Lysenko Anna V, Yaremenko Andrey I, Ivanov Vladimir M, Lyubimov Aleksandr I, Leletkina Natalia A, Prokofeva Alina A
Federal State Budgetary Educational Institution of Higher Education "Academician I.P. Pavlov First St. Petersburg State Medical University" of the Ministry of Healthcare of Russian Federation, Saint-Petersburg, Russia.
Peter the Great St. Petersburg Polytechnic University, Saint-Petersburg, Russia.
Ann Maxillofac Surg. 2023 Jul-Dec;13(2):158-162. doi: 10.4103/ams.ams_100_23. Epub 2024 Jan 15.
The use of a surgical guide during pre-operative planning significantly increases the efficiency and safety of dental implantation. However, the current widespread use of static navigation has led to a decrease in accuracy. Dynamic navigation, on the other hand, can be an alternative. This study compared the accuracy of dental implant placement on jaw models using static navigation, a virtual guide and the manual placement method.
Nine patients with favourable conditions were selected, and three-dimensional full-body jaw models were set up. Group I had 21 implants placed using static navigation, Group II had 21 implants placed using dynamic navigation and Group III had 21 implants placed using the 'free hand' method. Placement accuracy was calculated by the deviation between the planned implant position and the actual position obtained from post-operative cone-beam computed tomography and model scanning.
The deviation from the planned implant position was 0.4° in Group I and 0.5° in Group II. The 'free hand' method yielded the worst result, with a statistically significant difference between Groups I and II. However, implantation using dynamic navigation showed a lower variance of deviation, with the majority of implants having a deviation ≤0.5 mm (86% compared to 67% in the static navigation group).
The accuracy of implant positioning using a virtual guide with dynamic imaging was comparable to static navigation and surpassed the accuracy obtained using the 'free hand' technique. This study highlights the potential of dynamic navigation control in dental implantology and warrants further clinical research to improve this system.
在术前规划过程中使用手术导板可显著提高牙种植的效率和安全性。然而，目前静态导航的广泛应用导致了准确性的下降。另一方面，动态导航可能是一种替代方案。本研究比较了使用静态导航、虚拟导板和手动植入方法在颌骨模型上植入牙种植体的准确性。
选择9例条件良好的患者，建立三维全身颌骨模型。第一组使用静态导航植入21枚种植体，第二组使用动态导航植入21枚种植体，第三组使用“徒手”方法植入21枚种植体。通过术后锥形束计算机断层扫描和模型扫描获得的计划种植体位置与实际位置之间的偏差来计算植入准确性。
第一组与计划种植体位置的偏差为0.4°，第二组为0.5°。“徒手”方法的结果最差，第一组和第二组之间存在统计学显著差异。然而，使用动态导航植入时偏差的方差较低，大多数种植体的偏差≤0.5 mm（86%，而静态导航组为67%）。
使用具有动态成像的虚拟导板进行种植体定位的准确性与静态导航相当，且超过了使用“徒手”技术获得的准确性。本研究突出了动态导航控制在牙种植学中的潜力，值得进一步开展临床研究以改进该系统。
