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基于 CT 的回顾性研究:部分引导式种植体植入在无牙颌患者中的临床准确性。

Clinical accuracy of partially guided implant placement in edentulous patients: A computed tomography-based retrospective study.

机构信息

Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China.

出版信息

Clin Oral Implants Res. 2024 Jan;35(1):31-39. doi: 10.1111/clr.14191. Epub 2023 Oct 10.

Abstract

OBJECTIVES

This retrospective study was intended to evaluate the clinical accuracy of partially guided template in guiding implant placement in edentulous patients.

METHODS

A total of 120 implants were placed in 24 patients with at least one completely edentulous arch with a partially guided system. Based on CBCT data, a repeatable method was used to measure linear and angular deviations of implants at 3D level in Mimics medical software. The influence of supporting tissue and implant region on the accuracy was assessed, followed by the evaluation of direction of linear deviations in biologically vital areas.

RESULTS

Linear deviations of all implants were 1.91 ± 0.68 mm, 1.47 ± 0.68 mm, and 1.02 ± 0.69 mm at apical, apical lateral, and apical vertical levels. When at the cervical, cervical lateral, and cervical vertical levels, the linear deviations were 1.53 ± 0.65 mm, 0.98 ± 0.53 mm, and 1.01 ± 0.69 mm, respectively. Angular deviation of all implants was 7.14 ± 3.41°. Implants guided by mucosa + tooth-supported templates showed higher linear deviations at apical vertical level (1.21 ± 0.72 mm vs. 0.86 ± 0.63 mm, p < .05) and cervical vertical level (1.18 ± 0.72 mm vs. 0.87 ± 0.63 mm, p < .05) than mucosa-supported templates, and implants in maxilla were found higher angular deviation than mandible (7.89 ± 3.61° vs. 6.29 ± 2.97°, p < .05).

CONCLUSIONS

The partially guided template served as clinically viable surgical assistance in implant placement in edentulous patients. When using mucosa + tooth-supported template or placing implants in maxilla, more caution was required, especially in biologically vital areas.

摘要

目的

本回顾性研究旨在评估在无牙颌患者中使用部分引导模板指导种植体植入的临床准确性。

方法

使用部分引导系统,在 24 名至少有一个完全无牙颌弓的患者中植入了 120 个种植体。基于 CBCT 数据,使用可重复的方法在 Mimics 医学软件中测量 3D 水平上种植体的线性和角度偏差。评估了支持组织和种植体区域对准确性的影响,然后评估了在生物学重要区域线性偏差的方向。

结果

所有种植体的线性偏差分别为根尖、根尖侧和根尖垂直水平 1.91±0.68mm、1.47±0.68mm 和 1.02±0.69mm。在颈、颈侧和颈垂直水平时,线性偏差分别为 1.53±0.65mm、0.98±0.53mm 和 1.01±0.69mm。所有种植体的角度偏差为 7.14±3.41°。黏膜+牙支持模板引导的种植体在根尖垂直水平(1.21±0.72mm 比 0.86±0.63mm,p<0.05)和颈垂直水平(1.18±0.72mm 比 0.87±0.63mm,p<0.05)处的线性偏差较高,上颌种植体的角度偏差高于下颌(7.89±3.61°比 6.29±2.97°,p<0.05)。

结论

部分引导模板在无牙颌患者种植体植入中是一种可行的临床辅助手段。使用黏膜+牙支持模板或在上颌植入种植体时,需要更加谨慎,尤其是在生物学重要区域。

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