Feng Yuzhang, Yao Yufei, Yang Xingmei
Graduate student, Graduate Prosthodontics, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan Province, PR China.
Predoctoral student, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan Province, PR China.
J Prosthet Dent. 2023 Nov;130(5):731-737. doi: 10.1016/j.prosdent.2021.12.012. Epub 2022 Jan 6.
A less invasive and more convenient workflow is needed for dynamic navigation-guided implant surgery for the edentulous arch.
The purpose of this in vitro study was to evaluate the accuracy of a novel dynamic navigation device developed for the completely edentulous mandible.
Two temporary 1-piece mini-implants were placed in the anterior region of a completely edentulous mandibular model for fixation of the navigation device. A total of 40 implants were inserted in 10 completely edentulous mandibular models with the aid of the dynamic navigation device. The accuracy of placement was determined by overlapping the preoperative plan with the postoperative cone beam computed tomography (CBCT) scans. The difference in the accuracy at different implant positions was compared by MANOVA and Bonferroni-corrected ANOVAs. The difference in accuracy between implants #1-20 and #21-40 was assessed for learning progression.
The deviation of the implants (mean ±standard deviation) was 1.14 ±0.50 mm at the entry point and 1.29 ±0.48 mm at the apex. The mean ±standard deviation angular deviation was 3.02 ±1.32 degrees. No significant difference was seen between the planned and the placed deviation among the 4 implant positions. After repeated placement with this dynamic approach, implant accuracy at the entry (P=.001) and apex (P=.017) improved significantly.
The navigation device achieved acceptable implant placement accuracy in the edentulous mandible. Deviations between the planned and placed locations were not affected by different implant positions. After repeated operations with this dynamic approach, accuracy at the entry and apex improved significantly.
无牙颌的动态导航引导种植手术需要一种侵入性更小、更便捷的工作流程。
本体外研究的目的是评估一种为完全无牙下颌骨开发的新型动态导航设备的准确性。
在完全无牙下颌骨模型的前部区域植入两枚临时一体式微型种植体，用于固定导航设备。借助动态导航设备，在10个完全无牙下颌骨模型中总共植入40枚种植体。通过将术前计划与术后锥形束计算机断层扫描（CBCT）图像重叠来确定种植体植入的准确性。采用多变量方差分析（MANOVA）和经Bonferroni校正的方差分析（ANOVA）比较不同种植体位置的准确性差异。评估种植体#1 - 20和#21 - 40之间准确性的差异以了解学习进展情况。
种植体在入口点的偏差（均值±标准差）为1.14±0.50 mm，在根尖处为1.29±0.48 mm。平均±标准差的角度偏差为3.02±1.32度。4个种植体位置的计划偏差与实际植入偏差之间未见显著差异。采用这种动态方法重复植入后，入口点（P = 0.001）和根尖处（P = 0.017）的种植体准确性显著提高。
该导航设备在无牙下颌骨中实现了可接受的种植体植入准确性。计划位置与实际植入位置之间的偏差不受不同种植体位置的影响。采用这种动态方法重复操作后，入口点和根尖处的准确性显著提高。
