Shanghai University of Medicine and Health Sciences, Shanghai, 201318, People's Republic of China.
Int J Implant Dent. 2023 Oct 25;9(1):38. doi: 10.1186/s40729-023-00507-w.
This review aimed to reveal the influence of implant guides on surgical accuracy with regard to supporting types, manufacturing methods and design (including fixation screws and sleeves).
A literature search related to accuracy of surgical guides for dental implantation was performed in Web of Science and PubMed. Studies with in vivo or in vitro deviation data published in recent 5 years (2018-2022) were included and assessed by Newcastle-Ottawa Scale with regard to risk of bias and reliability degree of clinical studies. Accuracy-related deviation data were summarized as forest plots and normal distributions.
Forty-one articles were included with high degree of credibility. Data showed that implant surgery accuracy can be achieved with mean distance deviation < 2 mm (most < 1 mm) and angular deviation < 8° (most < 5°).
Bilateral tooth-supported guides exhibited highest in vitro accuracy and similar in vivo accuracy to unilateral tooth-supported guides; mucosa-supported guides exhibit lowest in vivo accuracy, while its in vitro data showed low credibility due to mechanical complexity of living mucosa tissue. Milling exhibited higher in vivo accuracy of guides than 3d-printing, though further data support was needed. Design of fixation screws and sleeves of implant guides affected the surgical accuracy and might remain a research focus in near future. However, lack of universal evaluation standards for implantation accuracy remained a major problem in this field. The influence of implant guides on surgical accuracy revealed in this review might shed light on future development of dental implantology.
本综述旨在揭示种植导板在支持类型、制造方法和设计（包括固定螺丝和套管）方面对手术精度的影响。
在 Web of Science 和 PubMed 上检索与牙种植手术导板精度相关的文献。纳入近 5 年（2018-2022 年）发表的体内或体外偏差数据的研究，并按照纽卡斯尔-渥太华量表（Newcastle-Ottawa Scale）评估其偏倚风险和临床研究的可靠性程度。将与精度相关的偏差数据总结为森林图和正态分布。
共纳入 41 篇可信度较高的文章。数据显示，种植手术精度可通过平均距离偏差<2mm（大多数<1mm）和角度偏差<8°（大多数<5°）来实现。
双侧牙支持导板具有最高的体外精度，与单侧牙支持导板的体内精度相似；黏膜支持导板的体内精度最低，而其体外数据由于活黏膜组织的机械复杂性而可信度较低。与 3D 打印相比，铣削具有更高的导板体内精度，但需要进一步的数据支持。种植导板固定螺丝和套管的设计影响手术精度，可能成为未来研究的重点。然而，种植精度的通用评价标准缺乏仍是该领域的主要问题。本综述中揭示的种植导板对手术精度的影响可能为未来牙种植学的发展提供启示。
