| Objective:The purpose of this project is to explore the influence of the positioning error of mucosa-supported surgical templates on the accuracy of implant surgery in edentulous patients.It is hoped that postoperative implant deviation can be predicted according to guide positioning error,so as to facilitate the adjustment and change of surgical plan and provide further references for clinical application.Methods:According to the inclusion and exclusion criteria,27 edentulous patients who were admitted to the Department of Implantology,Stomatological Hospital of Shanxi Medical University from October 2019 to January 2022 and met the inclusion criteria were collected.(1)After making the radiation guide plate for the patient and performing digital scanning,the patient wore the radiation guide plate to take Cone Beam Computed Tomography(CBCT).(2)The preoperative information of patients was imported into the digital guide design software(co Diagnosti X),and use this software,the implants were virtually-placed and a surgical template was developed.(3)In each patients,after checking the stability of the template and adaptation to the mucosa of the edentulous arch,CBCT was taken after installation of pins and again after surgery.(4)The intraoperative and postoperative CBCT images of patients were compared with the preoperative design,in order to measured the angle,cervical and apical deviation between the planned and the placed of pins and implants.According to the measurement results,the influence of the placement accuracy of the pins on the accuracy of edentulousjaw implantation was analyzed,as well as the influence of different supporting dental arches(upper or lower jaw)and implant length on the accuracy of the implant.Results:1.Under the fully-guided surgery,the placement accuracy of the surgical template and the implantA total of 27 edentulous patients were included in this study,with 81 pins and 132 implants.The deviation of pins angle ranged from 0.42 to 3.50°(with an average of 1.95±1.01°),the deviation of cervical ranged from 0.34 to 3.50 mm(with an average of0.89 ± 0.66 mm),and the deviation of apical ranged from 0.37 to 3.50 mm(with an average of 1.07±0.66 mm);The implants angle deviation ranged from 2.28° to 6.60°(with an average of 4.06±0.93°),the cervical deviation ranged from 0.64 mm to 3.18mm(with an average of 0.95±0.14 mm),and the apical deviation ranged from 0.95 mm to 2.76 mm(with an average of 1.70±0.39 mm).2.Correlation analysis of the influence of the placement accuracy of the fully-guided template on the precision of implantation surgeryAccording to the Pearson correlation analysis,there was significant correlation between the angle,cervical and apical deviation of the implant and the pin(P < 0.05),and there were positive correlation between these variables.3.Analysis of the effect of different supporting dental arches on surgical accuracyThe implant angle,cervical and apical deviation of maxillary edentulous implant group were significantly lower than that of mandibular implant group(P<0.05)under the guidance of mucosa-supported surgical templates.There was no significant difference in angle,cervical and apical direction between maxillary and mandibular retainers(P >0.05).4.Influence of implant length on surgical accuracyFor 8 mm,10 mm and 12 mm implant lengths,there were statistically significant differences in implant angle,cervical and apical deviation(P<0.05).Conclusion:1.The template in position precision of implants three-dimensional position precision is positive correlation,therefore,the error of postoperative implant can be predicted according to the error of placement of surgical template in clinic application.2.In the guidence of the fully-guided toothless jaw surgery,maxillary accuracy is higher than the lower jaw.3.In edentulous implants surgery guided by mucosa-supported surgical templates,the surgical deviation of long implants was greater than that of short implants. |
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