Yotpibulwong Thanida, Arunjaroensuk Sirida, Kaboosaya Boosana, Sinpitaksakul Phonkit, Arksornnukit Mansuang, Mattheos Nikos, Pimkhaokham Atiphan
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
Department of Radiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
Clin Oral Implants Res. 2023 Apr;34(4):330-341. doi: 10.1111/clr.14043. Epub 2023 Feb 24.
OBJECTIVE: To compare implant accuracy of combined static and dynamic (SD) computer-assisted implant surgery (CAIS) with static (S), dynamic (D) CAIS, and freehand surgery (FH) for single implant placement. MATERIALS AND METHODS: One hundred and twenty patients were randomized into four groups. Implants were placed using both stereolithographic surgical guide and dynamic navigation in the SD group, stereolithographic surgical guide in S group, dynamic navigation in D group, and conventional freehand in FH group. Analysis of deviation between planned and final implant position, as well as K means analysis was conducted for implant deviation at platform, apex, and angle (primary outcomes) and directional distribution at platform and apex (secondary outcome). RESULTS: Significant differences were found among the four groups (p < .001): The 3D deviation at the platform (mm) of SD, S, D, and FH groups was 0.62 ± 0.50, 1.06 ± 0.67, 1.02 ± 0.45, and 1.48 ± 0.68, respectively, at apex (mm) was 0.75 ± 0.57, 1.40 ± 0.71, 1.28 ± 0.50, and 2.18 ± 0.95, respectively, and angle (degrees) was 1.24 ± 1.41, 3.18 ± 2.04, 3.28 ± 1.57, and 7.50 ± 4.06, respectively. Deviation at the platform of FH group was significantly more toward mesial (p = .026) and coronal (p = .014) direction, while at the apex, toward distal (p = .004) and lingual (p = .002) than SD group. CONCLUSION: The use of combined static and dynamic CAIS provided significantly higher accuracy than the two alone and freehand surgery for single implant placement.
目的:比较静态与动态相结合(SD)的计算机辅助种植手术(CAIS)、静态(S)CAIS、动态(D)CAIS以及徒手手术(FH)在单颗种植体植入时的种植精度。 材料与方法:120例患者被随机分为四组。SD组使用立体光刻手术导板和动态导航植入种植体,S组使用立体光刻手术导板,D组使用动态导航,FH组采用传统徒手植入。分析计划种植体位置与最终种植体位置之间的偏差,并对种植体在平台、根尖和角度的偏差(主要结果)以及平台和根尖的方向分布(次要结果)进行K均值分析。 结果:四组之间存在显著差异(p < 0.001):SD组、S组、D组和FH组在平台的三维偏差(mm)分别为0.62±0.50、1.06±0.67、1.02±0.45和1.48±0.68,在根尖的三维偏差(mm)分别为0.75±0.57、1.40±0.71、1.28±0.50和2.18±0.95,角度偏差(度)分别为1.24±1.41、3.18±2.04、3.28±1.57和7.50±4.06。FH组在平台的偏差在近中方向(p = 0.026)和冠方方向(p = 0.014)上显著大于SD组,而在根尖,远中方向(p = 0.004)和舌侧方向(p = 0.002)上大于SD组。 结论:对于单颗种植体植入,静态与动态相结合的CAIS的使用比单独使用静态或动态CAIS以及徒手手术具有显著更高的精度。
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