采用改良的双扫描和三数字面重叠技术定位数字引导种植体在全无牙上颌的位置。

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

Journal of Prosthetic Dentistry Pub Date : 2025-03-01 DOI:10.1016/j.prosdent.2023.03.028

Jorge Troncoso-Pazos DDS , Pablo Matamala DDS , María Francisca Jusari DDS , Keila Risco DDS , Felipe-Rodrigo Aguilera DDS, MSC , Pedro Christian Aravena DDS, PhD

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引用次数: 0

摘要

问题说明:对于上颌完全无牙的患者，弹性和粘膜厚度的变化以及牙齿和刚性支撑结构的缺乏可能导致手术指南的适应性差和最终种植体位置的显著变化。是否改良的双扫描技术与表面重叠将改善种植体的安置尚不清楚。目的:本前瞻性临床研究的目的是利用改良双扫描方案获得的3个匹配数字面设计的粘膜支持无瓣手术引导器，评估上颌完全无牙患者的6个种植体的三维位置和相关性。材料和方法:在智利Santa Cruz公立医院，采用all-on-6协议在参与者的无牙上颌安装牙种植体。通过锥形束计算机断层扫描(CBCT)，用8个不透射线的陶瓷球体插入假体，并通过口腔内扫描仪扫描同一假体，制作了一个立体光刻粘膜支撑模板。在设计软件程序中，通过数字铸造可摘全口义齿的衬里获得粘膜。4个月后，进行第二次CBCT扫描，评估植入物的位置，测量3个位置:根尖、冠状、平台深度和成角。采用Kruskal-Wallis和Spearman相关检验比较6种种植体在全无牙颌的位置差异及其测点的线性相关性(α= 0.05)。结果:10例患者(年龄54.3±8.2岁;7女人)。6个种植体的根轴平均偏差为1.02±0.9 mm，冠状面0.76±0.74 mm，平台深度0.92±0.8 mm，主轴角度为2.92±3.65度。上颌左侧切牙区种植体的尖点和角点偏差最显著(p)。结论:采用3个指面重叠设计的立体光刻粘膜支撑导具的种植体平均位置值与系统综述和meta分析报道的结果相似。此外，种植体的位置根据种植体安装在无牙上颌骨的位置而变化。

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Position of digitally guided implants in completely edentulous maxillae by using a modified double-scan and overlap of three digital surface protocol

Statement of problem

In patients with a completely edentulous maxilla, the variability in resilience and mucosal thickness and the lack of teeth and rigid supporting structures may lead to poor adaptation of the surgical guide and significant variation in the definitive implant position. Whether a modified double-scan technique with overlap of surfaces will improve implant placement is unclear.

Purpose

The purpose of this prospective clinical study was to evaluate the 3-dimensional position and the correlation of 6 dental implants in participants with a completely edentulous maxilla using a mucosa-supported flapless surgical guide designed with 3 matched digital surfaces obtained with a modified double-scan protocol.

Material and methods

Dental implants were installed with an all-on-6 protocol in the edentulous maxilla of participants at the Santa Cruz Public Hospital, Chile. A stereolithographic mucosa-supported template was fabricated from a cone beam computed tomography (CBCT) scan made with a prosthesis with 8 radiopaque ceramic spheres inserted and by scanning the same prosthesis with an intraoral scanner. The mucosa was obtained by digitally casting the relining of the removable complete denture in the design software program. After 4 months, a second CBCT scan was obtained to evaluate the position of the installed implants measured at 3 locations: apical, coronal, platform depth, and angulation. Differences in position between the 6 implants in the completely edentulous maxilla and their linear correlation at the measured points were compared with the Kruskal-Wallis and Spearman correlation tests (α=.05).

Results

Sixty implants were installed in 10 participants (age 54.3 ±8.2 years; 7 women). The average deviation in the apical axis was 1.02 ±0.9 mm, coronal 0.76 ±0.74 mm, platform depth 0.92 ±0.8 mm, and the major axis angulation of the 6 implants was 2.92 ±3.65 degrees. The implant in the maxillary left lateral incisor region had the most significant deviation in apical and angular points (P<.05). A linear correlation between apical-to-coronal deviations and apical-to-angular deviations was observed for all implants (P<.05).

Conclusions

A stereolithographic mucosa-supported guide designed with the overlap of 3 digital surfaces had average dental implant position values similar to those reported by systematic reviews and meta-analyses. In addition, implant position varied based on the location of the implant installation in the edentulous maxilla.

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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.