60 名计划在前牙区接受牙种植治疗的患者纳入研究，并随机分为以下研究组（每组 20 名患者）：常规种植体支持修复治疗（对照组，30 个种植体）、使用部分引导模板的种植体支持修复治疗（试验组 1，36 个种植体）和使用完全引导模板的种植体支持修复治疗（试验组 2，33 个种植体）。完全引导模板用于控制种植体的深度。植入后，使用数字软件对计划种植体和放置种植体进行叠加，并分析偏差（角度、冠向、根尖、深度）。在最终修复后 6 个月和 1 年时评估美学参数。采用粉色美学评分（PES）和白色美学评分（WES）分别评估软组织和修复体的美学效果。PES 和 WES 的每个参数均采用 0-1-2 评分进行评估，其中 2 分为最佳，0 分为最差。
对照组、试验组 1 和试验组 2 之间的所有偏差参数均有显著差异（p<0.001）。对照组的平均角度、冠向、根尖和深度偏差均最高（分别为 6.61±1.09°、1.05±0.17mm、1.36±0.13mm 和 1.02±0.13mm），而试验组 2 的偏差最低（分别为 2.05±0.45°、0.39±0.12mm、0.28±0.09mm 和 0.24±0.06mm）。最终修复后 1 年，PES 值的平均值分别为对照组 7.09±0.56、试验组 1 8.39±0.54 和试验组 2 9.04±0.35。WES 值分别为对照组 7.24±0.54、试验组 1 8.47±0.44 和试验组 2 8.97±0.38。所有检查中，试验组 2 的平均 PES 和 WES 值均最高，对照组最低。对照组最终修复后 6 个月和 1 年的 PES 和 WES 值基线、6 个月和 1 年均显著低于试验组（p<0.001）。此外，试验组 1 最终修复后 6 个月和 1 年的 PES 和 WES 值基线、6 个月和 1 年均显著低于试验组 2（p<0.05）。
数字化手术导板可提高上颌美学区种植体三维位置的准确性，完全引导模板的精度高于部分引导模板，对获得上颌前牙理想的美学效果具有重要作用。
