Evaluation of the implant placement accuracy under dynamic navigation guidance using intraoral scanning

doi:10.12439/kqhm.1005-4979.2025.03.006

Abstract

Abstract:

Objective: To evaluate the accuracy of implant placement guided by dynamic navigation by comparing digital intraoral scanning (IOS) with the traditional cone beam CT (CBCT)-based method, and to provide further evidence for the feasibility of using IOS as an evaluation tool.Methods: Sixty mandibular resin models were printed, and 2 implants (31 and 36) were placed in each model using dynamic computer-aided implant surgery. One hundred and twenty implants were placed. Postoperatively, the achieved implant positions were assessed using both CBCT and IOS. The implant deviations were then measured by importing the data into an accuracy analysis software.Results: Significant differences between CBCT and IOS were observed in global coronal and angular deviations (P<0.01), but not for the other deviations. The differences between the two methods were statistically significant for the global coronal, lateral coronal, and angular deviations (P<0.01) at site 31, and for the vertical coronal, vertical apical, and angular deviations (P<0.05) at site 36.Conclusion: The accuracy of the IOS-based evaluation method for measuring implant accuracy is consistent with that of the conventional CBCT assessment method and meets the clinical requirements. However, further clinical study is required to confirm the accuracy and feasibility of this method.

Key words: intraoral scan, dynamic navigation, implant accuracy, cone beam CT

摘要：

目的： 采用数字化口腔内扫描（intraoral scan，IOS）方法评估动态导航引导下种植修复的准确性，并将该技术与传统的锥形束CT (cone beam CT，CBCT)评估方法进行比较，为IOS评估方法的可行性提供进一步的证据。方法： 打印60个下颌树脂模型，使用动态导航计算机辅助种植手术（computer-aided implant surgery，CAIS）在每个模型上植入2枚种植体（31牙和36牙），共植入120枚种植体。术后采用CBCT和IOS 2种方法获取种植体的植入位置，并将数据导入精度验证软件中测量种植体的偏差。结果：比较CBCT和IOS 2种评估方法计算的植入点总偏差和角度偏差，差异具有统计学意义（均P<0.01），其余偏差差异均无统计学意义。在31位点，2种方法植入点的总偏差、横向偏差和角度偏差差异均具有统计学意义（均P<0.01）；在36位点，2种方法的植入点深度偏差、根尖点深度偏差和角度偏差差异具有统计学意义（均P<0.05）。结论：IOS方法评估种植精度的准确性与传统CBCT评估方法较为一致，能达到临床要求，但仍需要进一步的临床研究来验证该方法的准确性和可行性。

关键词: 口腔内扫描, 动态导航, 种植精度, 锥形束CT

CLC Number:

R782

LIU Yitian, XU Zonghe, XIAO Yanjun, XU Qiyin, GUO Wen, ZHANG Sihui, WU Dong. Evaluation of the implant placement accuracy under dynamic navigation guidance using intraoral scanning[J]. 《Journal of Oral and Maxillofacial Surgery》, 2025, 35(3): 205-213.

刘怡田, 许宗和, 肖妍君, 许其印, 郭雯, 张思慧, 吴东. 口内扫描对动态导航引导下种植体植入精度的评估[J]. 《口腔颌面外科杂志》, 2025, 35(3): 205-213.

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URL: https://journal06.magtech.org.cn/Jweb_joms/EN/10.12439/kqhm.1005-4979.2025.03.006

https://journal06.magtech.org.cn/Jweb_joms/EN/Y2025/V35/I3/205

Figures/Tables 8

References 32

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偏差类型		n	平均值	标准差	95%CI	t值	P值
植入点总偏差/mm	CBCT	120	0.71	0.30
	IOS	120	0.66	0.27
	差值	120	0.05	0.20	0.02~0.09	2.789	0.006
植入点横向偏差/mm	CBCT	120	0.63	0.30
	IOS	120	0.60	0.28
	差值	120	0.03	0.21	0~0.07	1.788	0.076
植入点深度偏差/mm	CBCT	120	0.03	0.34
	IOS	120	0.04	0.28
	差值	120	-0.01	0.19	-0.04~0.02	-0.641	0.523
根尖点总偏差/mm	CBCT	120	0.83	0.35
	IOS	120	0.82	0.34
	差值	120	0.01	0.22	-0.03~0.05	0.295	0.769
根尖点横向偏差/mm	CBCT	120	0.75	0.36
	IOS	120	0.76	0.36
	差值	120	-0.02	0.24	-0.06~0.03	-0.749	0.455
根尖点深度偏差/mm	CBCT	120	0.02	0.33
	IOS	120	0.03	0.27
	差值	120	-0.01	0.19	-0.04~0.02	-0.522	0.603
角度偏差/(°)	CBCT	120	1.56	0.86
	IOS	120	1.73	0.95
	差值	120	-0.17	0.51	-0.27~-0.08	-3.753	<0.001

