自主机器人与完全引导式静态计算机辅助种植手术的体外和体内准确性。
In vitro and in vivo accuracy of autonomous robotic vs. fully guided static computer-assisted implant surgery.
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 Implant Dent Relat Res. 2024 Apr;26(2):385-401. doi: 10.1111/cid.13302. Epub 2024 Jan 12.
OBJECTIVES
To assess the accuracy of autonomous robotic and fully guided static computer-assisted implant surgery (sCAIS) performed on models and patients.
MATERIALS AND METHODS
This study was divided into in vitro and in vivo sections. In vitro, 80 operators were assigned to two groups randomly. Forty operators performed forty autonomous robotic implant (ARI group) surgeries and the remaining forty operators carried out forty fully guided sCAIS (FGI group) surgeries on maxillary models, respectively. Each operator placed an implant in one maxillary model. In vivo, 60 patients with 113 implants from 2019 to 2023 (ARI group: 32 patients, 58 implants; FGI group: 28 patients, 55 implants) receiving implant surgeries were incorporated in this retrospective research. The preoperative and postoperative cone beam computer tomographs (CBCTs) were utilized to estimate the linear deviations and angular deviations in two-dimensional (2D) and three-dimensional (3D) space. The Pearson's chi-square test, Shapiro-Wilk test, Student's t test, Mann-Whitney U test and mixed models were applied, and p <0.05 was considered statistically significant.
RESULTS
In vitro, a total of 80 implants were enrolled and significant differences were found between the two groups (p < 0.001): The 3D deviation at the platform of ARI and FGI group was 0.58 ± 0.60 mm and 1.50 ± 1.46 mm, respectively, at the apex was 0.58 ± 0.60 mm and 1.78 ± 1.35 mm, respectively, and angle was 1.01 ± 0.87° and 2.93 ± 1.59°, respectively. Also, except for mesiodistal deviation at the implant platform, the rest linear and angular deviations in the ARI group were significantly lower than those in the FGI group in 2D space (p < 0.001). In vivo, a significantly lower mean of angular deviation (0.95 ± 0.50°, p < 0.001) and the linear deviation at both platform (0.45 ± 0.28 mm, p < 0.001) and apex (0.47 ± 0.28 mm, p < 0.001) were observed in ARI group when compared to the FGI group (4.31 ± 2.60°; 1.45 ± 1.27 mm; 1.77 ± 1.14 mm).
CONCLUSIONS
The use of autonomous robotic technology showed significantly higher accuracy than the fully guided sCAIS.
目的
评估自主机器人和完全引导的静态计算机辅助种植手术（sCAIS）在模型和患者中的准确性。
材料与方法
本研究分为体外和体内两部分。在体外，80 名操作人员被随机分为两组。40 名操作人员进行了 40 例自主机器人种植（ARI 组）手术，其余 40 名操作人员分别对上颌模型进行了 40 例完全引导的 sCAIS（FGI 组）手术。每位操作人员在一个上颌模型中放置一个种植体。在体内，2019 年至 2023 年期间，纳入了 60 名患者的 113 个种植体（ARI 组：32 名患者，58 个种植体；FGI 组：28 名患者，55 个种植体）进行种植手术。本回顾性研究使用术前和术后锥形束计算机断层扫描（CBCT）来估计二维（2D）和三维（3D）空间中的线性偏差和角度偏差。应用 Pearson 卡方检验、Shapiro-Wilk 检验、Student's t 检验、Mann-Whitney U 检验和混合模型，p<0.05 为统计学意义。
结果
体外共纳入 80 个种植体，两组间差异有统计学意义（p<0.001）：ARI 和 FGI 组的平台 3D 偏差分别为 0.58±0.60mm 和 1.50±1.46mm，根尖处的 3D 偏差分别为 0.58±0.60mm 和 1.78±1.35mm，角度偏差分别为 1.01±0.87°和 2.93±1.59°。此外，在 2D 空间中，除了种植体平台的近远中向偏差外，ARI 组的其余线性和角度偏差均明显低于 FGI 组（p<0.001）。体内，ARI 组的角度偏差均值（0.95±0.50°，p<0.001）和平台（0.45±0.28mm，p<0.001）及根尖（0.47±0.28mm，p<0.001）的线性偏差明显低于 FGI 组（4.31±2.60°；1.45±1.27mm；1.77±1.14mm）。
结论
自主机器人技术的使用显示出明显高于完全引导的 sCAIS 的准确性。
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