Background

Dental implantology has become an established option for treating tooth loss over the recent decades. Before inserting an implant in a clinical situation, theoretical and practical training is recommended. Different methods are available to give assistance in determining the correctly planned implant position. In this study, two different guiding methods were assessed considering their accuracy for implant insertion in a group of dentists.

Methods

After three-dimensional planning of the implant positions, two surgical templates were manufactured as follows: in region 34 a stereolithographic template was used to perform a full-guided implant insertion, in region 44 a CAD/CAM milled template was used to determine the implant position and subsequently, perform a free-hand insertion. In total, 86 implants were placed in mandibular models by 43 dentists participating in a postgraduate curriculum. The differences between planned and achieved implant positions were measured and statistically analyzed.

Results

The implants inserted fully-guided showed a lower deviation of the three-dimensional angulation (2.266 ± 1.443 degrees vs. 7.954 ± 4.372 degrees) and the cumulated mismatch of the implant position (0.547 ± 0.237 mm vs. 1.160 ± 0.427 mm) compared to the free-handed mode. For the angulation and the mismatch at the implant base the differences were statistically significant (p < 0.001).

Conclusions

Within the limits of the study it can be summarized that the full-guided implant insertion leads to a higher transfer accuracy compared to the free-hand method in a cohort of dentist inexperienced in dental implantology. However, the clinical effect has to be discussed as the study was performed using artificial mandibles and ideal conditions.

中文翻译：

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使用定向模板和全引导模板进行种植体插入 — 参与种植牙课程的牙医队列的前瞻性模型分析

背景

近几十年来，种植牙已成为治疗牙齿脱落的既定选择。在临床情况下插入种植体之前，建议进行理论和实践培训。可以使用不同的方法来帮助确定正确规划的种植体位置。在这项研究中，考虑到两种不同的引导方法在一组牙医中植入种植体的准确性，对其进行了评估。

方法

在对种植体位置进行 3D 规划后，如下制造了两个手术模板：在区域 34 中使用立体光刻模板进行全引导种植体插入，在区域 44 中使用 CAD/CAM 铣削模板来确定种植体位置，然后执行徒手插入。参加研究生课程的 43 名牙医总共将 86 个种植体植入下颌模型。测量和统计分析计划和实现的种植体位置之间的差异。

结果

相比之下，完全引导植入的种植体显示出较低的三维角度偏差（2.266 ± 1.443 度与 7.954 ± 4.372 度）和种植体​​位置的累积失配（0.547 ± 0.237 毫米与 1.160 ± 0.427 毫米）徒手模式。对于种植体基部的角度和不匹配，差异具有统计学意义（p < 0.001）。

结论

在研究范围内，可以总结出，与徒手方法相比，在牙种植学方面缺乏经验的牙医队列中，全引导种植体插入可实现更高的转移精度。然而，由于该研究是使用人造下颌骨和理想条件进行的，因此必须讨论临床效果。