OMFS IMPATH Research Group, Department of Imaging and Pathology, KU Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium.
Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Harbin Medical University, Youzheng Street 23, NangangHarbin, 150001, China.
Int J Implant Dent. 2022 Oct 10;8(1):42. doi: 10.1186/s40729-022-00441-3.
PURPOSE: This study aimed to investigate the performance of novice versus experienced practitioners for placing dental implant using freehand, static guided and dynamic navigation approaches. METHODS: A total of 72 implants were placed in 36 simulation models. Three experienced and three novice practitioners were recruited for performing the osteotomy and implant insertion with freehand, surgical guide (pilot-drill guidance) and navigation (X-Guide, X-Nav technologies) approaches. Each practitioner inserted 4 implants per approach randomly with a 1-week gap to avoid memory bias (4 insertion sites × 3 approaches × 6 practitioners = 72 implants). The performance of practitioners was assessed by comparing actual implant deviation to the planned position, time required for implant placement and questionnaire-based self-confidence evaluation of practitioners on a scale of 1-30. RESULTS: The navigation approach significantly improved angular deviation compared with freehand (P < 0.001) and surgical guide (P < 0.001) irrespective of the experience. Surgical time with navigation was significantly longer compared to the freehand approach (P < 0.001), where experienced practitioners performed significantly faster compared to novice practitioners (P < 0.001). Overall, self-confidence was higher in favor of novice practitioners with both guided approaches. In addition, the confidence of novice practitioners (median score = 26) was comparable to that of experienced practitioners (median score = 27) for placing implants with the navigation approach. CONCLUSIONS: Dynamic navigation system could act as a viable tool for dental implant placement. Unlike freehand and static-guided approaches, novice practitioners showed comparable accuracy and self-confidence to that of experienced practitioners with the navigation approach.
目的:本研究旨在探讨新手和经验丰富的医生在徒手、静态引导和动态导航方法下放置牙种植体的表现。
方法:在 36 个模拟模型中放置了总共 72 个种植体。招募了 3 名经验丰富的医生和 3 名新手医生,分别使用徒手、手术导板(导向钻引导)和导航(X-Guide、X-Nav 技术)方法进行截骨和种植体植入。每位医生随机以 1 周的间隔使用 4 种方法植入 4 个种植体(4 个植入部位×3 种方法×6 名医生=72 个种植体),以避免记忆偏差。通过比较实际种植体偏差与计划位置、种植体放置所需时间以及医生基于 1-30 分的自我信心评估问卷来评估医生的表现。
结果:导航方法与徒手(P < 0.001)和手术导板(P < 0.001)方法相比,显著改善了角度偏差。导航方法的手术时间明显长于徒手方法(P < 0.001),而经验丰富的医生比新手医生的操作速度明显更快(P < 0.001)。总体而言,在使用引导方法时,新手医生的信心更高。此外,对于使用导航方法放置种植体,新手医生的信心(中位数评分为 26)与经验丰富医生的信心(中位数评分为 27)相当。
结论:动态导航系统可作为一种可行的牙种植体放置工具。与徒手和静态引导方法不同,新手医生在导航方法下表现出与经验丰富医生相当的准确性和信心。
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