Center of Excellence for Dental Implantology, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Suthep, 50200, A. Muang, Thailand.
Oral Maxillofac Surg. 2022 Jun;26(2):229-237. doi: 10.1007/s10006-021-00975-7. Epub 2021 Jun 23.
To evaluate and compare accuracy in position and inclination of a single-tooth implant placement using tooth-supported surgical drill guide (SDG) and surgical drill guide with implant insertion guide (SDIG) in fully digital workflow.
Thirty partially single edentulous patients were recruited. After randomization, participants were divided into 2 groups equally. The first group underwent implant placement through SDG only, while the second group was subjected to SDIG. All procedure proceeded under a fully digital workflow as the combination of digital scanning from an intraoral scanner, 3D radiographic images from cone-beam computed tomography (CBCT), implant planning software, and a 3D manufacturing machine. A post-operative CBCT was performed to compare the deviations (7 parameters) between planned and actual implant positions.
The mean global deviations at the shoulder and apex were 0.74 ± 0.36 and 1.29 ± 0.61 mm, respectively in the SDG group and 0.48 ± 0.22 mm and 0.71 ± 0.31 mm, respectively in the SDIG group. Likewise, the other parameters in the SDIG group showed fewer deviations than SDG for all measurements. Statistically significant differences were indicated by all parameters except for the horizontal deviation at the implant shoulder (p < .05).
In single-tooth implant placement with a tooth-supported guide using a computer-assisted (static) system with the SDIG could reduce deviations of actual implant position when compared with using SDG only. Besides, guided implant surgery by fully digital workflow is a practical procedure and provides precise implant position regarding the prosthetic-driven concept.
评估并比较使用基于牙支持的外科导板(SDG)和带有种植体插入导板的外科导板(SDIG)在全数字化工作流程中单颗种植体植入的位置和倾斜度的准确性。
共招募了 30 名部分单个缺牙患者。随机分组后,两组各有 15 名患者。第一组仅通过 SDG 进行种植体植入,而第二组则使用 SDIG。所有程序均在全数字化工作流程下进行,该流程结合了口内扫描仪的数字扫描、锥形束 CT(CBCT)的三维放射图像、种植体规划软件和 3D 制造机。术后进行 CBCT 检查,比较计划和实际种植体位置之间的偏差(7 个参数)。
SDG 组的肩峰和根尖的平均全局偏差分别为 0.74±0.36 和 1.29±0.61mm,SDIG 组的肩峰和根尖的平均全局偏差分别为 0.48±0.22mm 和 0.71±0.31mm。同样,SDIG 组的所有测量值中,其他参数的偏差均小于 SDG 组。除了种植体肩峰的水平偏差外(p<0.05),所有参数均显示出统计学上的显著差异。
在使用基于计算机辅助(静态)系统的基于牙支持的导板进行单颗种植体植入时,与仅使用 SDG 相比,使用 SDIG 可减少实际种植体位置的偏差。此外,全数字化工作流程引导的种植手术是一种实用的程序,根据修复体驱动的概念提供了精确的种植体位置。