国际口腔医学杂志 ›› 2019, Vol. 46 ›› Issue (1): 99-104.doi: 10.7518/gjkq.2019.01.018

• 综述 • 上一篇    下一篇

数字化导板与动态导航在口腔种植应用中的研究进展

张婷婷,胡建()   

  1. 口腔基础医学省部共建国家重点实验室培育基地和口腔生物医学教育部重点实验室,武汉大学口腔医学院; 武汉大学口腔医院修复科 武汉 430079
  • 收稿日期:2018-05-23 修回日期:2018-09-11 出版日期:2019-01-01 发布日期:2019-01-11
  • 通讯作者: 胡建 E-mail:00008460@whu.edu.cn
  • 作者简介:张婷婷,硕士,Email:331060279@qq.com

Research progress on the application of surgical template and dynamic navigation system in implant dentistry

Tingting Zhang,Jian Hu()   

  1. The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University & Dept. of Prosthodontics, Hospital of Stomatology, Wuhan University, Wuhan 430079, China
  • Received:2018-05-23 Revised:2018-09-11 Online:2019-01-01 Published:2019-01-11
  • Contact: Jian Hu E-mail:00008460@whu.edu.cn

摘要:

数字化导板与动态导航在临床的应用为以修复为导向、微创、精准地种植提供了便利,两者可辅助医生在术前规划制定种植方案,帮助术者术中避开重要的解剖结构,引导医生在安全的区域内实现微创种植。2种辅助技术虽然都具有较高的精确度,但在使用过程中仍然会产生一定的误差。本文将综合分析比较数字化导板与动态导航的临床操作过程以及可能影响其精确性的因素。

关键词: 数字化导板, 动态导航, 种植, 精确性

Abstract:

With the help of surgical template and dynamic navigation system, prosthetic-driven implant dentistry has become reality. Furthermore, they can help realize minimal invasion and improve accuracy. These technologies might help doctors make preoperative implant planning, and achieve safe surgery by avoiding anatomic structures during operation. While both methods aim to achieve high accuracy, some errors in the clinical application are still detected. This article analyzes differences between the application of surgical template and dynamic navigation in clinics, and factors that may influence their accuracy.

Key words: surgical guide, dynamic navigation, implant, accuracy

中图分类号: 

  • R783.4

图1

2种技术辅助种植的临床流程"

表1

2种技术的优势与不足"

类型 优势 不足
数字化导板 1)与导航相比,下颌无牙颌种植具有一定的优势; 1)导板方面:
2)可通过引导管辅助控制钻针方向。 ①导板制作完成后,术中方案无法改变;
②导板制作、试戴需要增加患者就诊次数,延长治疗周期;
③导板的完全就位及稳定性会受周围结构的影响;
④需要与工具盒搭配使用;
⑤影响局部种植位点降温及骨屑排出。
2)医生方面:导板干扰医生视野。
3)患者方面:
①导板使用受患者张口度的影响;
②种植位点间隙过窄影响导板的使用。
动态导航 1)CT拍摄、方案设计与实时引导种植可同天进行; 1)有一定技术敏感性;
2)由“盲视”转为“直视”; 2)术前需调整校准;
3)可实时动态引导医生种植; 3)手术器械可能影响医生“手感”;
4)可实时调整方案。 4)医生需注意自身及器械的位置;
5)下颌无牙颌术中实时定位受影响。

图2

2种技术的主要误差来源"

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