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[锥形束CT配准与口内扫描配准对机器人辅助手术中种植体准确性的影响:一项使用模拟颅骨模型的研究]

[Effect of cone beam CT registration versus intraoral scanning registration on implant accuracy in robot-assisted surgery: a study using simulated skull models].

作者信息

Wang Y X, Wang Y L, Yu S M, Zhao Y Y, Zhang Y F, Yan Q

机构信息

State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China.

出版信息

Zhonghua Kou Qiang Yi Xue Za Zhi. 2025 Aug 9;60(8):857-862. doi: 10.3760/cma.j.cn112144-20241025-00401.

Abstract

To compare the effects of using cone beam CT (CBCT) and oral scanning registration on implant positional accuracy during robot-assisted implant surgery, and to provide a basis for selecting the appropriate registration for robot-assisted implant surgical options. One patient with dentition defect, specifically missing teeth at positions 21 and 26 and having natural teeth adjacent mesially and distally to the edentulous area, who visited the Department of Oral Implantology, School of Hospital of Stomatology Wuhan University in 2024 were selected. Based on reconstructed imaging data, 30 identical jaw models were printed. These models were divided into a CBCT registration group and an intra-oral scanning registration group (15 models per group). An associate chief physician with extensive experience in implant surgery performed preoperative registration using the implant robot and completed the implant surgeries. Postoperative CBCT scans were used to determine the three-dimensional position of the implants. The deviations between the planned implant position and the actual position were evaluated, including deviations at the implantation point, apical point, and angular deviation. The differences between the two groups were compared. The implantation deviation was 0.675 (0.490) mm, apical deviation was (0.680±0.272) mm, and the angular deviation was 0.566°±0.147° in the CBCT registration group, and in the intra-oral scanning registration group, implantation deviation was 0.695 (0.313) mm, apical deviation was (0.667±0.217) mm, and the angular deviation was 0.523°±0.168°. There was no statistically significant error in implant precision between the two groups (>0.05). This experiment found that the use of intra-oral scanning registration in robot-assisted implant surgery can achieve similar implant placement accuracy as CBCT registration.

摘要

为比较在机器人辅助种植手术中使用锥形束CT(CBCT)和口腔扫描配准对种植体位置准确性的影响,并为机器人辅助种植手术选择合适的配准方式提供依据。选取2024年就诊于武汉大学口腔医院口腔种植科的1例牙列缺损患者,该患者21和26位牙齿缺失,缺牙区近远中均有天然牙。基于重建的影像数据,打印30个相同的颌骨模型。将这些模型分为CBCT配准组和口腔内扫描配准组(每组15个模型)。一位在种植手术方面经验丰富的副主任医师使用种植机器人进行术前配准并完成种植手术。术后使用CBCT扫描确定种植体的三维位置。评估计划种植位置与实际位置之间的偏差,包括植入点、根尖点的偏差以及角度偏差。比较两组之间的差异。CBCT配准组的植入偏差为0.675(0.490)mm,根尖偏差为(0.680±0.272)mm,角度偏差为0.566°±0.147°;口腔内扫描配准组的植入偏差为0.695(0.313)mm,根尖偏差为(0.667±0.217)mm,角度偏差为0.523°±0.168°。两组之间种植精度无统计学显著误差(>0.05)。本实验发现,在机器人辅助种植手术中使用口腔内扫描配准可达到与CBCT配准相似的种植体植入精度。

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