Имплантация по хирургическим шаблонам и без них. Клиническое исследование.

Отклонения по вертикали и горизонтали при формировании ложа с помощью хирургического шаблона: клиническое исследование сравнивающее формирование ложа «на глаз» или с помощью хирургического шаблона для пилотных свёрел.

Исследование на актуальную сегодня тему – что точнее: установка имплантатов с помощью хирургических шаблонов изготовленных при помощи КЛКТ или вручную, на глаз.

Выводы:

наибольшая неточность при хирургии с шаблоном в вертикальном направлении – по-глубине. Неточности в мезиально-дистальном или щечно-язычном направлении явно меньше. Хирургия без шаблонов дает неточности значительно выше, чем с шаблонами.
Clin Oral Implants Res. 2015 Nov;26(11):1315-20

Depth and lateral deviations in guided implant surgery: an RCT comparing guided surgery with mental navigation or the use of a pilot-drill template.

VERCRUYSSEN M, COUCKE W, NAERT I, JACOBS R, TEUGHELS W, QUIRYNEN M.
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Keywords:

CT imaging; accuracy; clinical research; guided implant surgery; surgical techniques

Aim:

To assess the accuracy of guided surgery compared with mental navigation or the use of a pilot-drill template in fully edentulous patients.

Materials & Methods:

Sixty consecutive patients (72 jaws), requiring four to six implants (maxilla or mandible), were randomly assigned to one of the following treatment modalities: Materialise Universal(®) mucosa, Materialise Universal(®) bone, Facilitate(™) mucosa, Facilitate(™) bone, mental navigation, or a pilot-drill template. Accuracy was assessed by matching the planning CT with a postoperative CBCT. Deviations were registered in a vertical (depth) and horizontal (lateral) plane. The latter further subdivided into BL (bucco-lingual) and MD (mesio-distal) deviations.

Results:

The overall mean vertical deviation for the guided surgery groups was 0.9 mm ± 0.8 (range: 0.0-3.7) and 0.9 mm ± 0.6 (range: 0.0-2.9) in a horizontal direction. For the non-guided groups, this was 1.7 mm ± 1.3 (range: 0.0-6.4) and 2.1 mm ± 1.4 (range 0.0-8.5), respectively (P < 0.05). The overall mean deviation for the guided surgery groups in MD direction was 0.6 mm ± 0.5 (range: 0.0-2.5) and 0.5 mm ± 0.5 (range: 0.0-2.9) in BL direction. For the non-guided groups, this was 1.8 mm ± 1.4 (range: 0.0-8.3) and 0.7 mm ± 0.6 (range 0.0-2.9), respectively. The deviation in MD direction was significantly higher in the non-guided groups (P = 0.0002).

Conclusions:

The most important inaccuracy with guided surgery is in vertical direction (depth). The inaccuracy in MD or BL direction is clearly less. For non-guided surgery, the inaccuracy is significantly higher.

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