目的:选择一名上颌骨后部牙槽骨广泛萎缩的患者,完成了机器人颧骨种植体的实验和临床病例,以研究种植体机器人系统在临床使用中的可行性。
方法:收集术前数字信息,以修复为导向,提前设计了机器人手术所需的植入位置和个性化优化标记。患者上颌骨和下颌骨的树脂模型和标记都是3D打印的。使用定制的专用精密钻头和用于机器人zy骨植入物的手机支架进行模型实验,并比较了机器人zy骨植入物组的准确性(植入物长度=52.5mm,n=10)与牙槽种植体组(种植体长度=18毫米,n=20)。根据口外实验的结果,进行了一项机器人手术的临床病例,该手术用于the骨植入物的放置和植入物支持的全足弓假体的立即装载。
结果:在模型实验中,骨种植体组报告的入口点误差为0.78±0.34mm,出口点误差为0.80±0.25mm,角度误差为1.33±0.41度。相比之下,牙槽种植组(对照组)报告的入口点误差为0.81±0.24mm,出口点误差为0.86±0.32mm,角度误差为1.71±0.71度。两组间无显著差别(p>0.05)。在临床病例中,两个颧骨植入物的平均进入点误差为0.83毫米,平均出口点误差为1.10mm,角度误差为1.46度。
结论:本研究中制定的术前计划和手术程序为机器人the骨植入手术提供了足够的准确性,总体偏差很小,上颌窦外侧壁偏离不受影响。
A patient with extensive atrophy of the alveolar ridge in the posterior portion of the maxilla was selected to complete an experimental and clinical case of the robotic zygomatic implant to investigate the viability of an implant robotic system in clinical use.
The preoperative digital information was collected, and the implantation position and personalized optimization marks needed for robot surgery were designed in advance in a repair-oriented way. The resin models and marks of the patient\'s maxilla and mandible are all printed in 3D. Custom-made special precision drills and handpiece holders for robotic zygomatic implants were used to perform model experiments and compare the accuracy of the robotic zygomatic implant group (implant length = 52.5 mm, n = 10) with the alveolar implant group (implant length = 18 mm, n = 20). Based on the results of extraoral experiments, a clinical case of robotic surgery for zygomatic implant placement and immediate loading of implant-supported full arch prosthesis was carried out.
In the model experiment, the zygomatic implant group reported an entry point error of 0.78 ± 0.34 mm, an exit point error of 0.80 ± 0.25 mm, and an angle error of 1.33 ± 0.41degrees. In comparison, the alveolar implant group (control group) reported an entry point error of 0.81 ± 0.24 mm, an exit point error of 0.86 ± 0.32 mm, and an angle error of 1.71 ± 0.71 degrees. There was no significant difference between the two groups (p > 0.05). In clinical cases, the average entry point error of two zygomatic implants is 0.83 mm, the average exit point error is 1.10 mm and the angle error is 1.46 degrees.
The preoperative planning and surgical procedures developed in this study provide enough accuracy for robotic zygomatic implant surgery, and the overall deviation is small, which is not affected by the lateral wall deviation of maxillary sinus.