| Objective:Currently widely used dental template is made on plaster models. The three-dimensional structure of the jaw is not clear. Therefore it can not guide the implant accurately and easily lead to the occurrence of surgical complications. With the aid of the reconstruction of CBCT data, three-dimensional reconstruction, CAD technology, rapid prototyping, the template for placement of implants were designed and manufactured to achieve the accurate implantation in order to reduce the surgical complications and improve the successful rate of implant surgery.Comparing of the implant position of traditional surgical template and the experimental production template come to understand the function of the CAD/CAM template for improving the accuracy of implant surgery. Also it provides a new surgical template production method for clinical.Methods:The experiment is divided into two parts:model experiment and clinical practice.The first part:Firstly, produce a traditional surgical guides and a radiographic positioning template. Secondly, The CBCT scan was performed on the plaster model with the radiographic positioning template. Basing on the data, three-dimensional model was reconstructed and the location of implant was determined, virtual implants were placed in the ideal position. Design template on computer and manufacture the template with the help of rapid prototyping technique.Tight implants were placed in the planed position of the plaster models aided by the CAD/CAM template and the traditional surgical template respectively, observe and evaluate the two template in the simulated implant and the actual implant surgery. After the CBCT scan, the pre-operative and post-operative CBCT was compared and the deviation between actual and virtual implants was measured to assess the accuracy of the template.The second part:After CBCT scan was performed on the patient who needed implant, three-dimensional model was constructed and the location of implant was determined. According to the implant position, the CAD/CAM dental template was designed.U sing rapid prototyping technology, all data obtained were used to fabricate the template which is to guide the implant surgical operation. After the operation, CBCT scanning and three-dimensional data reconstruction were used to evaluate the implant template.Results:1.With the help of the traditional surgical template, the deviations of the position at the top of the implant were1.63±0.11mm and at the bottom of the implant were2.22±0.08mm.The deviation of the position at the top of the implants was significantly smaller than the bottom of the implants。2. With the help of the CAD/CAM implant template, the deviations of the position at the top of the implant were0.87±0.21mm and at the bottom of the implant were0.82±0.16mm.The CAD/CAM implant template on the top and the bottom coupled with the three-dimensional direction deviation were less than the traditional surgical template, and the rapid prototyping template can improve the accuracy of implant.3.the CAD/CAM template could determine the direction and location of the implants before operation and the implant can be placed to the optional location accurately as designed,also it takes its place accurately and guide the drills steadily,so it played a role of navigation in implant surgery,which shows prospective in clinical application.Conclusion:The deviation of the rapid prototyping template produced by this method is less than the traditional surgical template in all directions, the position of implant is closer to the planning location.It can improve the navigation role greatly. The rapid prototyping template does not affect vision while operate and meet the requirements of clinical applications.The implants can be placed accurately as designed and can improve the accuracy of guiding for implant, which could improve the safety, the accuracy and the successful rate. |
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