State Key Laboratory of Oral Diseases & National Clinical Research Center of Oral Diseases & Dept. of Prosthetics, West China Hospital of Stomatology, Chengdu 610041, China.
Hua Xi Kou Qiang Yi Xue Za Zhi. 2021 Dec 1;39(6):732-738. doi: 10.7518/hxkq.2021.06.018.
This study aimed to evaluate the immediate accuracy of the digital osteotomy template in the digital stackable template.
From November 2018 to January 2020, 4 patients with dentition loss were selected from the Prosthodontics Department, West China Stomatological Hospital. All patients met the conditions for immediate planting and immediate restoration. Owing to the lack of vertical target-restoration space, the implantation plan included intraoperative osteotomy. According to the preoperative cone beam CT (CBCT) data, combined with aesthetic digital smile design (DSD) analysis, virtual wax design, and so on, the ideal bone plane design was performed. According to the virtual osteotomy plane, the virtual implantation plan was designed, and then the digital stackable template assuming osteotomy template, implantation guide, and temporary restoration were made and 3D printed. Osteotomy was performed under the guidance of digital osteotomy template during the operation. The preoperative CBCT and postoperative CBCT of all patients overlapped, the deviation between the actual osteotomy and the ideal osteotomy was calculated, and the angle deviation between the postoperative bone plane and the ideal bone plane was measured.
The ave-rage volume deviation between the postoperative design and the ideal one was 492.94 mm³, accounting for 21.21% of the preset osteotomy volume. The average deviation between the postoperative osteotomy and the ideal osteotomy in four patients was 0.024 8 mm. The average angle between the postoperative bone plane and the ideal bone plane was 6.03°.
The displacement deviation of virtual osteotomy design and the actual osteotomy one under the guidance of digital osteotomy template in the digital stackable template are highly consistent with the original design. Thus, this clinical technique is worth popularizing, accurate, and quantifiable.
本研究旨在评估数字化堆叠模板中数字截骨模板的即刻准确性。
本研究选取 2018 年 11 月至 2020 年 1 月华西口腔医院修复科就诊的 4 例牙列缺失患者，均符合即刻种植即刻修复条件。由于缺乏垂直目标修复空间，种植计划包括术中截骨。根据术前锥形束 CT（CBCT）数据，结合美学数字化微笑设计（DSD）分析、虚拟蜡型设计等，进行理想骨面设计。根据虚拟截骨平面，设计虚拟种植计划，然后制作和 3D 打印数字化堆叠模板，假设截骨模板、种植导板和临时修复体。手术中在数字截骨模板的指导下进行截骨。所有患者均行术前 CBCT 和术后 CBCT 重叠，计算实际截骨与理想截骨的偏差，测量术后骨面与理想骨面的角度偏差。
术后设计与理想设计的平均体积偏差为 492.94mm³，占预设截骨量的 21.21%。4 例患者术后截骨与理想截骨的平均偏差为 0.024 8mm。术后骨面与理想骨面的平均角度为 6.03°。
数字化堆叠模板中数字截骨模板引导下虚拟截骨设计与实际截骨的位移偏差与原始设计高度一致。因此，该临床技术值得推广，具有准确性和可量化性。
