Lan Dongping, Zhou Zheqing, Yang Yang, Xu Zhaoyu, Man Yi
State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
Clin Oral Implants Res. 2025 Feb;36(2):191-201. doi: 10.1111/clr.14374. Epub 2024 Oct 22.
To evaluate the influence of the three-dimensional (3D) printing technology, material, sterilization, and disinfection on the accuracy of guided surgical templates.
Fifty printed resin surgical templates were designed and fabricated using a digital light processing 3D printer with a photopolymerizing resin, and 50 printed metal surgical templates were designed and fabricated using a selective laser melting 3D printer with a titanium alloy. Templates from both groups were randomly divided into five subgroups involving different sterilization and disinfection procedures. The group without any sterilization or disinfection procedure served as the control group, whereas the other groups were used as the study groups (hydrogen peroxide gas plasma sterilization, 5% povidone-iodine disinfection, 75% ethyl alcohol disinfection, and steam autoclave sterilization). Implant simulations were performed on the 3D-printed resin models, and postoperative impressions were acquired with scan bodies attached to the implants. All surgical templates were digitally scanned. The root mean square was used to determine and quantify fabrication accuracy and reproducibility, and the definitive and planned implant positions were compared.
The printed resin templates exhibited lower fabrication accuracy and reproducibility, as well as higher 3D deviations, after steam autoclave sterilization (p < 0.001); however, the printed metal templates were not affected by the different sterilization or disinfection procedures (p > 0.05).
Printed metal surgical templates are viable alternatives for guided implant surgery. Preoperative steam or gas plasma sterilization is recommended, especially for metal templates, as resin templates show deformation and decreased accuracy after steam sterilization.
chictr.org.cn number: ChiCTR2400081334.
评估三维（3D）打印技术、材料、灭菌和消毒对引导手术模板准确性的影响。
使用配备光聚合树脂的数字光处理3D打印机设计并制作50个打印树脂手术模板，使用配备钛合金的选择性激光熔化3D打印机设计并制作50个打印金属手术模板。两组模板随机分为五个亚组，涉及不同的灭菌和消毒程序。未进行任何灭菌或消毒程序的组作为对照组，其他组作为研究组（过氧化氢气体等离子体灭菌、5%聚维酮碘消毒、75%乙醇消毒和蒸汽高压灭菌）。在3D打印树脂模型上进行种植体模拟，并使用连接到种植体的扫描体获取术后印模。对所有手术模板进行数字扫描。使用均方根来确定和量化制作精度和可重复性，并比较最终和计划的种植体位置。
蒸汽高压灭菌后，打印树脂模板的制作精度和可重复性较低，三维偏差较高（p < 0.001）；然而，打印金属模板不受不同灭菌或消毒程序的影响（p > 0.05）。
打印金属手术模板是引导种植手术的可行替代方案。建议术前采用蒸汽或气体等离子体灭菌，尤其是金属模板，因为树脂模板在蒸汽灭菌后会出现变形且精度降低。
中国临床试验注册中心编号：ChiCTR2400081334 。
