国产动态导航系统用于种植体植入的评价

Evaluation of a domestic dynamic navigation system for implant placement

目的:探究国产动态导航系统用于种植牙外科植入的准确性及学习曲线。方法:回顾分析在四川大学华西口腔医院种植科进行国产动态导航下口腔种植体植入的患者16例,测量术前规划和术后实际植体的入点偏差、根尖偏差和夹角偏差以评价精确性,并探究精确性随术者开展手术例数增加的变化。结果:本研究共纳入21颗种植体,上颌9颗,下颌12颗,前牙15颗,后牙6颗。入点偏差为(1.067±0.399)mm,根尖偏差为(1.140±0.499)mm,夹角偏差为(3.209±1.158)°。对比上下颌、左右侧、前后牙,3类偏差均不存在统计学差异。分区对比,1区种植体夹角偏差低于2区和3区,其余比对均无统计学差异。学习曲线分析发现,同一术者进行动态导航下植体植入的3类偏差均随手术例数的增加而下降;线性回归分析显示入点偏差、根尖偏差与手术例数均呈负相关,而夹角偏差回归性不具有统计学意义。结论:国产导航系统用于种植牙外科植入精确性高,且随着同一术者手术例数增加,入点偏差和根尖偏差逐渐减小。

Objective:To investigate the accuracy and learning curve of the domestic dynamic navigation system for dental implant placement.Methods:Sixteen patients who underwent oral implant placement under domestic dynamic navigation were recruited.The deviation of entry point,apex and angulation between preoperative planning implant and actual implant were measured to evaluate the accuracy.The changes of accuracy were also evaluated with the increase of surgical cases.Results:A total of 21 dental implants were included in this study,9 in the maxilla,12 in the mandible,15 in the anterior and 6 in the posterior area.The implants showed an entry point deviation of(1.067±0.399)mm,an apical deviation of(1.140±0.499)mm,and an angular deviation of(3.209±1.158)°.There were no statistical differences in the three types of deviation for the upper teeth relative to the lower teeth,the anterior teeth relative to the posterior teeth,and the left teeth relative to the right teeth.Discussing by quadrant,the deviation of implant angle in zone 1 was lower than that in zone 2 and 3,simultaneously the rest of the comparisons were not statistically different.Learning curve analysis revealed that all three types of deviations in the placement of oral implants under domestic dynamic navigation performed by the same operator decreased with the increase in the number of surgical cases.Linear regression analysis showed that the entry point deviation and apical deviation were negatively correlated with the number of surgical cases,while the regression of angular deviation was not statistically significant.Conclusion:The accuracy of domestic navigation system is high.And the entry point deviation and apical deviation decrease gradually with the increase of surgical cases by the same operator.