本文選題：計(jì)算機(jī)輔助設(shè)計(jì) + 種植導(dǎo)板��； 參考：《青島大學(xué)》2017年碩士論文

【摘要】：目的:應(yīng)用彩立方Tooth Implant軟件評估數(shù)字化外科導(dǎo)板用于多牙缺失種植手術(shù)中的精確度,探討其在多牙缺失種植中的優(yōu)勢,為更好地應(yīng)用數(shù)字化導(dǎo)板提供理論基礎(chǔ)。方法:選擇2015年1月至2016年10月,在青島大學(xué)附屬醫(yī)院口腔種植科行種植手術(shù)的多牙缺失的患者20例,根據(jù)患者自身?xiàng)l件和意愿分為A、B兩組,每組10例。術(shù)前均拍攝口腔頜面部錐形束CT(Cone-beam computed tomography,CBCT),將所得三維數(shù)據(jù)導(dǎo)入彩立方Tooth Implant軟件,利用Tooth Implant軟件分析數(shù)據(jù),制定手術(shù)方案。其中A組患者不使用種植導(dǎo)板,依靠術(shù)者的臨床經(jīng)驗(yàn)直接植入種植體;B組采用快速成型技術(shù)(rapid prototyping,RP)制作數(shù)字化導(dǎo)板,術(shù)中輔助種植體的植入。術(shù)后兩組患者再次拍攝CBCT,利用彩立方Tooth Implant軟件將術(shù)前與術(shù)后圖像進(jìn)行配準(zhǔn)比較,測量種植體實(shí)際位置與設(shè)計(jì)位置的誤差值,用SPSS 18.0軟件對所得數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果:20例患者共植入87顆種植體。全部種植體骨結(jié)合良好,無松動(dòng)脫落,未發(fā)現(xiàn)明顯邊緣骨吸收。A組種植體的實(shí)際位置與術(shù)前模擬的位置有一定差別,B組種植體的實(shí)際位置與模擬位置基本一致。A組共植入39顆種植體,肩部的測量誤差為(2.11±0.39)mm(1.35-3.09)mm,底部的測量誤差為(2.30±0.82)mm(1.55-4.96)mm,深度的測量誤差值(0.72±0.39)mm(-0.88-1.23)mm,角度的測量誤差值為(9.05±3.74)°(2.56-15.98)°;B組共植入48顆種植體,肩部的測量誤差為(1.26±0.57)mm(0.17-2.38)mm,底部的測量誤差為(1.56±0.57)mm(0.31-2.65)mm,深度的測量誤差值為(0.52±0.37)mm(-1.03-1.34)mm,角度的測量誤差值為(4.87±1.55)°(2.04-7.05)°。統(tǒng)計(jì)學(xué)分析得出結(jié)果:兩組種植體在肩部、底部、深度和角度方面均有統(tǒng)計(jì)學(xué)差異(P0.05)。結(jié)論:1.多牙缺失患者在數(shù)字化導(dǎo)板引導(dǎo)下行種植手術(shù),可以使種植體在頜骨中的三維位置更加精確,從而獲得良好的修復(fù)效果,有廣泛的應(yīng)用前景和良好的應(yīng)用價(jià)值。2.由于多牙缺失的患者解剖結(jié)構(gòu)復(fù)雜,加之?dāng)?shù)字化導(dǎo)板的制作以及手術(shù)操作過程等原因,使用數(shù)字化導(dǎo)板時(shí)也存在一定的誤差,因此不能隨意或盲目使用,應(yīng)在術(shù)前設(shè)計(jì)一定的安全距離,避免損傷重要的解剖結(jié)構(gòu)。
[Abstract]:Objective: To evaluate the accuracy of digital surgical guide plate in the operation of multiple tooth loss implantation with color cube Tooth Implant software, and to explore its advantages in the cultivation of multi tooth deletion and provide a theoretical basis for better application of digital guide plate. Methods: selection from January 2015 to October 2016 in the oral implant Department of the Affiliated Hospital of Qiingdao University. 20 patients with multiple tooth loss were divided into A, B two and 10 cases in each group according to the patient's own conditions and wishes. Before operation, the conical bundles of oral and maxillofacial tract CT (Cone-beam computed tomography, CBCT) were taken. The three dimensional data were introduced into the color cube Tooth Implant software, and the Tooth Implant software was used to analyze the data and formulate the operation scheme. The patients in the group did not use the implant guide plate, and the implant was implanted directly by the clinical experience of the operators; the B group used rapid prototyping (RP) to make the digital guide plate and the implantation of the auxiliary implants during the operation. After the operation, two groups of patients were photographed again, and the color cube Tooth Implant software was used to compare the preoperative and postoperative images. The error values of the actual position and the design position of the implants were statistically analyzed with SPSS 18 software. Results: 87 implants were implanted in 20 patients. All the implant bone was good, no loosening fell off, and there was a certain difference between the actual position of the implants and the position of the pre operation simulation in group B without obvious edge bone absorption in group.A. The actual position of the implant is basically the same as the simulated position in the.A group. The measurement error of the shoulder is (2.11 + 0.39) mm (1.35-3.09) mm, the measurement error at the bottom is (2.30 + 0.82) mm (1.55-4.96) mm, the depth measurement error value (0.72 + 0.39) mm (-0.88-1.23) mm, the angle measurement error value is (9.05 + 3.74) degree (2.56-15.98) degree; B group A total of 48 implants were implanted. The measurement error of the shoulder was (1.26 + 0.57) mm (0.17-2.38) mm, the measurement error at the bottom was (1.56 + 0.57) mm (0.31-2.65) mm, the measurement error of the depth was (0.52 + 0.37) mm (-1.03-1.34) mm and the angle measurement error value was (4.87 + 1.55) degree (2.04-7.05) degrees. Statistical analysis showed that two implants were at the shoulder and bottom, There are statistical differences in depth and angle (P0.05). Conclusion: 1. patients with multiple tooth deletion under the guidance of digital guide guidance can make the three-dimensional position of the implant more accurate in the jaw bone, thus obtaining a good repair effect. There is a broad application prospect and good application value.2. due to the dissection of the patients with multiple tooth loss. The construction of digital guide plate and operation process are complicated, and there are some errors in the use of digital guide plate. Therefore, it can not be used arbitrarily or blindly. We should design a certain safety distance before operation to avoid the important anatomical structure of damage.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R783.6

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 趙毅;張曉真;湯春波;;多牙缺失患者計(jì)算機(jī)導(dǎo)板應(yīng)用下種植術(shù)后誤差研究[J];口腔醫(yī)學(xué);2016年03期

2 趙t熝，

本文編號：2074831