Dotia Aditya, Selvaganesh Sahana, R P Abhinav, Nesappan Thiyaneswaran
Implantology, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, IND.
Oral Surgery, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, IND.
Cureus. 2024 Feb 5;16(2):e53621. doi: 10.7759/cureus.53621. eCollection 2024 Feb.
This study aims to evaluate the accuracy associated with the use of a dynamic navigation system for the lateral window opening for a direct sinus floor elevation (SFE) procedure with simultaneous implant placement.
A female patient, aged 27 years, reported to the Department of Implantology seeking treatment for her lost tooth. On radiographic examination, the residual alveolar ridge height was 6 mm in the 26 (left upper first molar) region. For the implant placement, the case was planned to be carried out under dynamic navigation (Navident, Claronav, Canada). To make the lateral window accessible to the sinus floor, an implant trajectory resembling the required window dimensions and prosthetic implant position was planned. Post-surgery cone beam computed tomography (CBCT) was taken to assess the accuracy of the lateral window and implant trajectories using Evalunav (Navident, Claronav, Canada) analysis with dynamic navigation software.
There was improved accuracy of the lateral window opening, and the visualization of the lateral window was maintained in real-time throughout the procedure, which was advantageous to eliminate the tearing of the thin sinus membrane. The deviations found in the trajectory of the lateral window in comparison between the planning and post-procedure were: (a) entry was deviated by 2.83 mm; (b) the apex was deviated by 2.52 mm; (c) vertically, the apex was deviated by 0.29 mm; and (d) there was an 8.93° deviation in the angulation of the trajectory. The implant that was placed simultaneously with the SFE's accuracy was in comparison with the position that was planned: (a) entry was deviated by 0.03 mm, (b) the apex was deviated by 0.82 mm, (c) vertically, the apex was deviated by 0.82 mm, and (d) there was a 0° deviation in the angulation of the trajectory.
Dynamic navigation technology can help overcome complications associated with direct sinus lift procedures by providing highly accurate and precise planning and execution of the surgical procedure. This can lead to improved implant stability and a reduced risk of complications.
本研究旨在评估在直接上颌窦底提升术（SFE）并同期植入种植体时，使用动态导航系统进行侧窗开窗的准确性。
一名27岁女性患者前往种植科就诊，寻求缺失牙治疗。经影像学检查，26区（左上第一磨牙）剩余牙槽嵴高度为6mm。对于种植体植入，该病例计划在动态导航（加拿大Claronav公司的Navident）下进行。为使上颌窦底能够进行侧窗开窗，规划了一条类似于所需窗尺寸和种植体修复位置的种植体轨迹。术后进行锥形束计算机断层扫描（CBCT），使用Evalunav（加拿大Claronav公司的Navident）分析和动态导航软件评估侧窗和种植体轨迹的准确性。
侧窗开窗的准确性有所提高，并且在整个手术过程中侧窗的可视化得以实时保持，这有利于避免薄的上颌窦黏膜撕裂。计划与术后侧窗轨迹的偏差为：（a）入口偏差2.83mm；（b）根尖偏差2.52mm；（c）垂直方向上，根尖偏差0.29mm；（d）轨迹角度偏差8.93°。与SFE同期植入的种植体的准确性与计划位置相比：（a）入口偏差0.03mm；（b）根尖偏差0.82mm；（c）垂直方向上，根尖偏差0.82mm；（d）轨迹角度偏差0°。
动态导航技术通过提供高度准确和精确的手术规划与执行，有助于克服与直接上颌窦提升术相关的并发症。这可提高种植体稳定性并降低并发症风险。
