摘要： 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。

关键词: 种植牙；  , 数字化导板；  , 三维精度；  , CBCT

Abstract: 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 alveolar ridges. The CT scan data obtained from the software can be used to produce sterolithographic models for 3D visualization 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.

Key words: implant, digital template, three-dimensional precision analysis, CBCT

中图分类号: 

• R782.13

• TP39.7