Lecturer, First Clinic Division, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, PR China.
Associate Professor, Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, PR China.
J Prosthet Dent. 2024 Apr;131(4):668-674. doi: 10.1016/j.prosdent.2022.03.014. Epub 2022 Apr 14.
Dynamic navigation for implant placement has been reported to be more accurate than freehand surgery. However, the accuracy of the calibration methods used for navigation in partially edentulous individuals with distal extensions remains unknown.
The purpose of this in vitro study on dental models was to evaluate the accuracy of 3 calibration methods of dynamic navigation for implant placement in the distal extension of partially edentulous arches.
Eleven standardized polyurethane mandibular models with distal extensions were prepared. The left first molar, second molar, and second premolar from each model (33 tooth sites) were randomly assigned to 1 of the 3 calibration methods: U-shaped tube embedded with radiopaque markers, anatomic tooth cusps, and bone markers with the random number table method. Preoperative and postoperative cone beam computed tomography images were obtained for deviation analyses. The primary outcomes were 3-dimensional (3D) deviation at the implant platform and apex and angular deviation. Differences among the test groups were analyzed by using a 1-way analysis of variance (ANOVA) and the least significant difference (LSD) post hoc test (α=.05).
The mean ±standard deviation 3D deviations were 0.78 ±0.34, 1.86 ±0.91, and 1.44 ±0.57 mm at the implant platform and 0.79 ±0.35, 2.19 ±1.01, and 1.49 ±0.50 mm at the apex in the U-shaped tube, tooth cusp, and bone marker groups, respectively. The 3D deviations at the implant platform and apex were significantly different among the groups (P<.01). The angular deviation was 1.36 ±0.54, 2.95 ±2.07, and 2.92 ±2.45 degrees, with no significant differences among the groups (P=.092).
In the dynamic navigation of implant placement in the distal extension of partially edentulous arches, the U-shaped tube calibration with radiopaque markers was more accurate than the anatomic tooth cusp or bone marker calibration.
与徒手手术相比，植入物放置的动态导航被报道更准确。然而，用于具有远中扩展的部分缺牙患者的导航的校准方法的准确性仍然未知。
本研究旨在通过对牙科模型进行体外研究，评估 3 种动态导航植入物放置校准方法在部分缺牙远中扩展牙槽弓中的准确性。
准备 11 个带有远中扩展的标准化聚亚安酯下颌模型。每个模型的左侧第一磨牙、第二磨牙和第二前磨牙（共 33 个牙位）随机分配到 3 种校准方法之一：U 形管内嵌入不透射线标记物、解剖牙尖和骨标记物，采用随机数字表法。获得术前和术后锥形束计算机断层扫描图像，进行偏差分析。主要结果是种植体平台和根尖的三维（3D）偏差和角度偏差。采用单因素方差分析（ANOVA）和最小显著差异（LSD）事后检验（α=.05）分析测试组之间的差异。
U 形管、牙尖和骨标记组在种植体平台的 3D 偏差分别为 0.78 ±0.34、1.86 ±0.91 和 1.44 ±0.57mm，在根尖的 3D 偏差分别为 0.79 ±0.35、2.19 ±1.01 和 1.49 ±0.50mm。各组间种植体平台和根尖的 3D 偏差差异有统计学意义（P<.01）。角度偏差分别为 1.36 ±0.54、2.95 ±2.07 和 2.92 ±2.45 度，各组间无显著差异（P=.092）。
在部分缺牙远中扩展牙槽弓的动态导航种植体放置中，带不透射线标记的 U 形管校准比解剖牙尖或骨标记校准更准确。
