Nava Paolo, Sabri Hamoun, Calatrava Javier, Zimmer Jacob, Chen Zhaozhao, Li Junying, Wang Hom-Lay
Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA.
Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain.
Clin Implant Dent Relat Res. 2025 Feb;27(1):e13401. doi: 10.1111/cid.13401. Epub 2024 Oct 3.
To evaluate the feasibility of ultrasound-image-based computer-assisted implant planning and placement.
Intraoral scans, cone-beam computerized tomography (CBCT), and ultrasound (US) scans with a custom positioning device were acquired in nine patients. Prosthetic-driven surgical guides were planned and fabricated based on ultrasound images and intraoral scans. Implants were then placed. Postoperative implant position was obtained intra-surgically by intraoral scan. Aside from the ultrasound-based plan, conventional implant planning was performed by the same operator on a pre-surgical CBCT for comparison. Linear deviations between ultrasound and CBCT-planned implant positions were measured and compared with the intra-surgical implant position, and the position deviations between two consecutive plannings were performed on the same CBCT by the same operator. The linear deviation between the 3D scan surface of the edentulous region and the ultrasonographic soft tissue profile segmentation was also assessed with reverse-engineering software. Means, standard deviations, and root mean square differences (RMSD) were calculated for every variable.
All the ultrasound-planned implants were successfully placed, and no complications were recorded. The mean deviations in angles, shoulders, and apexes were 5.27 ± 1.75° (RMSD: 5.53°), 0.92 ± 0.26 mm (RMSD: 0.95 mm), and 1.41 ± 0.61 mm (RMSD: 1.53 mm), respectively, between the US and CBCT-planned implants; 2.63 ± 0.43° (RMSD: 2.66°), 1.16 ± 0.30 mm (RMSD: 1.19 mm), and 1.26 ± 0.27 mm (RMSD: 1.28 mm) between the planned implant and intra-surgically recorded positions; and 2.90 ± 1.36° (RMSD: 3.18°), 0.65 ± 0.27 mm (RMSD: 0.70 mm), and 0.99 ± 0.37 mm (RMSD: 1.05 mm) between two consecutive CBCTs planning performed by the same operator. The mean deviation between the 3D surfaces of model scans and ultrasound-derived soft tissue profile in the edentulous area was 0.19 ± 0.08 mm.
Ultrasound-guided implant surgery represents a feasible non-ionizing alternative to conventional static guided implant surgical protocols for implant placement in sites with favorable characteristics.
评估基于超声图像的计算机辅助种植体规划与植入的可行性。
对9例患者进行口内扫描、锥形束计算机断层扫描（CBCT）以及使用定制定位装置进行的超声（US）扫描。基于超声图像和口内扫描规划并制作修复驱动的手术导板。然后植入种植体。术中通过口内扫描获取术后种植体位置。除了基于超声的规划外，由同一名操作人员在术前CBCT上进行传统种植体规划以作比较。测量超声与CBCT规划的种植体位置之间的线性偏差，并与术中种植体位置进行比较，且由同一名操作人员在同一CBCT上对两个连续规划之间的位置偏差进行测量。还使用逆向工程软件评估无牙区三维扫描表面与超声软组织轮廓分割之间的线性偏差。计算每个变量的均值、标准差和均方根差（RMSD）。
所有超声规划的种植体均成功植入，且未记录到并发症。超声与CBCT规划的种植体之间，角度、肩部和根尖的平均偏差分别为5.27±1.75°（RMSD：5.53°）、0.92±0.26 mm（RMSD：0.95 mm）和1.41±0.61 mm（RMSD：1.53 mm）；规划的种植体与术中记录位置之间分别为2.63±0.43°（RMSD：2.66°）、1.16±0.30 mm（RMSD：1.19 mm）和1.26±0.27 mm（RMSD：1.28 mm）；同一名操作人员在两个连续的CBCT规划之间分别为2.90±1.36°（RMSD：3.18°）、0.65±0.27 mm（RMSD：0.70 mm）和0.99±0.37 mm（RMSD：1.05 mm）。无牙区模型扫描三维表面与超声衍生软组织轮廓之间的平均偏差为0.19±0.08 mm。
超声引导下的种植手术是一种可行的非电离替代方法，可用于在具有良好特征的部位进行种植体植入的传统静态引导种植手术方案。
