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全口无牙患者种植导板手术的准确性:预测与实际结果的系统评价

Accuracy of Implant Guided Surgery in Fully Edentulous Patients: Prediction vs. Actual Outcome-Systematic Review.

作者信息

Azevedo Mafalda, Correia Francisco, Faria Almeida Ricardo

机构信息

Faculty of Dental Medicine, University of Porto, 4200-393 Porto, Portugal.

Specialization in Periodontology and Implants, Faculty of Dental Medicine, University of Porto, 4200-393 Porto, Portugal.

出版信息

J Clin Med. 2024 Aug 31;13(17):5178. doi: 10.3390/jcm13175178.

Abstract

Examine deviations between the digitally planned and actual implant positions in clinical studies using static fully guided surgical guides. Identify potential associated factors and strategies to minimize their likelihood. This systematic review was conducted following the PRISMA checklist. The literature search was conducted in the PubMed and Scopus databases up to February 2024 following the PICOS search strategy. Clinical trials conducted between 2013 and 2024, evaluating the accuracy of static fully guided surgical guides placed in fully edentulous patients, were included. The studies had to assess at least two of the following parameters: angular deviation, cervical deviation, apical deviation, and depth deviation. : Out of the 298 articles initially searched, six randomized clinical trials and three clinical trials were included. All but one article used mucosa-supported guides; the remaining one used bone-supported guides. Apical deviations were more significant than cervical deviations, and implants tended to be placed too superficially. The greatest mean deviations were 2.01 ± 0.77 mm for cervical and 2.41 ± 1.45 mm for apical deviations, with the largest angular deviation recorded at 4.98 ± 2.16°. The accuracy of the surgical guide is influenced by various factors, including the technique of image acquisition and subsequent planning, guide support methods, and the adopted surgical protocol. Apical deviations are influenced by cervical and angular deviations. Additionally, deviations were more pronounced in the mandible. Further studies with similar methodologies are necessary for a more precise assessment of the different factors and for establishing safety margins.

摘要

在使用静态全引导手术导板的临床研究中,检查数字化规划的种植体位置与实际位置之间的偏差。识别潜在的相关因素和降低其发生可能性的策略。本系统评价遵循PRISMA清单进行。按照PICOS检索策略,截至2024年2月在PubMed和Scopus数据库中进行文献检索。纳入2013年至2024年期间进行的评估全口无牙患者中放置的静态全引导手术导板准确性的临床试验。这些研究必须评估以下至少两个参数:角度偏差、颈部偏差、根尖偏差和深度偏差。在最初检索的298篇文章中,纳入了6项随机临床试验和3项临床试验。除1篇文章外,所有文章均使用黏膜支持导板;其余1篇使用骨支持导板。根尖偏差比颈部偏差更显著,种植体往往放置得过于表浅。颈部偏差的最大平均偏差为2.01±0.77mm,根尖偏差为2.41±1.45mm,最大角度偏差记录为4.98±2.16°。手术导板的准确性受多种因素影响,包括图像采集和后续规划技术、导板支持方法以及采用的手术方案。根尖偏差受颈部和角度偏差的影响。此外,在下颌骨中偏差更为明显。需要采用类似方法进行进一步研究,以更精确地评估不同因素并确定安全 margins。 (注:这里“安全 margins”可能是“安全边界”之类的意思,原文表述不太准确完整)

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/00d7/11396269/f64c1b778288/jcm-13-05178-g001.jpg

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