Du Bingran, Wang Xiaoyi, Wang Jun, Ji Mohan, Yi Qin, Jiang Jiang, Tan Jinchuan, Li Jianyi
Angle Orthod. 2025 Jan 1;95(1):43-50. doi: 10.2319/022624-147.1.
To develop and assess the efficacy of a novel combined patient-specific device (CPSD) for the accurate and safe insertion of infrazygomatic crest miniscrews in orthodontic procedures.
Twenty-eight miniscrews were placed in the infrazygomatic crest region of 28 cadaver maxillae using the direct manual method (n = 14) or the CPSD (n = 14) based on preset trajectories. The CPSD, designed based on the integration model, included a positioning guide, an insertion guide, and a depth-limiting groove. Deviations in the insertion site, tip location, insertion angle, and biting depth between the preset and real insertion trajectories were calculated to evaluate the accuracy of miniscrew insertion. Classification frequencies of root proximity, sinus penetration depth, and biting depth of the miniscrew after insertion were also calculated to evaluate the safety of miniscrew insertion.
Regarding evaluation of accuracy, significant differences were observed in the deviation values of the insertion site, tip location, insertion angle, and biting depth between the CPSD and freehand groups (P = .001, P < .001, P < .001, P = .039, respectively). Regarding evaluation of safety, a significant difference was observed in the classification frequencies of root proximity between the two groups (P = .016).
Compared with manual insertion, CPSD could be a preferred method for safe and accurate insertion of infrazygomatic crest miniscrews for orthodontists.
研发并评估一种新型个性化联合装置（CPSD）在正畸治疗中准确、安全植入颧下嵴微螺钉的有效性。
基于预设轨迹，采用直接手动法（n = 14）或CPSD（n = 14）将28枚微螺钉植入28具尸体上颌骨的颧下嵴区域。基于整合模型设计的CPSD包括定位导板、植入导板和深度限制凹槽。计算预设与实际植入轨迹之间在植入部位、尖端位置、植入角度和咬合深度方面的偏差，以评估微螺钉植入的准确性。还计算了植入后微螺钉的牙根接近度、鼻窦穿透深度和咬合深度的分类频率，以评估微螺钉植入的安全性。
在准确性评估方面，CPSD组和徒手操作组在植入部位、尖端位置、植入角度和咬合深度的偏差值上存在显著差异（分别为P = .001、P < .001、P < .001、P = .039）。在安全性评估方面，两组在牙根接近度的分类频率上存在显著差异（P = .016）。
与手动植入相比，CPSD可能是正畸医生安全、准确植入颧下嵴微螺钉的首选方法。
