摘要
目的:评价后牙缺失患者手术导板辅助实施不翻瓣手术对种植体植入精度的影响。方法:选取2009年3月—2010年6月后牙缺失进行不翻瓣种植手术患者38例,其中男19例,女19例,平均年龄(45.06±11.10)岁,分为非导航手术组和导航手术组2组,非导航手术组男10例、女9例,上颌缺失牙17颗,下颌缺失牙22颗,由手术医师目测决定种植体窝洞预备轴向;导航手术组男9例、女10例,上颌缺失牙14颗,下颌缺失牙17颗,应用手术导板辅助进行种植体窝洞预备。术后CT扫描,以种植体长轴为中心重建缺牙区冠状面和矢状面图像,以角度偏差5°、距离偏差2mm为标准,对种植体植入位置满意度计数,对下后牙缺失病例是否出现尖端接触舌侧骨皮质、有无影响种植体植入长度的种植体计数。应用Stata 7.0软件计算上述指标的百分率并进行2组间χ2检验。结果:经统计学检验分析,与非导航手术组相比,导航手术组种植体颊舌向和近远中向角度误差以及下颌后牙种植体到下颌神经管距离误差满意率较高,下颌后牙种植体尖端接触舌侧骨皮质的发生率较低,并且因骨皮质阻挡、影响种植体植入长度的发生率较低。结论:与非导航手术组相比,手术导板可降低种植体植入角度误差和骨皮质阻挡植入种植体的发生率,使种植体植入位置满意率更高,并显著提高下颌后牙缺失病例的种植体植入长度。
PURPOSE： To evaluate the effect of guide navigated flapless surgery on the precision of implant placement in the posterior tooth area.METHODS： Thirty eight patients（19 in each gender and with an average age of 45.06±11.1 years） with posterior teeth loss were divided into 2 groups that underwent flapless surgery with or without the aid of surgical guide.The 19 patients（10 males and 9 females） of the non-guided flapless surgery group received 39 implants,during which both osteotomy and implanting were performed by manual freehand.In the guided flapless surgery group,the 19 patients（9 males and 10 females） received 31 implants,during which surgical guide aid was applied for osteotomy.The postoperative CT 3D-reconstruction coronal and the sagittal images on the axis of the actual implants were compared between the two groups.The optimal placement and angle of the implants were measured and compared using the criterion that allows≤5° for implant angle deviation,and≤2mm for the distance between the implant apical tip and the mandibular nerve canal.The number of implants whose apical tip reached lingual cortical bone in the mandibular posterior area was counted,and Chi-square test was performed to evaluate the difference between the two groups.RESULTS： Compared with non-guided flapless surgery group,the precision of the implants was found to be significantly enhanced in the guided flapless surgery group,with a greater（P0.05） number of implants showing optimal implanting angle and minimal distance deviation.There were also more implants whose apical tip were nearer the mandibular nerve canal and yet did not reach the lingual cortical bone in the guided flapless surgery group.CONCLUSIONS： Surgical guides can help optimize the angle of pilot drill for osteotomy by significantly reducing deviation in both the angle and the distance between the apical tip of the implants and the mandibular nerve canal.Surgical guides can also improve the length of implants by avoiding obstruction of the lingual cortical plate in the mandibular posterior area.
出处
《中国口腔颌面外科杂志》
CAS
2011年第6期497-501,共5页
China Journal of Oral and Maxillofacial Surgery
基金
首都医学发展科研基金(2009-3062)~~
关键词
种植义齿
导航手术
不翻瓣手术
导板
Dental implants
Navigation surgery
Flapless surgery
Surgical guide
