| Objective: The aim of this study was to compare the accuracy of implant positions in anterior and posterior areas when using digital-guided implant surgery and freehand implant surgery.Probe into the factors that cause the differences to provide clinical diagnosis and treatment.Methods: A total of 60 implants were placed to 60 patients with missing teeth in anterior areas or posterior areas were treated with digital-guided implant surgery and freehand implant surgery in the Department of Stomatology of the Wuzhou Red Cross Hospital from October 2017 to December 2019.There were 30 patients who received digital-guided implant surgery,including 15 in anterior group and 15 in posterior group.There were 30 patients who received freehand implant surgery,including 15 in anterior group and 15 in posterior group.All the patient’s CT(Computed tomography,CT)and dental impressions was taken before surgery,and the impressions were perfused with plaster.The patient’s plaster model was scanned with 3D(3 Dimensional)laser scanning equipment.The CT data and plaster model data were imported into the 6D implant design software V2.0 to design virtual implant position and digital guide templates.The group with digital-guided implant surgery designed the digital guide template and printed the implant guide template to assist implant surgery,while the freehand implant surgery group received routine implant operation.Patient took CT scan after surgery.The preoperative and postoperative jaw data were imported into Mimics19.0 software for registration.The implant distance deviation between the postoperative implant position and the pre-implant design position in the implant neck,implant apex,the implant depth,the angular deviation of the implant axis were measured.SPSS 21.0 statistical software was used to analyze data.P <0.05 was considered statistically significant.Results: Sixty patients received 60 implants,all surgeries were successfully completed.All patients were checked after 6 months,and there was no loose or deciduous implant as well as marginal bone loss.All implants showed good osseointegration.The distance deviation in the entry point between the pre-implantation position and design position of the digital guide template group and the freehand group were(0.85±0.18)mm and(1.29±0.28)mm,the apex deviation were(1.27±0.17)mm and(1.70±0.21)mm,the depth deviation were(0.73±0.12)mm and(0.79±0.14)mm,and the angle deviation of axis were(3.46±0.45)° and(4.51±0.58)°.The deviation of entry point,apex and angle of axis had a significant difference between the two group(P<0.05),but there was no significant difference in depth deviation between the two group(P>0.05).The distance deviation in the entry point between the pre-implantation position and design position of the digital guide template group and the freehand group in anterior were(0.84±0.16)mm and(1.20±0.18)mm,the apex deviation were(1.19±0.14)mm and(1.57±0.24)mm,the depth deviation were(0.65±0.08)mm and(0.73±0.12)mm,and the angle deviation of axis were(3.17±0.24)°and(4.08±0.33)°.The deviation of entry point,apex and angle of axis had a significant difference between the two group(P<0.05),but there was no significant difference in depth deviation between the two group(P>0.05).The distance deviation in the entry point between the pre-implantation position and design position of the digital guide template group and the freehand group in posterior group were(0.87±0.19)mm and(1.39±0.34)mm,the apex deviation were(1.33±0.17)mm and(1.85±0.20)mm,the depth deviation were(0.80±0.11)mm and(0.85±0.14)mm,and angle of axis deviation were(3.75±0.43)°and(4.96±0.50)°.The deviation of entry point,apex and angle of axis had a significant difference between the two group(P<0.05),but there was no significant difference in depth deviation between the two group(P>0.05).The distance deviation in the entry point,apex and depth between the pre-implantation position and design position of digital-guided implant surgery between the posterior group and the anterior group were(0.84±0.16)mm and(0.87±0.19)mm,(1.19±0.14)mm and(1.33±0.17)mm,(0.65±0.08)mm and(0.80±0.11)mm,and angle of axis deviation were(3.17±0.24)° and(3.75±0.43)°,The deviation of apex,depth and angle of axis had a significant difference between the two group(P<0.05),but there was no significant difference in entry point between the two group(P>0.05).The distance deviation in the entry point,apex and depth between the pre-implantation position and design position of and freehand implant surgery between the posterior group and the anterior group were(1.20±0.18)mm and(1.39±0.34)mm,(1.57±0.24)mm and(1.85±0.20)mm,(0.73±0.12)mm and(0.85±0.14)mm,and angle of axis deviation were(4.08±0.33)° and(4.96±0.50)°,The deviation of apex,depth and angle of axis had a significant difference between the two group(P<0.05),but there was no significant difference in entry point between the two group(P>0.05).Conclusion: The accuracy of digital-guided implant surgery showed higher accuracy in implant entry point,apex,and angle compare to freehand implant surgery,the deviation in implant depth showed not obvious between the two surgeries.The accuracy of digital-guided implant surgery in anterior showed higher accuracy than posterior in implant apex,depth and angle of axis,the accuracy of entry point showed not obvious between the two areas.The accuracy of freehand implant surgery in anterior showed higher accuracy than posterior in implant apex,depth and angle of axis,the accuracy of entry point showed not obvious between the two areas.Digital-guided implant surgery could improve the accuracy of implant implantation compare to freehand implant surgery.The accuracy improvement of the anterior areas were greater than that of the posterior areas,and the anterior areas were improved more than the posterior areas. |
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