目的:本研究旨在评估与使用动态导航系统进行侧窗开口相关的准确性,以进行直接窦底抬高(SFE)手术,同时进行植入物放置。
方法:一名女性患者,27岁,报告给种植部寻求治疗她失去的牙齿。在射线照相检查中,在26(左上第一磨牙)区域,残余牙槽的高度为6毫米。对于植入物的放置,此案计划在动态导航下进行(Navident,克拉洛娜,加拿大)。为了使侧窗接近窦底,计划了类似于所需窗口尺寸和假体植入物位置的植入物轨迹。使用Evalunav(Navident,克拉洛娜,加拿大)用动态导航软件进行分析。
结果:提高了侧窗开口的精度,并且在整个过程中实时保持横向窗口的可视化,这有利于消除窦膜的撕裂。与计划和手术后相比,在横向窗口的轨迹中发现的偏差为:(a)入口偏离了2.83mm;(b)顶点偏离了2.52mm;(c)垂直,顶点偏离0.29毫米;(d)轨迹的角度偏差为8.93°。与SFE的精度同时放置的植入物与计划的位置相比:(a)入口偏离0.03mm,(b)顶点偏离0.82毫米,(c)垂直,顶点偏离0.82毫米,并且(d)轨迹的角度存在0°偏差。
结论:动态导航技术通过提供高度准确和精确的外科手术计划和执行,可以帮助克服与直接鼻窦提升手术相关的并发症。这可以导致改善的植入物稳定性和降低的并发症风险。
OBJECTIVE: This study aims to evaluate the accuracy associated with the use of a dynamic navigation system for the lateral window opening for a direct sinus floor elevation (SFE) procedure with simultaneous implant placement.
METHODS: A female patient, aged 27 years, reported to the Department of Implantology seeking treatment for her lost tooth. On radiographic examination, the residual alveolar ridge height was 6 mm in the 26 (left upper first molar) region. For the implant placement, the case was planned to be carried out under dynamic navigation (Navident, Claronav, Canada). To make the lateral window accessible to the sinus floor, an implant trajectory resembling the required window dimensions and prosthetic implant position was planned. Post-surgery cone beam computed tomography (CBCT) was taken to assess the accuracy of the lateral window and implant trajectories using Evalunav (Navident, Claronav, Canada) analysis with dynamic navigation software.
RESULTS: There was improved accuracy of the lateral window opening, and the visualization of the lateral window was maintained in real-time throughout the procedure, which was advantageous to eliminate the tearing of the thin sinus membrane. The deviations found in the trajectory of the lateral window in comparison between the planning and post-procedure were: (a) entry was deviated by 2.83 mm; (b) the apex was deviated by 2.52 mm; (c) vertically, the apex was deviated by 0.29 mm; and (d) there was an 8.93° deviation in the angulation of the trajectory. The implant that was placed simultaneously with the SFE\'s accuracy was in comparison with the position that was planned: (a) entry was deviated by 0.03 mm, (b) the apex was deviated by 0.82 mm, (c) vertically, the apex was deviated by 0.82 mm, and (d) there was a 0° deviation in the angulation of the trajectory.
CONCLUSIONS: Dynamic navigation technology can help overcome complications associated with direct sinus lift procedures by providing highly accurate and precise planning and execution of the surgical procedure. This can lead to improved implant stability and a reduced risk of complications.