CAD/CAM种植导板技术在上颌牙缺失种植修复中的应用

Application of CAD/CAM template in implant restoration for maxillary tooth loss

目的探究计算机辅助设计/计算机辅助制造(CAD/CAM)种植导板技术用于上颌牙缺失种植修复的价值。方法回顾性收集2017年1月至2019年2月三门峡口腔医院收治的87例上颌牙缺失行种植修复患者的临床资料,按种植修复方式分为常规组(41例,行传统牙种植修复)与CAD/CAM组(46例,采用CAD/CAM种植导板技术行种植修复)。比较两组种植体头部、根部、深度及角度偏差值;种植前及种植后6、12个月均以数字分级评分法评估语言功能,以称量法评估咀嚼效率,并进行牙周探针探诊,评估龈沟出血指数、菌斑指数。结果CAD/CAM组种植体角度偏差值及头部、根部、深度偏差值[(0.35±0.11)°、(0.57±0.17)mm、(0.58±0.16)mm、(0.45±0.13)mm]均低于常规组[(0.51±0.15)°、(0.79±0.23)mm、(0.84±0.25)mm、(0.71±0.25)mm],P均<0.05。种植6、12个月,两组语言功能评分及咀嚼效率均高于种植前(P均<0.05),且CAD/CAM组语言功能评分及咀嚼效率均高于常规组(P均<0.05)。种植6、12个月,CAD/CAM组龈沟出血指数、菌斑指数均低于常规组(P均<0.05)。结论CAD/CAM种植导板技术较常规牙种植修复种植体植入精度更高,且更能促进患者语言及咀嚼功能恢复,有助于维持良好的牙周状态。

Objective To investigate the value of computer aided design/computer aided manufacturing(CAD/CAM)template in implant restoration for maxillary tooth loss.Methods The clinical data of 87 patients with maxillary tooth loss who underwent implant restoration in Sanmenxia Dental Hospital from January 2017 to February 2019 were retrospectively collected.According to implant restoration methods,the selected patients were divided into routine group(41 cases,treated by traditional dental implant restoration)and CAD/CAM group(46 cases,treated by implant restoration with CAD/CAM template).The deviation values of implant head,root,depth and angle were compared between the two groups.Language function was evaluated with the numerical rating scale before implantation,6 months and 12 months after implantation.Chewing efficiency was evaluated by weighing method.And periodontal probing was conducted to evaluate the sulcus bleeding index and plaque index.Results The deviation values of implant angle,head,root and depth in the CAD/CAM group were(0.35±0.11)°,(0.57±0.17)mm,(0.58±0.16)mm and(0.45±0.13)mm,respectively,which were lower than the(0.51±0.15)°,(0.79±0.23)mm,(0.84±0.25)mm,(0.71±0.25)mm in the routine group(all P<0.05).Six months and 12 months after implantation,the scores of language function and masticatory efficiency in both groups were higher than those before implantation(all P<0.05),while the scores of language function and masticatory efficiency in the CAD/CAM group were higher than those in routine group(all P<0.05).Six months and 12 months after implantation,the sulcus bleeding index and plaque index in the CAD/CAM group were lower than those in the routine group(all P<0.05).Conclusions Compared with routine dental implant restoration,implant implantation with CAD/CAM template guide technology has a higher accuracy,which can better promote recovery of language and chewing function,and is conducive to maintaining good periodontal status.