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首页> 外文期刊>The Journal of Prosthetic Dentistry >Accuracy of three different types of stereolithographic surgical guide in implant placement: An in vitro study
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Accuracy of three different types of stereolithographic surgical guide in implant placement: An in vitro study

机译：三种不同类型的立体光刻手术指南在植入物中的准确性：一项体外研究

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Statement of problem: Precise treatment planning before implant surgery is necessary to identify vital structures and to ensure a predictable restorative outcome. Purpose: The purpose of this study was to compare the accuracy of implant placement by using 3 different types of surgical guide: bone-supported, tooth-supported, and mucosa-supported. Material and methods: Thirty acrylic resin mandibles were fabricated with stereolithography (SLA) based on data from the cone beam computerized tomography (CBCT) scan of an edentulous patient. Ten of the mandibles were modified digitally before fabrication with the addition of 4 teeth, and 10 of the mandibles were modified after fabrication with soft acrylic resin to simulate mucosa. Each acrylic resin mandible had 5 implants virtually planned in a 3-D software program. A total of 150 implants were planned and placed by using SLA guides. Presurgical and postsurgical CBCT scans were superimposed to compare the virtual implant placement with the actual implant placement. For statistical analyses, a linear mixed models approach and t-test with the 2-sided alpha level set at.016 were used. All reported P values were adjusted by the Dunn-Sidak method to control the Type I error rate across multiple pairwise comparisons. Results: The mean angular deviation of the long axis between the planned and placed implants was 2.2 ±1.2 degrees; the mean deviations in linear distance between the planned and placed implants were 1.18 ±0.42 mm at the implant neck and 1.44 ±0.67 mm at the implant apex for all 150 implants. After the superimposition procedure, the angular deviation of the placed implants was 2.26 ±1.30 degrees with the tooth-supported, 2.17 ±1.02 degrees with the bone-supported, and 2.29 ±1.28 degrees with the mucosa-supported SLA guide. The mean deviations in linear distance between the planned and placed implants at the neck and apex were 1.00 ±0.33 mm and 1.15 ±0.42 mm for the tooth-supported guides; 1.08 ±0.33 mm and 1.53 ±0.90 mm for the bone-supported guides; and 1.47 ±0.43 mm and 1.65 ±0.48 mm for the mucosa-supported SLA surgical guides. Conclusions: The results of this study show that stereolithographic surgical guides may be reliable in implant placement and that: 1) there was no statistically significant difference among the 3 types of guide when comparing angular deviation and 2) mucosa-supported guides were less accurate than both tooth-supported and bone-supported guides for linear deviation at the implant neck and apex.
机译：问题陈述：植入手术之前必须进行精确的治疗计划，以识别重要结构并确保可预测的修复结果。目的：本研究的目的是通过使用3种不同类型的手术指南（骨骼支撑，牙齿支撑和粘膜支撑）来比较植入物放置的准确性。材料和方法：根据来自无牙颌患者的锥束计算机X线断层扫描（CBCT）扫描的数据，使用立体平版印刷术（SLA）制造了30种丙烯酸树脂下颌骨。下颌骨中的十个在制造前通过添加4颗牙齿进行数字修改，而下颌骨在制造后用软质丙烯酸树脂模拟黏膜来进行修改。每个丙烯酸树脂下颌骨均在3D软件程序中虚拟计划了5个植入物。使用SLA指南计划并放置了总共150个植入物。叠加术前和术后CBCT扫描，以比较虚拟种植体位置与实际种植体位置。为了进行统计分析，使用了线性混合模型方法和t检验，其两面alpha水平设置为016。通过Dunn-Sidak方法调整所有报告的P值，以在多个成对比较中控制I型错误率。结果：计划种植体与放置种植体之间的长轴平均角度偏差为2.2±1.2度;对于所有150个种植体，计划种植体和放置种植体之间的线性距离的平均偏差在种植体颈部为1.18±0.42 mm，在种植体顶点为1.44±0.67 mm。叠加程序后，放置的植入物在牙齿支撑下的角度偏差为2.26±1.30度，在骨骼支撑下为2.17±1.02度，在黏膜支撑SLA导向器下为2.29±1.28度。牙齿支撑的导向器在颈部和根尖计划种植和放置的种植体之间的线性距离的平均偏差为1.00±0.33 mm和1.15±0.42 mm。骨支撑导向器为1.08±0.33毫米和1.53±0.90毫米;对于粘膜支持的SLA手术导向器，则为1.47±0.43 mm和1.65±0.48 mm。结论：这项研究的结果表明，立体光刻手术指南在植入物植入中可能是可靠的，并且：1）比较角度偏差时，三种类型的指南之间没有统计学上的显着差异; 2）粘膜支持的指南的准确性低于牙齿支撑和骨骼支撑导向器均可实现植入物颈部和根尖的线性偏离。

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