使用不同增材制造技术制作的CAD-CAM手术模板的静态计算机辅助植入手术(S-CAIS)的准确性。

IF 4.3 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Prosthetic Dentistry Pub Date : 2025-02-01 DOI:10.1016/j.prosdent.2023.03.025

Anshu Bathija BDS, MS , Panos Papaspyridakos DDS, MS, PhD , Matthew Finkelman PhD , Yongjeong Kim DDS , Kiho Kang DDS, MS , Andre B. De Souza DMD, MSc

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引用次数: 0

摘要

问题陈述:不同的3D打印机可用于引导植入手术，但缺乏评估其错误来源和成本效益的研究。目的:本体外研究的目的是比较使用不同增材制造技术制作的不同3D打印手术模板的准确性，并评估种植体位置对完全引导种植体放置准确性的影响。材料和方法:从标准镶嵌语言(STL)数据集中扫描并打印50例部分无牙的上颌排印牙，其无牙位置分别为右侧第二前磨牙(SP)、右侧侧切牙(LI)、左侧中切牙(CI)和左侧第一磨牙(FM)。本研究比较了5组种植体手术模板的制作方法:Varseo S-Bego (Bego)、Polyjet-Stratasys (Poly)、Low Force sterethography - formlabs (LFS)、P30+-Straumann (P30)和M2- carbon (M2)。在完全引导种植体放置后，扫描打印体，通过叠加STL文件将三维种植体位置与主模型进行比较。各组和亚组进行描述性统计，各组和亚组间比较采用双向混合方差分析、Tukey诚实显著性差异和事后Bonferroni检验(α= 0.05)。结果:结果有部位特异性，各组结果不一致。对于角度偏差，组内分析显示，放置在SP位点的P30值(1.4±0.8度)明显低于放置在LI位点的P30值(2.3±0.7度);P=.001)， CI(2.3±0.8度;P = .007)。对于种植体CI基部的3D偏移，LFS显著高于Bego (P= 0.002)， Poly (P= 0.035)或M2 (P= 0.001);P30也显著高于Bego (P= 0.014)和M2 (P= 0.006)。对于种植体CI, LFS的尖端3D偏移量明显高于Bego (P=.001)和M2 (P=.022)。结论:与初始种植计划相比，3D打印机的选择似乎影响了完全引导种植手术的最终种植位置。然而，尽管各组之间存在统计学上的显著差异，但所有增材制造技术都在临床可接受的范围内。

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Accuracy of static computer-aided implant surgery (S-CAIS) using CAD-CAM surgical templates fabricated from different additive manufacturing technologies

Statement of problem

Different 3D printers are available for guided implant surgery, but studies that evaluate their source of errors and their cost-effectiveness are lacking.

Purpose

The purpose of this in vitro study was to compare the accuracy of different 3-dimensional (3D) printed surgical templates made using different additive manufacturing technologies and to evaluate the effect of implant location on the accuracy of fully guided implant placement.

Material and methods

Fifty partially edentulous maxillary typodonts with edentulous sites in the right second premolar (SP), right lateral incisor (LI), left central incisor (CI), and left first molar (FM) locations were scanned and printed from the standard tessellation language (STL) datasets. The study compared 5 groups for the fabrication of implant surgical templates: Varseo S–Bego (Bego), Polyjet–Stratasys (Poly), Low Force Stereolithography–FormLabs (LFS), P30+–Straumann (P30), and M2–Carbon (M2). After fully guided implant placement, the typodont was scanned, and the 3D implant positions were compared with the master model by superimposing the STL files. Descriptive statistics were calculated for groups and subgroups, and comparisons among the groups and subgroups were conducted via 2-way mixed analysis of variance, Tukey honest significant difference, and post hoc Bonferroni tests (α=.05).

Results

The results were site specific and not consistent within each group. For angle deviation, the within-group analysis for P30 demonstrated significantly lower values for implants positioned at site SP (1.4 ±0.8 degrees) than for sites LI (2.3 ±0.7 degrees; P=.001) and CI (2.3 ±0.8 degrees; P=.007). For 3D offset at base for implant CI, LFS was significantly higher than Bego (P=.002), Poly (P=.035), or M2 (P=.001); P30 was also significantly higher than Bego (P=.014) and M2 (P=.006). LFS had a significantly higher 3D offset at the tip than Bego (P=.001) and M2 (P=.022) for implant CI.

Conclusions

The choice of 3D printer seemed to influence fully guided implant surgery in terms of the final implant position compared with initial implant planning. However, although statistically significant differences were present across groups, all additive manufacturing technologies were within clinically acceptable values.

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来源期刊

Journal of Prosthetic Dentistry 医学-牙科与口腔外科

CiteScore

7.00

自引率

13.00%

发文量

599

审稿时长

69 days

期刊介绍： The Journal of Prosthetic Dentistry is the leading professional journal devoted exclusively to prosthetic and restorative dentistry. The Journal is the official publication for 24 leading U.S. international prosthodontic organizations. The monthly publication features timely, original peer-reviewed articles on the newest techniques, dental materials, and research findings. The Journal serves prosthodontists and dentists in advanced practice, and features color photos that illustrate many step-by-step procedures. The Journal of Prosthetic Dentistry is included in Index Medicus and CINAHL.