计算机辅助动态导航技术在种植手术中的临床精度影响因素分析

The study of measuring the accuracy of computer assisted real-time navigation technology in dental implant surgery

目的本研究利用计算机辅助动态导航技术引导进行种植外科手术,探索动态导航技术在种植手术中精度的影响因素,为实现精准、微创、高效的种植外科手术提供理论依据。方法选取2018年6月至2020年12月期间在烟台市口腔医院接受计算机辅助动态导航种植外科手术的病例51例,共66颗种植体。在动态导航引导下完成种植体植入,术后拍摄CBCT获取种植体三维位置,测量每颗种植体的颈部距离误差、根方距离误差及轴向角度误差。所得数据应用SPSS 22.0软件进行统计学分析,各组间测量值对比采用独立样本/检验,检验水准α=0.05,P<0.05被认为有显著性差异。结果上下颌精度对比分析,两组颈部距离误差分别为(0.59±0.16)mm和(0.63±0.19)mm,根方距离误差分别为(0.75±0.14)mm和(0.70±0.18)mm,轴向角度误差分别为(3.46±1.80)。和(3.07±1.12)°,两组数据均无统计学意义(P>0.05)。前牙区与后牙区精度对比分析,两组颈部距离误差分别为(0.60±0.21)mm和(0.60±0.16)mm,根方距离误差分别为(0.72±0.16)mm和(0.72±0.15)mm,轴向角度误差分别为(3.28±1.85)。和(3.28±1.31)°,两组数据之间均无统计学意义(P>0.05).翻瓣和不翻瓣两组结果显示,颈部距离误差分別为(0.68±0.17)mm和(0.55±0.15)mm,根方距离误差分别为(0.81±0.15)mm和(0.67±0.12)mm,轴向角度误差分别为(3.29±1.65)°和(3.35±1.58)°,两组数据之间均无统计学意义(P>0.05)。结论不同颌位、不同牙位及是否翻瓣对计算机辅助动态导航手术精度无明显影响。

Objective In this prospective study,the accuracy of computer assisted real-time navigation technology in den tai impla nt surgery was calculated,which provided theoretical basis for the further improvement of the accuracy of minimally invasive implant surgery.Methods A according to the inclusion criteria,we enrolled a sample composed of patients who had computer assisted real-time navigation implants placed between June 2018 through December 2020 in Yantai Stomatological Hospital.The cone beam sean was taken and the intraoral sean was performed.The implants were placed by aid of the computer assisted real-time navigation software and the post-surgical CBCT was taken.The errors between the designed and the actually placed implants were measured to evaluate the accuracy and effectiveness.The pre・op virtual implant and the post-op actual implant were displayed in the same three・dimensional coordinate system.The errors of shoulder distanee,root distance and angle of each implant were measured.The data was analysed by SPSS 22.0 software.The data in each group were expressed as mean+standard error(x^(-)±s).Independent sample t test was used to compare the measurements among the groups.The test level was a=0.05,P<0.05 was considered to have significant difference.Results Comparing the accuracy in maxillary and mandibular,the shoulder distance error was(0.59±0.16)mm and(0.63±0.19)mm,the root distance error was(0.75±0.14)mm and(0.70±0.18)mm,and the angle error was(3.46±1.80)°and(3.07±1.12)°respectively.Comparing the accuracy in anterior and posterior regions,the shoulder distance error was(0.60±0.21)mm and(0.60±0.16)mm,the root distance error was(0.72±0.16)mm and(0.72±0.15)mm,and the angle error was(3.28±1.85)°and(3.28±1.31)°respectively.Comparing the accuracy in flap and flapless,the shoulder distance error was(0.68±0.17)mm and(0.55±0.15)mm,the root distance error was(0.81±0.15)mm and(0.67±0.12)mm,and the angle error was(3.29±1.65)°and(3.35±1.58)°respectively.Conclusion The accuracy of computer-aided dynamic navigation system have no obvious deviation in shoulder distance,root distance and angle.