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目的:为了提高复杂牙种植手术的植体植入精度和不翻瓣手术的准确性,植体植入的位点和深度得以控制,避免了由于人为操作不当造成的失误。方法:在牙种植手术中采用Straumann系统的全程导航技术,利用术前数据融合和数字模型设计,通过快速成型技术制造的CAD/CDM导板及专用导航工具,完成全部种植手术步骤。结果:16例牙列缺失的患者通过全程导航技术完成了种植手术和上部修复,完全符合术前的设计和修复要求,效果非常好。此技术使植体的植入更为精准,操作简单,手术时间明显缩短,术后反应和并发症显著减少。讨论:在复杂种植手术中应用全程导航技术,无论在深度的止动还是逐级备洞的控制都有相应的专用工具配合使用,提示明确、操作简便。全程导航技术特别适用不翻瓣和骨高度不足的种植手术。全程导航技术存在误差。后牙、特别是第二磨牙受开口度限制操作仍显困难。术者的经验和手术技巧依然是牙种植手术成功的重要因素。结论:全程导航技术在复杂牙列缺失和不翻瓣手术的种植手术中的使用取得非常好的临床效果,是很有推广和发展前景的。
OBJECTIVE: To improve the precision of implant implantation and the accuracy of non-flap surgery in complex dental implant surgery, the site and depth of implant implantation can be controlled to avoid mistakes caused by improper human operation. METHODS: The complete implant procedure was performed using the Straumann system’s full-range navigation technique in dental implants, using preoperative data fusion and digital model design, CAD / CDM guide plates and dedicated navigation tools manufactured by rapid prototyping. Results: Sixteen patients with missing dentition completed the operation of implantation and the upper repair through the whole navigation technology, which fully met the requirements of preoperative design and repair and the effect was very good. This technique allows implant implants more accurate, simple operation, significantly shorter operative time, postoperative response and complications significantly reduced. Discussion: The application of full navigation in complex implant surgery technology, both in the depth of the stop or step-by-step control of the hole has a corresponding special tools used in conjunction, tips clear, easy to operate. The whole navigation technology is particularly suitable for non-flap and bone implant surgery. There are errors in the whole navigation technology. Posterior teeth, especially the second molars, are still difficult to restrict by the opening degree. The surgeon’s experience and surgical skills are still an important factor in the success of dental implants. Conclusion: The application of full-course navigation technology in implant surgery with complicated dentition defect and non-flap surgery has achieved very good clinical results and is very promising for promotion and development.