| 许诺,韩爽,汪世超,王莉莉,童琳.正畸微型种植体数字化导板在前牙区的设计及应用[J].口腔材料器械杂志,2026,35(2):105-108. |
| 正畸微型种植体数字化导板在前牙区的设计及应用 |
| Design and application of a digital surgical guide for orthodontic micro-implants in the anterior region |
| 投稿时间：2025-12-31 修订日期：2026-03-23 |
| DOI：10.11752/j.kqcl.2026.02.08 |
| 中文关键词: 锥形束CT 种植体引导手术 导板 微型种植体 计算机辅助设计与制作 |
| 英文关键词:Cone beam computed tomography Implant-guided surgery Surgical guide Microimplant Computer-aided design and manufacturing |
| 基金项目: |
| 作者 | 单位 | E-mail | | 许诺 | 合肥市口腔医院周谷堆门诊部, 正畸科, 安徽医科大学合肥口腔临床学院, 合肥 240001 | sunny2000768@126.com | | 韩爽 | 合肥市口腔医院周谷堆门诊部, 正畸科, 安徽医科大学合肥口腔临床学院, 合肥 240001 | | | 汪世超 | 合肥市口腔医院周谷堆门诊部, 正畸科, 安徽医科大学合肥口腔临床学院, 合肥 240001 | | | 王莉莉 | 合肥市口腔医院周谷堆门诊部, 正畸科, 安徽医科大学合肥口腔临床学院, 合肥 240001 | | | 童琳 | 安徽省医学科学研究院, 合肥 230001 | |
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| 中文摘要: |
| 目的 探讨数字化导板的设计并引导微型种植体在前牙区植入的应用研究。方法 选择2022年12月至2024年8月初诊于合肥市口腔医院周谷堆门诊部需解决前牙露龈笑的女性患者10例。将患者CBCT扫描数据以DICOM文件的形式导出，口腔扫描仪获取的患者口内数字模型以STL文件导出，两者发送至EXO CAD软件进行配对，模拟植入支抗钉形成个性化导板STL数据进行3D打印，在导板引导下植入20枚微型种植体。术后行CBCT拍摄，通过三维重建，与手术前的导板模拟植入位置进行比较，并对微型种植体与牙根的距离进行测量。每个月复诊加力，记录微型种植体的松动及脱落情况。结果 术后20颗微型种植体距离上颌中切牙距离为（2.15±0.36）mm，距离上颌侧切牙距离为（3.89±0.69）mm，均在安全范围。植入的支抗钉与模拟时的尖端偏差（1.02±0.19）mm，帽端偏差（1.44±0.35）mm，支抗钉的冠部与尖部角度偏差为（5.08±0.94）°。随访6个月，20颗微型种植体稳定性良好，无松动、脱落。结论 利用数字化导板植入微型种植体，可以在前牙区获得良好的安全性与精确性，高效解决露龈笑。 |
| 英文摘要: |
| Objective To investigate the design of a digital surgical guide and its application in guiding the placement of micro-implants in the anterior region. Methods Ten female patients with gummy smile requiring treatment at the Zhougudui Outpatient Department of Hefei Stomatological Hospital from December 2022 to August 2024 were included. CBCT scan data were exported in DICOM format, and intraoral digital models obtained by oral scanning were exported in STL format. These datasets were matched using EXOCAD software to simulate micro-implant placement and generate individualized STL data for 3D printing of the guide. Under guide-assisted placement, 20 microimplants were inserted. Postoperative CBCT scans were obtained, and three-dimensional reconstruction was performed to compare the actual implant positions with the preoperative simulated positions. The distances between the microimplants and tooth roots were measured to evaluate placement accuracy and safety. Patients were followed up monthly for loading, and loosening or loss of the micro-implants was recorded. Results Postoperatively, the distances from the 20 micro-implants to the maxillary central incisors and maxillary lateral incisors were (2.15±0.36) mm and (3.89±0.69) mm, respectively, both within the safe range. The deviation between the actual and simulated positions was (1.02±0.19) mm at the tip and (1.44±0.35) mm at the head, and the angular deviation was (5.08±0.94) °. During the 6-month followup period, all 20 micro-implants remained stable, with no loosening or loss. Conclusion Placement of orthodontic micro-implants with a digital surgical guide achieved good safety and accuracy in the anterior region and provided an effective approach for the correction of gummy smile. |
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