即刻与延期种植导航手术的术者操作误差分析

Comparison of the operating error in dynamic navigation system between immediate and delayed dental implant placement

目的:研究在即刻与延期种植两种局部骨条件下进行动态导航种植手术的术者操作误差。方法:根据种植时机将拟进行单颗牙种植的患者分为即刻种植(n=9)与延期种植(n=12)两组,由熟悉导航操作的医师在动态导航引导下完成种植手术。观察每例手术终末扩孔钻的最终位置在动态导航屏幕上显示的与术前虚拟设计间的误差(即术者操作误差),主要体现为3个指标:钻针末端的水平距离误差(Lateral);钻针的轴向角度误差(Angular);钻针末端的纵向深度误差(Longitudinal)。对两组间的上述指标进行统计分析。结果:两组间的Lateral指标具有统计学差异(P<0.05),即刻种植组为(0.56±0.29)mm,延期种植组为(0.96±0.46)mm;余指标未见显著的组间差异。结论:即便是熟悉种植导航操作的术者亦难以完全避免术者操作误差。在即刻种植中使用动态导航系统可以更好的控制水平距离误差,减少侧穿等种植并发症的发生。

Objective:Comparison of the operating error in dynamic navigation system between immediate and delayed dental implant placement.Methods:A total of 21 patients in need of a single implant were recruited and divided into 2 groups according to the timing of implant placement(immediate,n=9 and delayed,n=12).All implants were placed by well-trained clinicians with dynamic navigation system.The deviation between the real position of the final drill and the virtual planning that displayed on the dynamic navigation screen was recorded as follows:the lateral error at the apex(Lateral),the angular error(Angular)and the longitudinal error at the apex(Longitudinal).Results:The mean deviation of Lateral error in the immediate group was(0.56±0.29)mm,significantly lower than that of the delayed group(0.96±0.46 mm)(P<0.05).No significant differences were found in Angular and Longitudinal error.Conclusion:Even well-trained clinicians were difficult to avoid the operating error.The use of dynamic navigation system during immediate implant placement results in smaller lateral error,which could reduce the complication rates such as cortical plate perforation.