Int J Comput Dent. 2021 Sep 23;24(3):303-315.
Dynamic navigation has important potential advantages over the static approach for fully edentulous patients. To the best of the authors' knowledge, this is the first published case report describing the use of a dynamic implant navigation technique for a fully edentulous patient.
A 55-year-old female presented for the replacement of missing teeth. Treatment with an implant-supported fixed dental prosthesis was proposed. A digital navigation implant surgery/immediate provisionalization protocol was used. An acrylic resin denture was fabricated as a radiographic guide. Digital data were obtained through the double scan technique, and a prosthetically driven 3D implant positioning was designed. Four titanium mini screws were inserted into the mandible for registration. The first implant was inserted in a freehand manner and attached to a patient tracker. After calibration and registration, the navigation system was set up. The other five implants were inserted using the navigation system. The procedure followed for the maxilla was similar. After surgery, a loading procedure was performed within 24 h.
Following implant placement, a postoperative CBCT scan was performed. The results showed that all implants were placed precisely, in accordance with the treatment plan.
From the results obtained it appears that a fully digital workflow for prosthetically driven implant navigation surgery is suitable for the treatment of fully edentulous patients requiring an implant-supported fixed restoration. High-level evidence is needed to determine the accuracy and precision of this workflow.
动态导航对于全口无牙患者具有比静态方法更重要的潜在优势。据作者所知，这是首例描述使用动态种植体导航技术治疗全口无牙患者的病例报告。
一名 55 岁女性前来修复缺失的牙齿。建议采用种植体支持的固定义齿修复。使用数字化导航种植手术/即刻临时修复方案。制作丙烯酸树脂义齿作为放射导板。通过双扫描技术获取数字数据，并设计了基于修复体的 3D 种植体定位。将四个钛迷你螺钉插入下颌骨进行注册。首先以徒手的方式植入第一颗种植体，并连接到患者跟踪器上。校准和注册后，设置导航系统。使用导航系统植入其他五颗种植体。上颌的手术过程类似。手术后 24 小时内进行了负载程序。
植入后进行了术后 CBCT 扫描。结果显示所有种植体均按治疗计划精确植入。
从获得的结果来看，对于需要种植体支持的固定修复的全口无牙患者，基于修复体驱动的种植体导航手术的全数字化工作流程是合适的。需要更高水平的证据来确定该工作流程的准确性和精度。
