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目的:评价后牙缺失患者手术导板辅助实施不翻瓣手术对种植体植入精度的影响。方法:选取2009年3月—2010年6月后牙缺失进行不翻瓣种植手术患者38例,其中男19例,女19例,平均年龄(45.06±11.10)岁,分为非导航手术组和导航手术组2组,非导航手术组男10例、女9例,上颌缺失牙17颗,下颌缺失牙22颗,由手术医师目测决定种植体窝洞预备轴向;导航手术组男9例、女10例,上颌缺失牙14颗,下颌缺失牙17颗,应用手术导板辅助进行种植体窝洞预备。术后CT扫描,以种植体长轴为中心重建缺牙区冠状面和矢状面图像,以角度偏差5°、距离偏差2mm为标准,对种植体植入位置满意度计数,对下后牙缺失病例是否出现尖端接触舌侧骨皮质、有无影响种植体植入长度的种植体计数。应用Stata 7.0软件计算上述指标的百分率并进行2组间χ2检验。结果:经统计学检验分析,与非导航手术组相比,导航手术组种植体颊舌向和近远中向角度误差以及下颌后牙种植体到下颌神经管距离误差满意率较高,下颌后牙种植体尖端接触舌侧骨皮质的发生率较低,并且因骨皮质阻挡、影响种植体植入长度的发生率较低。结论:与非导航手术组相比,手术导板可降低种植体植入角度误差和骨皮质阻挡植入种植体的发生率,使种植体植入位置满意率更高,并显著提高下颌后牙缺失病例的种植体植入长度。
OBJECTIVE: To evaluate the effect of surgical guide plate assisted with non-flap surgery on implantation accuracy of implant in patients with posterior tooth loss. Methods: Thirty-eight patients (19 males and 19 females) with a mean age of (45.06 ± 11.10) years from March 2009 to June 2010 were enrolled in this study. The patients were divided into non-navigation group There were 2 males in navigation group, 10 males and 9 females in non-navigator group, 17 missing maxillary teeth and 22 missing teeth in mandibular. Female 10 cases, missing teeth in the maxillary 14, missing teeth 17 mandibular, surgical guide plate assisted implant hole preparation. After CT scan, the coronal and sagittal images of the edentulous area were reconstructed with the long axis of the implant as the center. The degree of satisfaction of the implant was counted by the standard deviation of 5 ° and the distance deviation of 2 mm. Whether there is a sharp contact with the lingual cortical bone in the missing cases or not, whether there are any implants that affect the implant length. The Stata 7.0 software was used to calculate the percentages of the above indicators and to perform 2 tests between the two groups. Results: Compared with non-navigational group, the satisfaction rate of buccal-lingual and mesial to mid-way errors and the error of distance between mandibular and posterior dentate to mandibular nerve canal in navigation group were higher than those in non-navigated group The incidence of apex implants contacting the lingual cortical bone is low, and the incidence of implant implants is low due to cortical bone block. CONCLUSIONS: Compared with non-navigational group, the operation guide plate can reduce the implanting angle error and the incidence of cortical bone implant implants, make the implantation site satisfaction rate higher and significantly improve the mandibular posterior teeth loss Implant length of case implant.