摘要
目的评价3D打印种植导板在后牙区即刻种植的临床效果及精确性。方法选取后牙区即刻种植的患者20例,拍摄口腔颌面锥形束CT(cone beam computed tomography,CBCT),硅橡胶取印模,灌模型,将CBCT图像和石膏模型扫描数据配准,合成三维颌骨模型,通过Simplant软件设计种植体植入位置,制作3D种植导板。在导板的引导下进行种植窝的预备,并植入种植体,术后拍摄CBCT。应用Mimics软件对比手术前设计的种植体位置与术后实际种植体位置的差异,测量颈部水平偏差距离、根端偏差距离、轴向偏离角度。结果 20例患者共20枚种植体的三维位置与术前设计的位置基本一致,颈部水平偏差距离为(0.65±0.19)mm,根端偏差距离为(0.45±0.14)mm,轴向偏离角为(3.20±0.68)°。种植上部修复完成后随访6~12个月,无种植体松动脱落,种植体周围骨质稳定性良好,没有明显骨吸收,种植冠修复体咬合接触良好。结论 3D打印手术导板可以准确将术前设计方案转移到手术中,可以提高种植手术的精准度,降低手术风险和并发症的发生,有利于后期上部冠修复,在难度较大的后牙即刻种植的修复中有着重要意义。
Objective To evaluate the clinical effect and accuracy of 3D printing implant template applied to the immediate implantation in posterior teeth areas.Methods Twenty patients of the immediate implantation in posterior teeth are selected.After cone beam computed tomography（CBCT） scan of oral maxillofacial,silicone rubber impression,perfusion model,the registration is required between CBCT image and plaster model scanning data in order to compound a three dimensional jaw model.The implant position is designed via Simplant software and then 3D implant template is ready to fabricate.Under guide of template,the implant socket is prepared for implants and CBCT is required after the operation.Through Mimics software,the differences between designing position and actual position of implant should be measured mainly in neck-horizontal deviation distance,apical deviation distance as well as axial deviation angle.Results The three dimensional position of twenty implants respectively in twenty patients are basically as same as the designing position with neck-horizontal deviation distance of（0.65±0.19） mm,apical deviation distance of（0.45±0.14） mm,axial deviation angle of（3.20±0.68）°.For 6-12 months of follow-up after restoration,no implant loosens off,the stability of bones around implant is sound without distinct bone resorption.The implant coping restoration can offer a good occlusion.Conclusion 3D printing surgical guide can accurately transfer designing plan into the operation,improve precision of implantation and reduce the operation risk and complications.Also,it is beneficial to restore upper copings in later period and plays an important role in the difficult immediate implantation of posterior teeth.
出处
《河北医科大学学报》
CAS
2017年第6期691-694,共4页
Journal of Hebei Medical University
关键词
牙种植体
3D打印技术
种植导板
dental implants
3D printing technology
implanted guiding plate
