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新手临床医生使用动态计算机辅助种植手术的培训效果:一项前瞻性比较研究。

Training outcomes of novice clinicians in the use of dynamic computer assisted implant surgery: A prospective comparative study.

作者信息

Teparrukkul Hatsapon, Serichetaphongse Pravej, Chengprapakorn Wareerat, Arunjaroensuk Sirida, Mattheos Nikos, Pimkhaokham Atiphan

机构信息

Department of Esthetic Restorative and Implant Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.

Faculty of Dentistry, Siam University, Bangkok, Thailand.

出版信息

J Dent Sci. 2024 Dec;19(Suppl 2):S122-S127. doi: 10.1016/j.jds.2024.07.018. Epub 2024 Jul 31.

Abstract

BACKGROUND/PURPOSE: The increasing importance of computer assisted implant surgery (CAIS) in the practice of implant dentistry calls for adequate education and training of clinicians. However, limited evidence exists to support optimal educational strategies and best practices. This study aimed to investigate the effectiveness of distributed training with dynamic CAIS (d-CAIS) on the precision of freehand implant placement by inexperienced operators.

MATERIALS AND METHODS

Six senior undergraduate dental students underwent simulation training in freehand implant surgery (5 implants) followed by distributed training in d-CAIS (6 implants). A final assessment of freehand implant placement (5 implants) was conducted thereafter. Outcomes were compared to a benchmark set by an experienced surgeon who repeated the same simulation exercises. Total surgical time and implant placement precision were recorded.

RESULTS

The average precision of implant placement improved significantly after the d-CAIS training for novice operators. 3D platform deviation (1.63 ± 0.85 vs 0.92 ± 0.23;  < 0.001), 3D apical deviation (1.93 ± 0.88 vs 1.21 ± 0.19;  < 0.001), and angular deviation (5.27 ± 2.30 vs 2.74 ± 1.37;  < 0.001). The students achieved platform deviation comparable to this of the expert, but lagged in angle, apex precision, and total surgical time.

CONCLUSION

Short-term, distributed simulation training with d-CAIS can significantly enhance the precision of freehand implant placement by novice operators. However, novice operators still lagged at certain aspects of precision and surgical time when compared with the performance of an experienced surgeon in the same setup.

摘要

背景/目的:计算机辅助种植手术(CAIS)在种植牙科实践中的重要性日益增加,这就要求对临床医生进行充分的教育和培训。然而,支持最佳教育策略和最佳实践的证据有限。本研究旨在调查动态CAIS(d-CAIS)分布式培训对无经验操作者徒手种植体植入精度的有效性。

材料与方法

六名高年级本科牙科学生在徒手种植手术(5颗种植体)方面接受了模拟培训,随后在d-CAIS方面接受了分布式培训(6颗种植体)。此后进行了徒手种植体植入(5颗种植体)的最终评估。将结果与一位经验丰富的外科医生重复相同模拟练习所设定的基准进行比较。记录总手术时间和种植体植入精度。

结果

对于新手操作者,d-CAIS培训后种植体植入的平均精度有显著提高。三维平台偏差(1.63±0.85对0.92±0.23;<0.001)、三维根尖偏差(1.93±0.88对1.21±0.19;<0.001)和角度偏差(5.27±2.30对2.74±1.37;<0.001)。学生们实现的平台偏差与专家相当,但在角度、根尖精度和总手术时间方面滞后。

结论

d-CAIS的短期分布式模拟培训可显著提高新手操作者徒手种植体植入的精度。然而,与经验丰富的外科医生在相同设置下的表现相比,新手操作者在精度和手术时间的某些方面仍有差距。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3913/11725117/53a6a1bb8070/gr1.jpg

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