隧道式模板辅助种植微种植体精确性的研究

Study on the accuracy of tunnel-type template assisting mini-implant anchorage surgery

目的研究自行研制的放射检查模板及隧道式外科手术模板辅助种植体支抗种植的精确性,评价其临床实用价值。方法采用透明托作标记制作放射模板,以多层螺旋CT(MSCT)对猪颅骨定位扫描并重建。在MSCT影像上精确设计三维种植角度。根据角度数据信息制作隧道式手术模板,并种植32枚微螺钉支抗。术后MSCT再次扫描重建,并解剖猪颅骨牙槽突。对术前MSCT设计角度、术后MSCT测量角度及术后解剖组织块实物测量角度作统计学分析。结果 32枚微螺钉种植情况满意,无伤及邻近牙根及周围重要组织结构的情况。术前设计与术后MSCT测量角度比较,以及术前设计与实物测量角度比较,在轴位面及侧断面上其差异均无统计学意义(P>0.05),且一致性极好。结论自行研制的放射模板及隧道式手术模板能高效、精确地引导种植支抗手术,尤其对疑难病例,为提高种植术的成功率提供可靠保障。

Objective To assess the accuracy of the radiographic and the tunnel-type surgical template assisting implant anchorage surgery.Methods The transparent radiographic templates were made in order to assist MSCT to scan two pigs＇skulls locatively.After the implant anchorage angles was designed in MSCT images accurately,the tunnel-type surgical template was made according to angle data values.Then 32 miniscrews were implanted in the up and lower alveolar processes with the surgical template assistant,and the two pigs＇skulls were rescanned by MSCT.After dissecting the pigs alveolar processes,the data of the MSCT preoperative planning angles,the MSCT postoperative measurement angles and the measurement angles of anatomic bone samples were analyzed statistically.Results Thirty-two miniscrews were implanted successfully.All of them never hurt dental roots and important structures around them.Comparing MSCT preoperative planning angles with MSCT postoperative measurement angles and anatomic bone samples measurement angles,there was no significant difference on axial sections or crossed-sections,and the concordance correlation was very good.Conclusion It is proved that the radiographic and the tunnel-type surgical templates are accurate and reliable for operation,which will help to improve the success rate of implant anchorage,especially for the difficult cases.