偏差类型		n	平均值	标准差	95%CI	t值	P值
植入点总偏差/mm	CBCT	120	0.71	0.30
	IOS	120	0.66	0.27
	差值	120	0.05	0.20	0.02~0.09	2.789	0.006
植入点横向偏差/mm	CBCT	120	0.63	0.30
	IOS	120	0.60	0.28
	差值	120	0.03	0.21	0~0.07	1.788	0.076
植入点深度偏差/mm	CBCT	120	0.03	0.34
	IOS	120	0.04	0.28
	差值	120	-0.01	0.19	-0.04~0.02	-0.641	0.523
根尖点总偏差/mm	CBCT	120	0.83	0.35
	IOS	120	0.82	0.34
	差值	120	0.01	0.22	-0.03~0.05	0.295	0.769
根尖点横向偏差/mm	CBCT	120	0.75	0.36
	IOS	120	0.76	0.36
	差值	120	-0.02	0.24	-0.06~0.03	-0.749	0.455
根尖点深度偏差/mm	CBCT	120	0.02	0.33
	IOS	120	0.03	0.27
	差值	120	-0.01	0.19	-0.04~0.02	-0.522	0.603
角度偏差/(°)	CBCT	120	1.56	0.86
	IOS	120	1.73	0.95
	差值	120	-0.17	0.51	-0.27~-0.08	-3.753	<0.001

偏差类型		n	平均值	标准差	95%CI	t值	P值
植入点总偏差/mm	CBCT	60	0.67	0.29
	IOS	60	0.59	0.26
	差值	60	0.08	0.20	0.03~0.13	3.025	0.004
植入点横向偏差/mm	CBCT	60	0.59	0.29
	IOS	60	0.52	0.27
	差值	60	0.07	0.20	0.02~0.12	2.789	0.007
植入点深度偏差/mm	CBCT	60	0.08	0.30
	IOS	60	0.04	0.26
	差值	60	0.04	0.20	-0.02~0.09	1.365	0.178
根尖点总偏差/mm	CBCT	60	0.84	0.38
	IOS	60	0.82	0.40
	差值	60	0.02	0.20	-0.03~0.07	0.859	0.394
根尖点横向偏差/mm	CBCT	60	0.78	0.40
	IOS	60	0.77	0.42
	差值	60	0.01	0.22	-0.05~0.07	0.336	0.738
根尖点深度偏差/mm	CBCT	60	0.07	0.29
	IOS	60	0.03	0.26
	差值	60	0.04	0.20	-0.01~0.09	1.511	0.136
角度偏差/(°)	CBCT	60	1.72	0.95
	IOS	60	1.94	1.09
	差值	60	-0.22	0.56	-0.37~-0.07	-3.013	0.004

偏差类型		n	平均值	标准差	95%CI	t值	P值
植入点总偏差/mm	CBCT	60	0.67	0.29
	IOS	60	0.59	0.26
	差值	60	0.08	0.20	0.03~0.13	3.025	0.004
植入点横向偏差/mm	CBCT	60	0.59	0.29
	IOS	60	0.52	0.27
	差值	60	0.07	0.20	0.02~0.12	2.789	0.007
植入点深度偏差/mm	CBCT	60	0.08	0.30
	IOS	60	0.04	0.26
	差值	60	0.04	0.20	-0.02~0.09	1.365	0.178
根尖点总偏差/mm	CBCT	60	0.84	0.38
	IOS	60	0.82	0.40
	差值	60	0.02	0.20	-0.03~0.07	0.859	0.394
根尖点横向偏差/mm	CBCT	60	0.78	0.40
	IOS	60	0.77	0.42
	差值	60	0.01	0.22	-0.05~0.07	0.336	0.738
根尖点深度偏差/mm	CBCT	60	0.07	0.29
	IOS	60	0.03	0.26
	差值	60	0.04	0.20	-0.01~0.09	1.511	0.136
角度偏差/(°)	CBCT	60	1.72	0.95
	IOS	60	1.94	1.09
	差值	60	-0.22	0.56	-0.37~-0.07	-3.013	0.004

偏差类型		n	平均值	标准差	95%CI	t值	P值
植入点总偏差/mm	CBCT	60	0.76	0.31
	IOS	60	0.73	0.28
	差值	60	0.03	0.21	-0.03~0.08	0.974	0.334
植入点横向偏差/mm	CBCT	60	0.67	0.30
	IOS	60	0.67	0.28
	差值	60	0.00	0.21	-0.06~0.05	-0.116	0.908
植入点深度偏差/mm	CBCT	60	-0.02	0.37
	IOS	60	0.04	0.30
	差值	60	-0.06	0.16	-0.10~-0.02	-2.783	0.007
根尖点总偏差/mm	CBCT	60	0.81	0.31
	IOS	60	0.82	0.27
	差值	60	-0.01	0.24	-0.07~0.05	-0.349	0.728
根尖点横向偏差/mm	CBCT	60	0.72	0.32
	IOS	60	0.76	0.30
	差值	60	-0.04	0.25	-0.11~0.02	-1.303	0.198
根尖点深度偏差/mm	CBCT	60	-0.02	0.37
	IOS	60	0.03	0.29
	差值	60	-0.06	0.16	-0.10~-0.02	-2.787	0.007
角度偏差/(°)	CBCT	60	1.41	0.72
	IOS	60	1.53	0.74
	差值	60	-0.13	0.44	-0.24~-0.01	-2.239	0.029

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