CAJ | 학술논문

目的：评估应用以修复为导向的数字化导板进行种植牙手术后，种植体在颌骨内的实际位置与软件模拟位置的误差，探讨数字化导板的临床应用价值。方法：2011-07—2012-06期间于诸暨市人民医院口腔种植中心进行数字化导板种植牙手术者，患者术前拍摄口腔锥形束CT（CBCT），获取DICOM格式的CT数据后制作数字化种植导板,完成种植手术后再次拍摄CBCT，获取实际种植体在颌骨内的具体三维位置。选取其中5例患者24枚种植体进行术前、术后精度比较。根据手术前后2次数据，在医学牙种植设计软件中进行三维重建,比较种植体实际位置与术前模拟位置在三维方向上的误差。结果：24枚种植体在完成种植后均获得良好的位置，在位点、深度和轴向角度的三维方向上与原设计的误差分别为(0.22±0.07) mm、(0.17±0.08) mm、(0.65±0.19)°，且均P<0.05，差异无统计学意义。常规完成种植修复后通过12~24个月的随访观察，无种植体松动脱落，上部修复体咬合接触良好。结论：数字化口腔种植导板可以精确转移术前设计方案，可以避免损伤颌骨重要解剖结构，降低手术风险，有利于上部结构修复，值得临床推广应用。
목적：평고응용이수복위도향적수자화도판진행충식아수술후，충식체재합골내적실제위치여연건모의위치적오차，탐토수자화도판적림상응용개치。방법：2011-07—2012-06기간우제기시인민의원구강충식중심진행수자화도판충식아수술자，환자술전박섭구강추형속CT（CBCT），획취DICOM격식적CT수거후제작수자화충식도판,완성충식수술후재차박섭CBCT，획취실제충식체재합골내적구체삼유위치。선취기중5례환자24매충식체진행술전、술후정도비교。근거수술전후2차수거，재의학아충식설계연건중진행삼유중건,비교충식체실제위치여술전모의위치재삼유방향상적오차。결과：24매충식체재완성충식후균획득량호적위치，재위점、심도화축향각도적삼유방향상여원설계적오차분별위(0.22±0.07) mm、(0.17±0.08) mm、(0.65±0.19)°，차균P<0.05，차이무통계학의의。상규완성충식수복후통과12~24개월적수방관찰，무충식체송동탈락，상부수복체교합접촉량호。결론：수자화구강충식도판가이정학전이술전설계방안，가이피면손상합골중요해부결구，강저수술풍험，유리우상부결구수복，치득림상추엄응용。
Objective: The purpose of this study was to investigate the clinical value of computer-guided digital template in implantology. Methods: From 2011 July to 2012 June, twenty-four implants of five patients were selected to measure the deviation between planned implants and actual implants by pre- and post-operative CBCT images. Patients accepted the CBCT scanning before the operation. A recently developed interactive 3D CT software program was applied to use raw data (DICOM files) from the CT scan to display reformatted CT images for the inspection of the bony anatomy of the alveo-lar ridges. The CT scan data obtained from the software can be used to produce sterolithographic models for 3D visualiza-tion of planning complex implantology. All patients had the CBCT scanning again after operation to get the 3D data of the actual implants. Results:Twenty-four implants were all obtained in ideal physiological positions. The deviation of the site, the depth and the axial angle of the three-dimensional direction was (0.22±0.07) mm, (0.17±0.08) mm, and (0.65±0.19) ° respectively. Conclusion: The oral digital template can accurately transfer the preoperative design, and avoid to damage the important anatomical structure of jaw bones, and obtain the satisfactory denture restoration.