| Objective: To compare the clinical treatment effects of digital guide-guided implant surgery and traditional free-hand implant surgery for the treatment of dentition defects in the aesthetic area,evaluate the accuracy,aesthetic effects,complications and patient satisfaction of the two groups respectively,and explore the digital guide-guided assistance The pros and cons of implant surgery provide a reference for implant restoration treatment of dentition defects in the aesthetic area.Methods: From June 2019 to November 2020,49 patients who underwent anterior dental implant restoration in the Department of Stomatology,Affiliated Hospital of Youjiang Medical College for Nationalities were selected,with a total of 70 anterior teeth.Among them,there are 30 male cases and 19 female cases,with an age range of 18-63 years old,with an average age of 36.65±11.79 years old.Using the research method of Non-randomized Concurrent Controlled Trial(Non-R),the above-mentioned patients were divided into digital guide-guided implant surgery(guide)group and traditional free-hand implant surgery(free-hand)group.There were 25 people in the free-hand group,28 implants and 19 bone grafts;24 people in the guide plate group,42 implants and 25 bone grafts.All operations were performed by the same senior doctor.All patients were taken CBCT before operation.The guide plate group makes the corresponding guide plate and completes the operation according to its design position,direction and depth;the traditional group completes the operation according to the preoperative CBCT software design plan.Patients in the two groups underwent crown repair after 3-6 months.CBCT was taken immediately after the operation,and then the deviation between the actual implant position and the planned implant position of the two groups of patients(coronal linear deviation,crown horizontal deviation,crown height deviation,apical straight line)was measured Offset,apex horizontal offset,apex height offset,and angle offset).The red and white aesthetic scores(PES/WES scores)immediately after restoration and 3 months after restoration were recorded to evaluate the effect of the aesthetic restoration of the anterior teeth in the two groups.From the beginning of the operation to the end of the study,through regular follow-up visits and continuous follow-up of the patients,the intraoperative and postoperative complications of implant surgery were recorded to evaluate the incidence of intraoperative and postoperative complications of the two implant procedures.The difference in patient satisfaction after the two implantation procedures was evaluated by the visual analogue scale(VAS).Results:(1)Misalignment: In this study,the accuracy of the guide plate group and the free-handed group were compared.The median linear deviations of the crown were 1.66mm and 2.42mm,respectively(P<0.05).The straight line of the crown of the guide plate group The deviation is smaller than that of the free-handed group;the median horizontal deviation of the crown is 1.63mm and 2.40mm,respectively(P<0.05),the horizontal deviation of the crown in the guide plate group is smaller;the median of the horizontal deviation of the root tip The numbers were 1.13mm and 1.75mm,respectively(P<0.05),the horizontal deviation of the apex of the guide plate group was smaller;the median of the linear deviation of the root apex were 1.77mm and 2.77mm(P<0.05),the guide plate group The linear deviation of the root apex is smaller;the median angle deviation is 3.96°and 5.67°(P<0.05),the angle deviation of the guide plate group is smaller;the median height deviation of the crown is 0.22mm,respectively And 0.24mm(P>0.05),there was no difference in the crown height deviation between the two groups;the median of the apical height deviation was 0.88mm and1.39mm(P>0.05),there was no difference in the apical height deviation between the two groups.(2)Red and white aesthetic score: the median of PES immediate scores in the guide group and free-handed group were 9 and 8 points respectively(P<0.05),the guide group PES immediate score was higher;the median of PES scores after 3 months The scores were 10 and10 points respectively(P>0.05).There was no difference in the PES scores of the two groups after 3 months;the median of the WES immediate scores were 8 and 8 points respectively(P>0.05),and the two groups had no WES immediate scores.Differences;the median scores of WES after 3 months were 8 and 8 points(P>0.05),and there was no difference in the scores of the two groups after 3 months.The effect of bone grafting on the red and white aesthetic scores of the guide plate group and free-handed group patients was not statistically significant(P>0.05).(3)Complications: The survival rate of implants in both groups was100%,and the incidence of intraoperative complications in the guide plate group was 8.3%.The incidence of peri-implant mucositis in the digital guide group and the traditional free-hand group was 4.0% and 4.2%,respectively.The incidence of loosening of the healing cap screws in the two groups was 8.0% and 8.3%,respectively.There was no significant difference in the incidence of intraoperative complications,biological complications and implant complications between the two groups(P>0.05).The probabilities of biological complications and implant complications in the free-hand group were 5.3% and 10.5%,respectively,while those without bone grafts had any complications;the bone graft patients in the guide plate group had intraoperative complications,The probabilities of biological complications and implant complications were 8.0%,4.0%,and 4.0%,respectively.Only5.9% of patients without bone grafts had implant complications;however,after statistical testing,patients with and without bone grafts The probability of complications in the two groups was not statistically significant.(4)Patient satisfaction: There was no dissatisfaction with the two methods in terms of overall satisfaction,and there was no difference in overall satisfaction of patients between the two groups regardless of whether the bone graft was grafted or not(P>0.05).Conclusions:(1)Implant surgery guided by digital guide plate made by indirect digital impression can effectively increase the accuracy of implant placement,especially in the horizontal direction.(2)In terms of safety,under the condition of strict control of indications for implant restoration,digital guide-guided implant surgery and traditional free-hand implant surgery both show good safety.(3)In terms of aesthetics,the advantage of the digital implant restoration process is that it has a satisfactory red aesthetic when restoring the tooth.Regardless of whether the bone is grafted or not,the digital implant restoration process and traditional implant restoration in the anterior tooth area can be used in a short period of time.To achieve a more stable aesthetic effect,the long-term effect needs further observation. |
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