Accuracy of orthodontic miniscrew implantation guided by stereolithographic surgical stent based on cone-beam CT-derived 3D images
Accuracy of orthodontic miniscrew implantation guided by stereolithographic surgical stent based on cone-beam CT-derived 3D images
复制标题
DOI：
10.2319/033111-231.1
复制
发表时间：
2012-03-01
影响因子：
3.4
通讯作者：
Moriyama, Keiji
中科院分区：
文献类型：
--
作者：
Qiu, Ling Ling;Haruyama, Naoto;Moriyama, Keiji
目的：研制基于锥形束计算机断层扫描（CBCT）三维（3D）图像的支架引导正畸微型种植手术支架，并评价其准确性。材料与方法：根据基于三维CBCT图像的虚拟植入方案，采用立体光刻矫治器（SLAs）制作10个手术支架。自钻孔微型支架各30个，分别植入3个幻影中上颌或下颌后弓两侧各2 ~ 3个位置：2个幻影中20个由10个外科支架引导（支架组），1个幻影中10个由徒手引导（徒手组）。测量了6个参数（日冕和尖端的中远端和垂直偏差以及中远端和垂直角偏差）以比较组间的差异。结果：支架组无根损伤，徒手组10个微型支架中有4个与根接触。支架组中远端和垂直方向的冠侧偏差分别为0.15 +/- 0.09和0.19 +/- 0.19 mm，尖侧偏差分别为0.28 +/- 0.23和0.33 +/- 0.25 mm；中远端和垂直方向的角度偏差分别为1.47 +/- 0.92和2.13 +/- 1.48。徒手组相应的结果分别为0.48 +/- 0.46 mm和0.94 +/- 0.87 mm（冠），0.81 +/- 0.61 mm和0.78 +/- 0.49 mm（尖），7.490 +/- 6.09和6.31 +/- 3.82。两组间6项参数均有显著差异（学生t检验，P < 0.05）。结论：基于三维CBCT图像的sla支架可提供安全、准确的微创植入方法。（直角矫正，2012;82:284-293）
Objective: To develop surgical stents for cone-beam computed tomography (CBCT) 3-dimensional (3D) image-based stent-guided orthodontic miniscrew implantation and to evaluate its accuracy.Materials and Methods: Ten surgical stents were fabricated with stereolithographic appliances (SLAs) according to 3D CBCT image-based virtual implantation plans. Thirty self-drilling miniscrews were implanted at two to three positions on each side of the maxillary or mandibular posterior arches in three phantoms: 20 guided by 10 surgical stents in two phantoms (stent group) and 10 guided freehand in one phantom (freehand group). Six parameters (mesiodistal and vertical deviations at the corona and apex and mesiodistal and vertical angular deviations) were measured to compare variations between the groups.Results: No root damage was found in the stent group, whereas four of 10 miniscrews contacted with roots in the freehand group. In the stent group, deviations in the mesiodistal and vertical directions were 0.15 +/- 0.09 and 0.19 +/- 0.19 mm at the corona, respectively, and 0.28 +/- 0.23 and 0.33 +/- 0.25 mm at the apex, respectively; angular deviations in the mesiodistal and vertical directions were 1.47 +/- 0.92 and 2.13 +/- 1.48, respectively. In the freehand group, the corresponding results were 0.48 +/- 0.46 mm and 0.94 +/- 0.87 mm (corona), 0.81 +/- 0.61 mm and 0.78 +/- 0.49 mm (apex), and 7.490 +/- 6.09 and 6.31 +/- 3.82. Significant differences were found in all six parameters between the two groups (Student's t-test, P < .05).Conclusions: 3D CBCT image-based SLA-fabricated surgical stents can provide a safe and accurate method for miniscrew implantation. (Angle Orthod. 2012;82:284-293.)