摘要
背景:上颌后牙缺损修复可以采用种植牙技术,但以往的种植模板大多利用传统石膏模型完成,无法有效保证种植体植入的准确性,容易导致各种并发症的出现,影响修复效果。目的:探讨计算机辅助设计和计算机辅助制作外科导板在上颌后牙种植修复过程中的应用效果。方法:纳入30例上颌后牙牙列缺损患者,均实施种植修复治疗。经CT上颌骨扫描,利用计算机辅助设计/计算机辅助制造技术(computer aided design/computer aided manufacturing technology,CAD/CAM)制作外科导板,在导板辅助下植入种植体进行修复。植入后测量虚拟植入位置和实际植入的偏差情况,随访12个月,观察临床修复效果与患者口腔牙周组织情况。结果与结论:(1)30例患者一共涉及36个CAD/CAM外科导板,经患者戴入口腔之后均获得稳定的固位效果;(2)36枚种植体,均在外科导板辅助下顺利完成准确的,植入过程未出现任何问题;(3)植入后种植体的虚拟植入位置和实际植入位置之间存在的头部偏离情况极小,不会对临床种植体植入精度产生影响;(4)植入前与植入后6及12个月患者的口腔牙周组织龈沟液、肿瘤坏死因子α、龈沟出血指数无明显变化;(5)结果说明在上颌后牙临床治疗过程中,利用CAD/CAM外科导板进行种植体修复治疗会出现一定的种植体头部偏离和角度偏离现象,但并不影响种植体的植入精度,修复效果理想,且治疗后患者处于良好的牙周组织状态。
BACKGROUND： Maxillary posterior tooth defects can be repaired using the dental implant. However, implantation accuracy is not ensured by traditional plaster models used as implant template, which leads to the incidence of complications, and affects the repair effects. OBJECTIVE： To study application effects of surgical guide plates designed using the computer aided design（CAD）/computer aided manufacturing（CAM） technology for the repair of maxillary posterior tooth defects. METHODS： Implant treatment was performed in 30 patients with maxillary posterior tooth defects. Surgical guide plate was made using the CAD/CAM technology after CT scan of the jaw bone. The repair was conducted with guide plate assistant. The deviation between the virtual and actual implant position was measured after implantation. The clinical repair effects and periodontal tissues were observed during the 12-month follow-up. RESULTS AND CONCLUSION： Thirty-six CAD/CAM surgical guide plates in 30 patients were stabilized after implantation. Thirty-six implants were emplaced precisely with the assist of the surgical guide plates. There was no any problem during the process of implantation. The deviation of the head between the virtual and actual implant position was very small, which did not affect the accuracy of implant placement. Before and 6 and 12 months after the repair, gingival crevicular fluid, tumor necrosis factor-α, and sulcus bleeding index were not obviously changed in the patients. Our results suggest that the implant head deviation and angle deviation appear during the repair process of maxillary posterior tooth defects using CAD/CAM surgical guide for dental implants; however, the implantation accuracy is not affected. The repair effect is ideal and periodontal tissue is in good status after implantation.
出处
《中国组织工程研究》
CAS
北大核心
2016年第20期2933-2939,共7页
Chinese Journal of Tissue Engineering Research
基金
云南省自然科学基金面上项目(2009CD087)~~
