| 余润平,袁芸,张洪铭,黄慧.3D打印铝合金种植手术导板准确度的体外评价[J].口腔材料器械杂志,2023,32(3):158-164. |
| 3D打印铝合金种植手术导板准确度的体外评价 |
| Accuracy of 3D-printed aluminum alloy implant surgical guides:An in-vitro study |
| 投稿时间：2023-02-21 修订日期：2023-06-08 |
| DOI：10.11752/j.kqcl.2023.03.02 |
| 中文关键词: 3D打印 种植导板 准确度 |
| 英文关键词:3D print Implant surgical guide Accuracy |
| 基金项目:国家自然科学基金(编号:81771105) |
| 作者 | 单位 | E-mail | | 余润平 | 上海交通大学医学院附属第九人民医院口腔修复科, 上海交通大学口腔医学院, 国家口腔医学中心, 国家口腔疾病临床医学研究中心, 上海市口腔医学重点实验室, 上海市口腔医学研究所, 上海 200011 | | | 袁芸 | 上海交通大学医学院附属第九人民医院口腔修复科, 上海交通大学口腔医学院, 国家口腔医学中心, 国家口腔疾病临床医学研究中心, 上海市口腔医学重点实验室, 上海市口腔医学研究所, 上海 200011 | | | 张洪铭 | 上海交通大学医学院附属第九人民医院口腔修复科, 上海交通大学口腔医学院, 国家口腔医学中心, 国家口腔疾病临床医学研究中心, 上海市口腔医学重点实验室, 上海市口腔医学研究所, 上海 200011 | | | 黄慧 | 上海交通大学医学院附属第九人民医院口腔修复科, 上海交通大学口腔医学院, 国家口腔医学中心, 国家口腔疾病临床医学研究中心, 上海市口腔医学重点实验室, 上海市口腔医学研究所, 上海 200011 | huanghui_68@126.com |
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| 中文摘要: |
| 目的 在体外树脂模型上设计并模拟种植体植入实验, 分析比较一种新型铝合金材质种植导板与传统树脂导板的准确度差异。方法 选取一名肯氏 III 类牙列缺损患者并制取硅橡胶印模, 灌制超硬石膏模型后使用口内扫描仪扫描, 设计并打印 20 个树脂模型。将患者的锥束计算机断层扫描(CBCT)数据导入软件(3Shape Implant Studio 2019) 并规划该患者的种植方案, 设计种植导板。使用 3D 打印机分别制作树脂与铝合金材质手术导板各一个。通过全程引导手术将种植体植入模型中, 植入后拍摄术后 CBCT。在软件中测量术后 CBCT 图像与原治疗计划图像, 在近远中面和唇腭面分析种植体相对于原设计在三维线性以及角度上的准确度差异。结果 种植体在金属导板引导下的线性偏差分别为近中(0.51±0.63) mm, 远中(0.49±0.58) mm, 唇向(1.14±1.40) mm, 腭向(1.15±1.42) mm; 垂直向(2.09±0.84) mm。近远中角度和唇腭侧角度的角度偏差分别为(1.41°±0.81°) 和(1.78°±1.03°)。种植体在垂直向的偏差与近远中角度、唇腭侧角度偏差与树脂导板引导下的种植体偏差有统计学差异(P<0.05),金属材质导板表现出更好的准确度, 而两种材质导板在近远中向和唇腭向上的偏差无统计学差异。结论 通过 3D 打印技术制作的铝合金材质导板的线性和角度偏差均在临床可接受范围内, 且相较于传统树脂导板, 铝合金材质导板由于其高强度、形态小巧的特性, 具有更良好的手术视野和散热能力, 能够有效提高种植手术的准确度和成功率。 |
| 英文摘要: |
| Objective This study aimed to analyze and compare the accuracy of a 3D-printed aluminum alloy implant surgical guide and the traditional resin template by designing and simulating implantation experiments on an in-vitro resin model. Methods A patient with Kennedy III dentition defect was selected, and a silicone rubber impression was prepared. A plaster model was molded, and a digital model was obtained with a scanner to print 20 resin models. The patient's cone beam computed tomography (CBCT) data were imported into the software (3Shape Implant Studio 2019) to design the treatment plan and implant surgical guide. One surgical guide made of resin and one of aluminum were produced using a 3D printer. The implants were placed in the models utilizing a guided procedure. The post-operative CBCT images were acquired and analyzed against the original images in the software to evaluate the difference in the accuracy of the 3D linearity and angularity of the implants in the proximal-distal and labiodistal planes in terms of the original design. Results The implant displacement of group metal surgical guides were (0.51±0.63) mm mesially(M), (0.49±0.58) mm distally(D), (1.14±1.40) mm labially(L), and (1.15±1.42) mm palatally(P); (2.09±0.84) mm vertically (V). The angulation displacement of the mesiodistal angle and the labiopalatal angle was (1.41°±0.81°) (AMD) and (1.78°±1.03°) (ALP). There were statistical differences between the vertical deviation and the mesiodistal, labiopalatal angulation of the implant (P<0.05), and the metal surgical guide showed a higher degree of accuracy. However, there was no significant difference between the two kinds of surgical guides in the mesial and distal directions and the labial and palatal directions. Conclusions The linearity and angulation displacement of the 3D-printed aluminum alloy surgical guide is considced to be within the acceptable range clinical application. Compared with the traditional resin surgical guides, the aluminum alloy template has better surgical vision and heat dissipation ability due to its high strength and structure, which can effectively improve the accuracy and success rate of implant surgery. |
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