摘要：

目的：本文旨在通过研究不同支持式外科导板的三维精度，探讨影响导板精确性的因素，为导板的临床使用提供实验依据。方法：选取32例患者在导板引导下植入127枚种植体，利用软件对比术前设计位点、术后种植体实际位点在植入深度、角度、肩部和根部上的偏移差异，并进行统计学分析。结果：两组患者分别应用牙支持式外科导板和黏膜支持式外科导板，两组种植体偏差深度分别为（0.33±0.29） mm和（0.59±0.51） mm，肩部偏差分别为（0.32±0.27） mm和（0.76±0.55） mm，角度偏差分别为（1.83±1.52）°和（2.98±2.23）°；根部偏差分别为（0.42±0.32） mm 和（0.89±0.73） mm。统计分析得出P<0.05，组间差异具有统计学意义。表明牙支持式外科导板精确度高于黏膜支持式外科导板。压板式和止停环式导板偏差深度分别为（0.53±0.43） mm 和（0.58±0.39） mm，肩部偏差分别为（0.66±0.51） mm和（0.52±0.37） mm，角度偏差分别为（2.32±2.01）°和（2.83±2.52）°，根部偏差分别为（0.84±0.63） mm 和（0.92±0.72） mm。统计学分析得出P>0.05，说明两组间差异没有统计学意义，提示两种导板设计精度相同。结论：牙支持式种相对黏膜支持式种植外科导板能获得更高的精度；而止停环式种植外科导板在降低临床操作难度的同时，也能够获得与压板式种植外科导板引导下同样的精度。

关键词: 数字化导板, 口腔种植, 三维精度, 计算机辅助设计

Abstract: Objective: By comparing the accuracy of different types of digital guide plates, the influencing factors of implant implantation accuracy were discussed, which provided theoretical basis and experimental data for clinical application of digital guide plates. Methods: A total of 127 implants were selected from 32 patients. The implant angular deviations, depth deviations, deviations of neck and apex were measured by preoperative and postoperative CT data. The errors between the actual implant position and the preoperative simulated position were compared. Results: The mean depth deviations were （0.33±0.29） mm and （0.59±0.51） mm, the mean deviations in position at the neck were （0.32±0.27） mm and （0.76±0.55） mm the mean deviations in position at the apex were （0.42±0.32） mm and （0.89±0.73） mm and angular deviations were （1.83±1.52）° and （2.98±2.23）° with tooth- and mucosa-supported stereolithographic guides, respectively (P<0.05). The mean distance deviations when pressuring templates guided and non-pressuring templates were used were （0.66±0.51） mm and （0.52±0.37） mm, respectively, at the neck and (0.84±0.63) mm and (0.92±0.72) mm, respectively, at the apex, with corresponding mean angular deviations of （2.32±2.01）° and （2.83±2.52）° (P>0.05). Conclusions: The accuracy of dental support implant guides is better than that of mucosal support implant guides; stop-ring implant guides can reduce the difficulty of clinical operation and obtain the same results as press-plate implant guides.

Key words: Digital guide plate, Oral implant, Precision evaluation, Computer Aided Design

中图分类号: 

• R782.4