PDF(Pubmed)
Abstract：
Digital workflows have become integral in orthodontic diagnosis and therapy, reducing risk factors and chair time with one-visit protocols. This study assessed the transfer accuracy of fully digital planned insertion guides for orthodontic mini-implants (OMIs) compared with freehanded insertion. Cone-beam computed tomography (CBCT) datasets and intraoral surface scans of 32 cadaver maxillae were used to place 64 miniscrews in the anterior palate. Three groups were formed, two using printed insertion guides (A and B) and one with freehand insertion (C). Group A used commercially available customized surgical templates and Group B in-house planned and fabricated insertion guides. Postoperative CBCT datasets were superimposed with the planning model, and accuracy measurements were performed using orthodontic software. Statistical differences were found for transverse angular deviations (4.81° in A vs. 12.66° in B and 5.02° in C, p = 0.003) and sagittal angular deviations (2.26° in A vs. 2.20° in B and 5.34° in C, p = 0.007). However, accurate insertion depth was not achieved in either guide group; Group A insertion was too shallow (-0.17 mm), whereas Group B insertion was deeper (+0.65 mm) than planned. Outsourcing the planning and fabrication of computer-aided design and computer-aided manufacturing insertion guides may be beneficial for certain indications; particularly, in this study, commercial templates demonstrated superior accuracy than our in-house-fabricated insertion guides.
摘要：
数字工作流程已成为正畸诊断和治疗中不可或缺的一部分，通过一次访问协议减少风险因素和主席时间。这项研究评估了与徒手插入相比，用于正畸微型植入物（OMI）的全数字计划插入指南的转移准确性。使用32具尸体上颌骨的锥形束计算机断层扫描（CBCT）数据集和口内表面扫描在前腭中放置了64个小条。组成了三个小组，两个使用打印的插入指南（A和B）和一个徒手插入（C）。A组使用市售定制手术模板，B组使用内部计划和制造的插入引导件。术后CBCT数据集与规划模型叠加，使用正畸软件进行准确性测量。横向角度偏差的统计差异（A中的4.81°与B中12.66°,C中5.02°,p=0.003）和矢状角偏差（A中的2.26°与B为2.20°,C为5.34°,p=0.007)。然而,在任一引导组中均未达到精确的插入深度;A组插入太浅(-0.17mm),而B组插入比计划更深(+0.65mm)。将计算机辅助设计和计算机辅助制造插入指南的规划和制造外包对某些适应症可能有益；特别是，在这项研究中，商业模板显示出比我们的内部制造的插入指南更高的准确性。
