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半主动机器人系统在萎缩性上颌后牙区种植体植入中的应用:一项回顾性病例系列研究。

Application of a semi-active robotic system for implant placement in atrophic posterior maxilla: A retrospective case series.

作者信息

Zhao Ningbo, Zhu Rongrong, Liao Lifan, Zhang Meng, He Longlong, Zhou Qin

机构信息

Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, PR China; Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Disease, College of Stomatology, Xi'an Jiaotong University, PR China; Department of Implant Dentistry, College of Stomatology, Xi'an Jiaotong University, PR China.

Department of Implant Dentistry, College of Stomatology, Xi'an Jiaotong University, PR China.

出版信息

J Dent. 2025 Mar;154:105593. doi: 10.1016/j.jdent.2025.105593. Epub 2025 Jan 26.

Abstract

OBJECTIVE

The study aimed to evaluate the accuracy and safety of a semi-active robotic system for implant placement in atrophic posterior maxilla.

METHODS

Patients underwent robot-assisted implant placement in atrophic posterior maxilla were identified and included. Cone-beam computed tomography (CBCT) was performed before surgery. The virtual implant position and drilling sequences were planned in the robotic planning system. Patients with positioning marker took an intraoral scan. The preoperative CBCT and the intraoral scan were superimposed in the robotic software. After registration, the implant bed was prepared utilizing the robotic arm with 1 mm safety margin below the maxillary sinus floor. The transcrestal sinus floor elevation (TSFE) was performed by the dentist, followed by the implant placement with the robotic arm. A postoperative CBCT was taken and superimposed with the preoperative one to calculate the accuracy of implant placement. Complications and adverse events were recorded. Deviations between the implant platform and apex levels were analyzed using the paired t-test. P < 0.05 was considered statistically significant.

RESULTS

Twenty-seven implants of 20 patients were included. No intraoperative and postoperative complications were reported. The global, lateral and vertical platform deviations were 0.73 ± 0.27 mm, 0.35 ± 0.23 mm and 0.35 ± 0.57 mm, respectively. The global, lateral and vertical apex deviations were 0.77 ± 0.23 mm, 0.41 ± 0.20 mm and 0.34 ± 0.57 mm, respectively. There were significant differences between the global, lateral and vertical deviations between the implant platform and apex levels (P < 0.05, respectively). The angular deviation was 1.58 ± 0.76°.

CONCLUSIONS

High accuracy and safety for implant placement in atrophic posterior maxilla could be achieved using a semi-active robotic system, with the TSFE procedure performed by the dentist.

CLINICAL SIGNIFICANCE

This study provides significant evidence to support the application of semi-active robotic systems for implant placement in atrophic posterior maxilla.

摘要

目的

本研究旨在评估一种半主动机器人系统用于萎缩性上颌后牙区种植体植入的准确性和安全性。

方法

纳入接受机器人辅助萎缩性上颌后牙区种植体植入的患者。术前进行锥形束计算机断层扫描(CBCT)。在机器人规划系统中规划虚拟种植体位置和钻孔顺序。佩戴定位标记的患者进行口内扫描。术前CBCT和口内扫描在机器人软件中进行叠加。配准后,使用机械臂在距上颌窦底下方1 mm安全边缘处制备种植窝。由牙医进行经牙槽嵴上颌窦底提升术(TSFE),然后使用机械臂植入种植体。术后进行CBCT并与术前CBCT叠加以计算种植体植入的准确性。记录并发症和不良事件。使用配对t检验分析种植体平台和根尖水平之间的偏差。P < 0.05被认为具有统计学意义。

结果

纳入20例患者的27枚种植体。未报告术中及术后并发症。种植体平台的整体、横向和垂直偏差分别为0.73±0.27 mm、0.35±0.23 mm和0.35±0.57 mm。种植体根尖的整体、横向和垂直偏差分别为0.77±0.23 mm, 0.41±0.20 mm和0.34±0.57 mm。种植体平台和根尖水平之间的整体、横向和垂直偏差存在显著差异(P均< 0.05)。角度偏差为1.58±0.76°。

结论

使用半主动机器人系统并由牙医进行TSFE手术,可在萎缩性上颌后牙区实现较高的种植体植入准确性和安全性。

临床意义

本研究为支持半主动机器人系统在萎缩性上颌后牙区种植体植入中的应用提供了重要证据。

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