三维计算机辅助种植手术导板的准确性:模板设计影响的前瞻性体内研究

Accuracy of Three-Dimensional Computer-Aided Implant Surgical Guides: A Prospective In Vivo Study of the Impact of Template Design.

作者信息

Vartan Noel, Gath Lotta, Olmos Manuel, Plewe Konstantin, Vogl Christoph, Kesting Marco Rainer, Wichmann Manfred, Matta Ragai Edward, Buchbender Mayte

机构信息

Department of Oral and Maxillofacial Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, Glückstrasse 11, 91054 Erlangen, Germany.

Department of Prosthodontics, University Hospital Erlangen of Friedrich-Alexander Universität Erlangen-Nürnberg, Glückstrasse 11, 91054 Erlangen, Germany.

出版信息

Dent J (Basel). 2025 Mar 29;13(4):150. doi: 10.3390/dj13040150.

Abstract

: Digital planning and the use of a static surgical guide for implant placement provide predictability and safety for patients and practitioners. The aim of this study was to investigate differences in the accuracy and fit of long and short guides. : In patients with at least one missing tooth, long (supported by the entire dental arch) and short templates (supported by two teeth, mesial and distal) were compared via intraoral scans and the superimposition of the STL files of the initial planning and the actual position in the patient's mouth along the X-, Y- and Z-axes. Furthermore, this study evaluated the conditions (e.g., mouth opening, the implant position) under which fully guided implantation can be realized. : The largest deviation was observed in the Z-axis, although this deviation was not as high for the short templates (0.2275 mm) as it was for the long templates (0.4007 mm). With respect to the 3D deviation (dXYZ), the average deviation from the mean value was 0.2953 mm for the short guides and 0.4360 mm for the long guides ( = 0.002). The effect size (Cohen's d) was 0.709, which was between the medium (0.50) and large effect sizes (0.80). The shorter templates showed a smaller deviation from the actual plan by 80%. With a mouth opening ≥50 mm, fully guided surgery can be performed in the molar region. In the premolar region, the lower limit was 32 mm. : The 3D accuracy was significantly higher for the shorter template, which could therefore be favored.

摘要

数字化规划以及使用静态手术导板进行种植体植入可为患者和从业者提供可预测性和安全性。本研究的目的是调查长导板和短导板在准确性和适配性方面的差异。:在至少有一颗牙齿缺失的患者中,通过口内扫描以及沿X、Y和Z轴将初始规划的STL文件与患者口腔内的实际位置进行叠加,比较了长导板(由整个牙弓支撑)和短导板(由两颗牙齿,即近中牙和远中牙支撑)。此外,本研究评估了能够实现完全引导式种植的条件(例如,开口度、种植体位置)。:在Z轴上观察到的偏差最大,不过短导板的这种偏差(0.2275毫米)不像长导板(0.4007毫米)那么大。关于三维偏差(dXYZ),短导板的平均偏差为0.2953毫米,长导板为0.4360毫米(P = 0.002)。效应量(科恩d值)为0.709,介于中等效应量(0.50)和大效应量(0.80)之间。较短的导板与实际规划的偏差小80%。当开口度≥50毫米时,可在磨牙区进行完全引导式手术。在前磨牙区,下限为32毫米。:较短导板的三维准确性明显更高,因此可能更具优势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4837/12025446/7ee3a7e6cb36/dentistry-13-00150-g001.jpg

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