华西口腔医学杂志 ›› 2021, Vol. 39 ›› Issue (6): 732-738.doi: 10.7518/hxkq.2021.06.018

• 临床技术改进 • 上一篇    

数字化堆积导板中截骨导板引导后截骨量的即刻精度研究

卢嘉仪(), 余嘉怡, 解晨阳, 高静, 于海洋()   

  1. 口腔疾病研究国家重点实验室 国家口腔疾病临床医学研究中心 四川大学华西口腔医院口腔修复科,成都 610041
  • 收稿日期:2020-07-28 修回日期:2021-03-11 出版日期:2021-12-01 发布日期:2021-12-03
  • 通讯作者: 于海洋 E-mail:lujiayi2018@126.com;yhyang6812@scu.edu.cn
  • 作者简介:卢嘉仪,硕士,E-mail:lujiayi2018@126.com
  • 基金资助:
    四川省科技厅基金(2020YFS0040)

Immediate precision of the digital osteotomy template in the digital stackable template: a clinical study

Lu Jiayi(), Yu Jiayi, Xie Chenyang, Gao Jing, Yu Haiyang()   

  1. State Key Laboratory of Oral Diseases & National Clinical Research Center of Oral Diseases & Dept. of Prosthetics, West China Hospital of Stomatology, Chengdu 610041, China
  • Received:2020-07-28 Revised:2021-03-11 Online:2021-12-01 Published:2021-12-03
  • Contact: Yu Haiyang E-mail:lujiayi2018@126.com;yhyang6812@scu.edu.cn
  • Supported by:
    Sichuan Provincial Science and Technology Department Fundation(2020YFS0040)

摘要: 目的

初步评价数字化堆积导板中截骨导板引导后截骨量的即刻精度。

方法

选择2018年11月—2020年1月于四川大学华西口腔医院修复科就诊的4例无牙颌患者,所有患者符合即刻种植即刻修复的设计条件,由于患者的骨平面上的目标修复体空间不足,种植方案设计包含术中截骨,根据患者术前锥形束CT(CBCT)数据,结合患者数字微笑设计(DSD)分析、虚拟蜡型设计等,进行目标骨平面的预先虚拟设计,制作并三维打印集截骨导板、种植导板及临时修复体于一体的数字化堆积导板,以期指导术中精确截骨、正确位点种植和上部即刻修复。术中在数字化堆积导板中截骨导板的引导下,进行截骨操作。对比所有患者的术前、术后CBCT,计算实际截骨与预设截骨的体积偏差、位移偏差和角度偏差。

结果

4例患者术后截骨与预设截骨的体积偏差量平均值为492.94 mm³,占预设截骨体积的21.21%;位移偏差值平均值为0.024 8 mm,位移偏差量的散点集中趋势显著;角度偏差平均为6.03°。

结论

数字化堆积导板中截骨导板引导下进行种植固定修复过程中的截骨操作,实际截骨骨量、骨平面角度与预先设计一致性程度较好,是一种值得推广的精准可量化的临床技术。

关键词: 数字化堆积导板, 种植固定修复, 骨面目标修复空间高度

Abstract: Objective

This study aimed to evaluate the immediate accuracy of the digital osteotomy template in the digital stackable template.

Methods

From November 2018 to January 2020, 4 patients with dentition loss were selected from the Prosthodontics Department, West China Stomatological Hospital. All patients met the conditions for immediate planting and immediate restoration. Owing to the lack of vertical target-restoration space, the implantation plan included intraoperative osteotomy. According to the preoperative cone beam CT (CBCT) data, combined with aesthetic digital smile design (DSD) analysis, virtual wax design, and so on, the ideal bone plane design was performed. According to the virtual osteotomy plane, the virtual implantation plan was designed, and then the digital stackable template assuming osteotomy template, implantation guide, and temporary restoration were made and 3D printed. Osteotomy was performed under the guidance of digital osteotomy template during the operation. The preoperative CBCT and postoperative CBCT of all patients overlapped, the deviation between the actual osteotomy and the ideal osteotomy was calculated, and the angle deviation between the postoperative bone plane and the ideal bone plane was measured.

Results

The ave-rage volume deviation between the postoperative design and the ideal one was 492.94 mm³, accounting for 21.21% of the preset osteotomy volume. The average deviation between the postoperative osteotomy and the ideal osteotomy in four patients was 0.024 8 mm. The average angle between the postoperative bone plane and the ideal bone plane was 6.03°.

Conclusion

The displacement deviation of virtual osteotomy design and the actual osteotomy one under the guidance of digital osteotomy template in the digital stackable template are highly consistent with the original design. Thus, this clinical technique is worth popularizing, accurate, and quantifiable.

Key words: digital stackable template, implant supported fixed dental prothesis, vertical target restoration space

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