数字化导板在多牙缺失种植修复中的临床应用研究

Clinical Application of Digital Guide Plate in Implant Restoration of Multiple Teeth

目的讨论在多牙缺失种植修复中应用数字化导板技术辅助外科手术的临床应用价值。方法方便筛选出2017年10月—2019年9月于该院进行口腔种植修复的多牙缺失患者20例,应用平行对照法对患者进行分组,即参照组与观察组。参照组不使用数字化导板,即传统的自由手种植,仅依靠医生的临床经验完成种植体的植入;观察组应用数字化种植外科导板辅助完成种植体植入。术后分别将两组术前和术后图像进行配准比较,测量其种植体植入的角度、植入的深度、种植体底部及肩部位置的误差值。结果入选的20例患者共计植入种植体83颗,其中参照组共计植入种植体42颗,种植体的实际植入位置与术前模拟设计位置存在一定的差异;观察组共计植入种植体41颗,种植体的实际植入位置与术前模拟设计位置基本一致。全部种植体均呈现良好的骨结合,且未发生边缘骨吸收、松动、脱落等不良状况。参照组的角度误差、植入深度误差、种植体底部误差、种植体肩部误差分别为(9.08±3.29)mm、(0.76±0.35)mm、(2.34±0.83)mm、(2.12±0.34)mm,观察组的角度误差、植入深度误差、种植体底部误差、种植体肩部误差分别为(4.38±1.48)mm、(0.50±0.32)mm、(1.54±0.56)mm、(1.24±0.52)mm。相较于参照组,观察组的植入角度误差、植入深度误差、种植体底部误差、种植体肩部误差均呈现明显的下降趋势,组间差异有统计学意义(t=8.358,3.530,5.135,9.147,P=0.001、0.001、0.001、0.001)。结论在多牙缺失种植修复中应用数字化种植外科导板辅助引导手术,有助于提高种植体在颌骨中的三维位置的精确度,从而获得理想的修复效果,具有较高的临床应用价值。

Objective To discuss the clinical application value of digital guide technology in assisting surgical operation in the restoration of multiple tooth missing implants.Methods 20 patients with multiple tooth loss who underwent dental implant restoration in the hospital from October 2017 to September 2019 were screened out,and the patients were divided into groups,namely the reference group and the observation group,using the parallel control method.The reference group did not use the digital guide plate,the traditional free-hand implantation,and only relied on the doctor's clinical experience to complete the implant implantation;the observation group used the digital implant surgical guide to assist in the completion of the implant implantation.After the operation,the two groups of preoperative and postoperative images were registered and compared,and the angle of implant implantation,implantation depth,implant bottom and shoulder position error values were measured.Results A total of 83 implants were implanted in the 20 selected patients,of which a total of 42 implants were implanted in the reference group.There was a certain difference between the actual implant position and the preoperative simulated design position;the observation group had a total of implant implants.There were 41 implants,and the actual implant position was basically the same as the preoperative simulated design position.All implants showed good osseointegration,and there were no adverse conditions such as edge bone resorption,loosening,and shedding.The angle error,implant depth error,implant bottom error,and implant shoulder error of the reference group were(9.08±3.29)mm,(0.76±0.35)mm,(2.34±0.83)mm,(2.12±0.34)mm,respectively,the angle error,implant depth error,implant bottom error,implant shoulder error of the observation group were(4.38±1.48)mm,(0.50±0.32)mm,(1.54±0.56)mm,(1.24±0.52)mm,respectively.Compared with the reference group,the observation group's implant angle error,implant depth error,implant bottom error,and implant shoulder error all showed a significant downward trend.Difference between groups were statistically significant(t=8.358,3.530,5.135,9.147,P=0.001,0.001,0.001,0.001).Conclusion The application of digital implant surgical guides in the restoration of multiple tooth missing implants can help to improve the accuracy of the three-dimensional position of the implant in the jaw,so as to obtain the ideal restoration effect,which has high clinical application value.