金属正畸微种植钉支抗导板的数字化设计与应用

Digital design and application of metal orthodontic miniscrew guide

目的:基于数字化技术设计并制作个性化金属种植钉支抗导板,评价其安全性及稳定性。方法:纳入需要种植钉支抗正畸病例40例,实验组(20例)在导板引导下植入种植钉,对照组(20例)采用传统方式植入。术后1、 3、 6月对2组微种植钉植入精确性、稳定性和安全性进行评估。结果:结果显示实验组种植钉实际植入与设计之间的角度偏差为1.23°±0.71°,钉冠部差异为(0.39±0.12) mm,钉尖部为(0.77±0.46) mm;加力后实验组无种植钉松动,仅对照组2例在术后1个月和3个月发生松动;实验组种植钉与牙根最近距离为(1.34±0.35) mm,对照组为(1.04±0.52) mm(P<0.05);实验组无种植钉与牙根接触病例,安全性Ⅰ级82.5%, Ⅱ级17.5%;对照组有3颗与牙根接触,安全性Ⅰ级60%,Ⅱ级32.5%,Ⅲ级7.5%。结论:基于数字化设计的金属种植钉支抗导板具有更高的精确性、安全性。

Objective: To study the security and stability of the individualized metal orthodontic miniscrew guide prepared by digital design and manufacture. Methods: 40 orthodontic patients underment orthodontic treatment with miniscrew anchorage were included. The guide was used in 20 cases for the plasment of the anchorate(test group) and another 20 cases without the use of the guide were included as the controls. The accuracy, stability and security were evaluated 1, 3 and 6 months after operation. Results: The results showed that the angle deviation between the actual and the design of the miniscrew was 1.23°±0.71°, the deviation at the crown was(0.39±0.12) mm, at the apical was(0.77±0.46) mm. In the control group, the miniscre was loosened at 1 month and 3 month respectively in 2 cases after implantation. The minimum distance between the miniscrew and the root of the test and control group was(1.34±0.35) mm and(1.04±0.52) mm respectively(P<0.05). There was no contact between the root and the miniscrew in the test group, the safety grade Ⅰ and Ⅱ was 82.5% and 17.5% in test group;3 miniscrews contacted with the root in the control group and the safety grade Ⅰ,Ⅱ and Ⅲ was 60%,32.5% and 7.5%, respectively. Conclusion: The implantation of orthodontic miniscrew adided with digital design and manufactured guide has higher accuracy, security and stability.