数控机床金属导板辅助无牙颌种植的实验研究
The experimental study on edentulous mandible implantation assisted by metal surgical guides based on computer numerical control technology
目的 探讨利用数控机床（computer numerical control, CNC）制造个性化下颌无牙颌金属种植导板的新方法。 方法 8具下颌无牙颌标本随机分为两组，分别运用CNC技术加工出金属导板、运用快速成型（rapid prototyping, RP）技术加工出树脂导板并测量其在体外实验中辅助置钉的精确性。 结果 CNC与RP导板在下颌骨中部水平面上的绝对偏差分别为(0.23±0.14) mm、(1.01±0.27) mm，差异有统计学意义（P=0.000）；在矢状面上分别为(0.30±0.24) mm、(0.95±0.24) mm，差异有统计学意义（P=0.000）。 结论 在体外实验中，CNC金属下颌无牙颌种植导板辅助种植精确性高于RP树脂导板。
Objective To explore a new method for manufacturing customized edentulous mandible metal implant surgical guides using computernumerical control (CNC) machines. Methods Eight corpse edentulous mandibles were randomly divided into two groups, CNC metal guides and rapid prototyping (RP) resin guides were manufactured respectively. All guides were used to assist edentulous mandible implantations to analyze the accuracy in vitro. Results The absolute deviation on horizontal plane was (0.23±0.14) mm in the CNC group and (1.01±0.27) mm in the RP group, respectively, between which the difference was significant (P=0.000). The absolute deviation on sagittal plane was (0.30±0.24) mm in the CNC group and (0.95±0.24) mm in the RP group, respectively, between which the difference was significant (P=0.000). Conclusions In vitro implantations, CNC surgical guides assisted implantations have higher accuracy than RP guides.
CNC machine / Edentulous mandible / Implant surgical guide / Computer aided design
[1] Jorge J R, Barao V A, Delben J A. Titanium in dentistry: historical development, state of the art and future perspectives[J]. J Indian Prosthodont Soc,2013,13(2):71-77.
[2] Duttenhoefer F, Souren C, Menne D. Long-term survival of dental implants placed in the grafted maxillary sinus: systematic review and meta-analysis of treatment modalities[J]. PLoS One, 2013, 8(9):e75357.
[3] Al-Sabbagh M, Bhavsar I. Key local and surgical factors related to implant failure[J]. Dent Clin North Am, 2015, 59(1):1-23.
[4] Kalra M, Aparna I N, Dhanasekar B. Evolution of surgical guidance in implant dentistry[J]. Dent Update, 2013, 40(7):577-578, 581-582.
[5] Flugge T V, Nelson K, Schmelzeisen R. Three-dimensional plotting and printing of an implant drilling guide: simplifying guided implant surgery[J]. J Oral Maxillofac Surg, 2013, 71(8):1340-1346.
[6] 芮娜，汤春波，戴文雍，等. 计算机辅助设计制造牙种植导板软件的自主研发[J]. 口腔医学, 2014, 34(10):743-745.
[7] 唐克岩. 我国数控机床产业发展现状与展望[J]. 机床与液压, 2012, 40(5):145-147.
[8] Edge MJ. Surgical placement guide for use with osseointegrated implants[J]. J Prosthet Dent, 1987, 57(6):719-722.
[9] Fortin T, Bosson JL, Coudert JL. Reliability of preoperative planning of an image-guided system for oral implant placement based on 3-dimensional images: an in vivo study[J]. Int J Oral Maxillofac Implants, 2003,18(6):886-893.
[10] Becker W, Wikesjo UM, Sennerby L. Histologic evaluation of implants following flapless and flapped surgery: a study in canines[J]. J Periodontol, 2006, 77(10):1717-1722.
[11] Reyes A, Turkyilmaz I, Prihoda TJ. Accuracy of surgical guides made from conventional and a combination of digital scanning and rapid prototyping techniques[J]. J Prosthet Dent, 2015, 113(4):295-303.
[12] Greenberg AM. Cone beam computed tomography scanning and diagnosis for dental implants[J]. Oral Maxillofac Surg Clin North Am, 2015, 27(2):185-202.
[13] Kumta S, Kumta M, Jain L. A novel 3D template for mandible and maxilla reconstruction: Rapid prototyping using stereolithography[J]. Indian J Plast Surg, 2015, 48(3):263-273.
[14] Nokar S, Moslehifard E, Bahman T. Accuracy of implant placement using a CAD/CAM surgical guide: an in vitro study[J]. Int J Oral Maxillofac Implants, 2011, 26(3):520-526.
[15] 白宇哲，李长树，徐楚，等. 数控机床技术在下颈椎个体化导向模板制作中的应用[J]. 中国临床解剖学杂志, 2015, 33(3):284-287.
[16] Mccall B, Tkaczyk T S. Rapid fabrication of miniature lens arrays by four-axis single point diamond machining[J]. Opt Express, 2013, 21(3):3557-3572.
国家自然科学基金重大项目（61190120，61190122，61190123）
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