数字化种植导板在下颌后牙区连续多牙缺失下的临床应用

doi:10.6040/j.issn.1671-7554.0.2019.1318

摘要/Abstract

摘要： 目的探讨在下颌后牙区连续多牙缺失下数字化种植导板的应用价值。方法收集拟行种植修复的60例连续多牙缺失的患者临床资料,根据患者意向,将病例分为两组, 研究组(30例)采用数字化种植导板辅助完成种植,术前拍摄口腔科锥形束CT(CBCT),制取患者牙列模型,通过专用种植软件3shape完成种植导板的设计,种植导板的打印由3D打印完成;对照组(30例)是医师根据自己的临床经验靠自由手完成种植手术。两组术后均进行CBCT拍摄,评估种植体在三维位置上的差异,通过测量对比术后与术前设计的三维位置,分析种植体的精确度。结果两组种植体的初期稳定性在植入时均可达到良好的状态,种植体周围软硬组织较稳定。研究组在种植导板的辅助下顺利完成种植治疗,患者术中无明显不适感,术后肿胀及疼痛程度不明显,患者对结果较满意。研究组与对照组初期种植成功率比较差异无统计学意义(P=0.379,P>0.05);研究组植入的种植体颈部偏离值、根尖部偏离值、角度偏离值、深度偏离值均小于对照组［颈部偏差值(t=10.567, P<0.001)、根尖部偏差值(t=10.784, P<0.001)、深度偏差值(t=10.840,P<0.001)、角度偏差值(t=8.245,w=529, P<0.001)］,研究组偏差均小于对照组,两组间比较差异有统计学意义(P<0.05);研究组与对照组术后3个月满意度比较差异无统计学意义(P>0.05)。结论数字化种植导板辅助连续多牙缺失种植修复有较高的临床应用价值,使种植体在颌骨上的三维位置更精准及合理,为后期冠修复奠定良好基础,充分体现以修复为导向的种植理念。

关键词: 数字化, 种植导板, 多牙缺失, 临床应用, 3D打印技术

Abstract: Objective To explore the application value of digital implantation guide in continuous multiple tooth loss in the posterior mandibular region. Methods The clinical data of 60 patients with continuous multiple tooth loss were collected. According to their choice of treatment, the patients were divided into 2 groups. The research group(n=30)used digital implant guide to complete the implantation, the cone beam CT(CBCT)was photographed before operation to prepare the dentition model, and the implant guide was designed with a special implant software 3shape and printed with 3D printing. The control group(n=30)completed the implantation based on dentists experience. After operation, CBCT imaging was taken in both groups to evaluate the three-dimensional differences. The accuracy of implants was analyzed by measuring and comparing the three-dimensional positions designed before and after operation. Results The initial stability was good in both groups at the time of implantation, and there was no obvious swelling or pain, and patients were satisfied with the operation. There was no significant difference in the initial success rate of implantation 山东大学学报 (医学版)58卷2期 -黄平,等.数字化种植导板在下颌后牙区连续多牙缺失下的临床应用 \=-between the 2 groups(P=0.379, P>0.05). The study group had smaller implants neck deviation value (t=10.567, P<0.001), apical deviation(t=10.784, P<0.001), angle deviation(t=8.245, w=529, P<0.001), and depth deviation(t=10.840, P<0.001). There was no significant difference in satisfaction between the 2 groups 3 months after surgery(P>0.05). Conclusion The digital implantation guide has high clinical application value in the repair of continuous multi-tooth loss, which makes the three-dimensional position of implants on the jawbone more accurate and rational, lays a good foundation for later crown restoration, and fully reflects the restoration-oriented planting concept.

Key words: Digitalization, Planting guide, Multiple tooth loss, Clinical application, 3D printing technology

中图分类号:

R782

黄平,商红国. 数字化种植导板在下颌后牙区连续多牙缺失下的临床应用[J]. 山东大学学报 (医学版), 2020, 58(2): 60-63.

HUANG Ping, SHANG Hongguo. Clinical application of digital implant guide in the absence of continuous multiple teeth in the mandibular posterior tooth area[J]. Journal of Shandong University (Health Sciences), 2020, 58(2): 60-63.

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