Mahmoud Nermine Ramadan, Kamal Eldin Mohamed Hatem, Diab Mai Hassan, Mahmoud Omar Samy, Fekry Yasser El-Sayed
Oral Surgery Department, Faculty of Dentistry, October 6 University, 12573, Egypt.
Removable Prosthodontic Department, Faculty of Dentistry, October 6 University, 12573, Egypt.
Saudi Dent J. 2024 Nov;36(11):1472-1476. doi: 10.1016/j.sdentj.2024.09.006. Epub 2024 Sep 3.
This study compares, in terms of rehabilitation and recovery, freehand implant placement using flapless or mini-flap procedures with the use of 3D implant design software and specialized surgical templates among patients who are partially or completely edentulous. A secondary aim is to propose an algorithm for predicting the accuracy of implant placement. Method.Patients with an alveolar height of at least 7 mm and an alveolar width of at least 4 mm were randomly assigned to two groups. Group I comprised ten patients who received computer-guided dental implant placement, while Group II comprised ten patients who received manual placements. A temporary prosthodontic was immediately inserted onto the implants, which was replaced by a permanent one after 4-6 months.
The study enrolled twenty patients. A blinded, independent assessor evaluated the outcome variables, which included implant failure, marginal bone loss, treatment duration, post-surgical pain and swelling, use of painkillers, surgical time, and patient satisfaction. Pain scores in Group II were significantly higher than those in Group I, but there were no other significant differences. All patients experienced pain after 2 days, but by 7 days, only two patients in Group I and four patients in Group II were still suffering, although this difference was not statistically significant. After 14 days, all patients were asymptomatic.
Although the freehand technique is straightforward for experienced surgeons, surgical guides enhance the accuracy of implant placement, particularly in a deficient alveolar ridge.
本研究比较在部分或完全无牙患者中，使用无瓣或微创瓣技术徒手植入种植体与使用三维种植体设计软件及专用手术模板植入种植体在康复和恢复方面的情况。次要目的是提出一种预测种植体植入准确性的算法。方法：将牙槽嵴高度至少为7毫米且牙槽嵴宽度至少为4毫米的患者随机分为两组。第一组包括10名接受计算机引导下牙种植体植入的患者，第二组包括10名接受徒手植入的患者。在种植体上立即植入临时假牙，4至6个月后更换为永久假牙。
该研究共纳入20名患者。由一名盲法独立评估者评估结果变量，包括种植体失败、边缘骨丢失、治疗持续时间、术后疼痛和肿胀、止痛药使用情况、手术时间以及患者满意度。第二组的疼痛评分显著高于第一组，但在其他方面无显著差异。所有患者在术后2天均感到疼痛，但到第7天，第一组仅有2名患者仍感疼痛，第二组有4名患者仍感疼痛，尽管这种差异无统计学意义。14天后，所有患者均无症状。
尽管徒手技术对经验丰富的外科医生来说操作简单，但手术导板可提高种植体植入的准确性，尤其是在牙槽嵴不足的情况下。
