光学导航与电磁导航辅助下精准牙种植手术效果比较
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摘要
目的对比研究计算机辅助光学导航与电磁导航下精准牙种植手术的优缺点。方法下颌牙列缺损拟行牙种植手术患者10例,采集患者颌骨CBCT影像,5例在计算机辅助光学导航下行牙种植手术,5例在计算机辅助电磁导航下行牙种植手术。术后拍摄CBCT进行种植位点评估。结果两组患者均获得了良好的治疗效果,所有植体均植入理想的颌骨位置中。两组患者植体整体角度偏差范围不超过25°,植入深度偏差均不超过1.4mm;光学导航组植体植入角度偏差小于电磁导航组(t=3.5,P<0.05),两组患者植体植入深度差异无显著性(P>0.05)。结论计算机辅助光学导航与电磁导航下均可完成精准牙种植手术,在应用过程中,两者各有优势和不足,电磁导航对于手术室环境要求较苛刻,在常规环境中精度略低于光学导航。在进一步研究中如果可以将光学导航和电磁导航相结合进行精准牙种植手术,将大大提高计算机辅助导航在牙种植领域的应用范围,特别是为复杂牙种植手术提供新的助力。
Objective To compare the advantages and disadvantages of precise dental implant placement with computeraided optical navigation and electromagnetic navigation. Methods A total of ten patients with mandibular dentition defects and planned to undergo precise dental implant placement were enrolled,and the cone beam computed tomography(CBCT)images of the jaw bone were collected.Precise dental implant placement was performed in 5 cases with computer-aided optical navigation and in the other 5 cases with computer-aided electromagnetic navigation.Postoperative CBCT images were collected again for implantation site evaluation. Results Both groups of patients achieved good outcomes,and all implants were implanted in the ideal jaw position.The overall angular deviation and depth deviation of the implants in the two groups were no more than 25°and 1.4 mm,respectively.The optical navigation group had a smaller angle deviation of than the electromagnetic navigation group(t=3.5,P<0.05),but there was no significant difference in implant depth between the two groups(P>0.05). Conclusion Both computeraided optical navigation and electromagnetic navigation can be used for precise dental implant placement,and they both have advantages and disadvantages in the application process.Electromagnetic navigation is more demanding for the operating room environment,and its precision is slightly lower than that of optical navigation in the general environment.In further studies,if optical navigation and electromagnetic navigation can be combined to perform precise dental implant placement,the application scope of computer-aided navigation in the field of dental implantation will be greatly improved,especially providing assistance for complex dental implantation surgery.
Objective To compare the advantages and disadvantages of precise dental implant placement with computeraided optical navigation and electromagnetic navigation. Methods A total of ten patients with mandibular dentition defects and planned to undergo precise dental implant placement were enrolled,and the cone beam computed tomography(CBCT)images of the jaw bone were collected.Precise dental implant placement was performed in 5 cases with computer-aided optical navigation and in the other 5 cases with computer-aided electromagnetic navigation.Postoperative CBCT images were collected again for implantation site evaluation. Results Both groups of patients achieved good outcomes,and all implants were implanted in the ideal jaw position.The overall angular deviation and depth deviation of the implants in the two groups were no more than 25°and 1.4 mm,respectively.The optical navigation group had a smaller angle deviation of than the electromagnetic navigation group(t=3.5,P<0.05),but there was no significant difference in implant depth between the two groups(P>0.05). Conclusion Both computeraided optical navigation and electromagnetic navigation can be used for precise dental implant placement,and they both have advantages and disadvantages in the application process.Electromagnetic navigation is more demanding for the operating room environment,and its precision is slightly lower than that of optical navigation in the general environment.In further studies,if optical navigation and electromagnetic navigation can be combined to perform precise dental implant placement,the application scope of computer-aided navigation in the field of dental implantation will be greatly improved,especially providing assistance for complex dental implantation surgery.
引文
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[16]CASAP N,WEXLER A,ELIASHAR R.Computerized navigation for surgery of the lower jaw:Comparison of 2navigation systems[J].J Oral Maxillofacial Surg,2008,66(7):1467-1475.
[2]SMITH J R,ROWE P J,BLYTH M,et al.The effect of electromagnetic navigation in total knee arthroplasty on knee kinematics during functional activities using flexible electrogoniometry[J].Clin Biomech(Bristol,Avon),2013,28(1):23-28.
[3]CHEHAB M A,BRINJIKJI W,COPELAN A,et al.Navigational tools for interventional radiology and interventional oncology applications[J].Semin Intervent Radiol,2015,32(4):416-427.
[4]BERGER M,NOVA I,KALLUS S,et al.Can electromagnetic-navigated maxillary positioning replace occlusional splints in orthognathic surgery?A clinical pilot study[J].JCraniomaxillofac Surg,2017,45(10):1593-1599.
[5]CHEN X J,WU Y Q,WANG C T.Application of a surgical navigation system in the rehabilitation of maxillary defects using zygoma implants:Report of one case[J].Int J Oral Maxillofac Implants,2011,26(5):e29-e34.
[6]程,曾晓莉,李存荣,等.上海市1579名中老年人牙缺失与义齿修复情况调查[J].上海口腔医学,2009,18(6):561-566.
[7]苏勇,章攀.口腔种植修复与常规修复治疗牙列缺失的临床效果对比[J].中国口腔种植学杂志,2017,22(2):87-89.
[8]蒋钟玮,陈才香,张瑾,等.口腔种植修复与常规修复牙列缺失的效果比较[J].实用临床医学,2018,19(10):60-61,82.
[9]赵保东,许家森,王艳辉,等.前牙区牙种植即刻修复的临床评价[J].中国口腔种植学杂志,2009,14(02):114.
[10]谢华德,孙海鹏,姜健,等.数字化种植外科导板精确性的影响因素[J].口腔疾病防治,2018,26(10):669-672.
[11]D’HAESE J,VAN DE VELDE T,KOMIYAMA A,et al.Accuracy and complications using computer-designed stereo lithographic surgical guides for oral rehabilitation by means of dental implants:A review of the literature[J].Clin Implant Dent Relat Res,2012,14(3):321-335.
[12]HULTIN M,SVENSSON K G,TRULSSON M.Clinical advantages of computer-guided implant placement:A systematic review[J].Clin Oral Implant Res,2012,23(s6):124-135.
[13]HASSFELD S,MHLING J.Computer assisted oral and maxillofacial surgery:A review and an assessment of technology[J].Int J Oral Maxillofacial Surg,2001,30(1):2-13.
[14]GRUNERT P,DARABI K,ESPINOSA J,et al.Computer-aided navigation in neurosurgery[J].Neurosurg Rev,2003,26(2):73-99.
[15]EWERS R,SCHICHO K,UNDT G,et al.Basic research and12years of clinical experience in computer-assisted navigation technology:A review[J].Int J Oral Maxillofacial Surg,2005,34(1):1-8.
[16]CASAP N,WEXLER A,ELIASHAR R.Computerized navigation for surgery of the lower jaw:Comparison of 2navigation systems[J].J Oral Maxillofacial Surg,2008,66(7):1467-1475.