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J Dent. 2022 Apr;119:103942. doi: 10.1016/j.jdent.2021.103942. Epub 2021 Dec 31.
The aim of this human cadaver study was to compare the accuracy of guided versus free-hand zygomatic implant placement. For the guided implant placement laser sintered titanium templates were used.
Forty zygomatic implants were placed in ten cadavers heads. For each case two implants were inserted using the guided protocol (Ezgoma guide, Noris Medical, Israel) and the related surgical kit and the other two by using a free hand approach. Post-operative computed tomography (CT) scans were carried out to assess the deviations between planned and inserted implants. The accuracy was measured by overlaying the post-operative CT scan (with the final position of the achieved implants) with the pre-operative CT scan (with the planned implants).
The difference of the mean between planned and placed zygomatic implants by using surgical guides or free hand were statistically significant for all the variables evaluated: angular deviation (1.19°±0.40° and 4.92°±1.71°, p<0.001), linear distance deviation at coronal point (0.88 mm±0.33 mm and 2.04 mm±0.56 mm, p<0.001), at apical point (0.79 mm±0.23 mm and 3.23 mm±1.43 mm, p<0.001) and at apical depth (0.35 mm±0.25 mm and 1.02 mm±0.61 mm, p<0.001).
The proposed guided surgery system exhibited a higher accuracy for all the investigated variables, when compared to the free hand technique.
本项人体尸体研究旨在比较有引导和自由手两种方式的颧骨种植体植入的准确性。在引导种植体植入中使用了激光烧结钛模板。
在十具尸体头部共植入了 40 个颧骨种植体。对于每种情况，使用两种引导式方案（Ezgoma 引导器，以色列诺里斯医疗公司）及其相关手术套件植入两个种植体，而使用自由手方式植入另外两个种植体。术后进行计算机断层扫描（CT）以评估计划植入和实际植入的种植体之间的偏差。通过将术后 CT 扫描（具有实际植入的最终位置）与术前 CT 扫描（具有计划植入的位置）叠加来测量准确性。
使用手术导板或自由手时，所有评估变量的计划和植入的颧骨种植体之间的平均差异均具有统计学意义：角度偏差（1.19°±0.40°和 4.92°±1.71°，p<0.001），冠状点的线性距离偏差（0.88 mm±0.33 mm 和 2.04 mm±0.56 mm，p<0.001），根尖点（0.79 mm±0.23 mm 和 3.23 mm±1.43 mm，p<0.001）和根尖深度（0.35 mm±0.25 mm 和 1.02 mm±0.61 mm，p<0.001）。
与自由手技术相比，所提出的引导手术系统在所有研究变量上均显示出更高的准确性。
