Song Young Woo, Yoo Seung Ha, Jung Ui-Won
Department of Periodontology, Dental Hospital, Veterans Health Service Medical Center, Seoul, Republic of Korea.
Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Republic of Korea.
J Adv Prosthodont. 2024 Feb;16(1):1-11. doi: 10.4047/jap.2024.16.1.1. Epub 2024 Feb 23.
The present experiment aimed to evaluate the placement accuracy of fully guided implant surgery using a mucosa-supported surgical guide when the protocol of osteotomy and installation was modified (MP) compared to when the protocol was sequentially and conventionally carried out (CP).
For 24 mandibular dentiform models, 12 dentists (6 experts and 6 beginners) performed fully guided implant placements two times at the right first and second molar sites using a mucosa-supported surgical guide, once by the CP (CP group) and at the other time by the MP (MP group). The presurgical and postsurgical stereolithographic images were superimposed, and the deviations between the virtually planned and actually placed implant positions and the procedure time were compared statistically ( < .05).
The accuracies were similar in the CP and MP groups. In the CP group, the mean platform and apex deviations at the second molar site for the beginners were +0.75 mm and +1.14 mm, respectively, which were significantly larger than those for the experts ( < .05). In the MP group, only the mean vertical deviation at the second molar site for the beginners (+0.53 mm) was significantly larger than that for the experts ( < .05). The procedure time was significantly longer for the MP group (+94.0 sec) than for the CP group ( < .05).
In fully guided implant surgery using a mucosa-supported guide, the MP may improve the placement accuracy when compared to the CP, especially at sites farther from the most-posterior natural tooth.
本实验旨在评估与按顺序常规进行手术方案(CP)时相比,当截骨和种植体植入方案进行修改(MP)时,使用黏膜支持式手术导板的全引导种植手术的植入精度。
对于24个下颌牙列模型,12名牙医(6名专家和6名初学者)使用黏膜支持式手术导板在右侧第一和第二磨牙部位进行两次全引导种植体植入,一次采用CP(CP组),另一次采用MP(MP组)。将术前和术后的立体光刻图像进行叠加,并对虚拟计划植入位置与实际植入位置之间的偏差以及手术时间进行统计学比较(P<0.05)。
CP组和MP组的精度相似。在CP组中,初学者在第二磨牙部位的平均平台偏差和根尖偏差分别为+0.75mm和+1.14mm,显著大于专家的偏差(P<0.05)。在MP组中,仅初学者在第二磨牙部位的平均垂直偏差(+0.53mm)显著大于专家的偏差(P<0.05)。MP组的手术时间(+94.0秒)显著长于CP组(P<0.05)。
在使用黏膜支持式导板的全引导种植手术中,与CP相比,MP可能会提高植入精度,尤其是在距离最末端天然牙较远的部位。