| Purpose:The ultimate goal of implant restoration is to accurately simulate the physiological position of the missing tooth,replace its aesthetic appearance and function,and achieve long-term stability of soft and hard tissues.The realization of this goal mainly depends on the three-dimensional position of the implant,that is,the position of the final prosthesis determines the three-dimensional position of the implant,which is the restoration-oriented implantation.The accurate three-dimensional position of the implant is a necessary condition to obtain the aesthetic effect.Studies have shown that digital implant surgical guide plate can improve the accuracy of implant implantation.Compared with the mucosal-supported,bone-supported and mixed support types of half surgical guide,the use of tooth-supported type of full guide surgical template is more accurate to implant of ideal three-dimensional position.However,the use of domestic implant surgical guide does not require remote processing,which reduces the time of diagnosis and treatment,reduces the cost of treatment,and facilitates medical communication.In this study,the accuracy of the full-guide digital implant surgical guide supported by 3Shape software and produced by 3D printing in the aesthetic area of anterior teeth was discussed,and then the possible relevant influence factors the accuracy of the digital implant surgical guide board in the aesthetic area of anterior teeth were analyzed,so as to provide guidance for clinical work and some references for clinical practice.Materials and Methods:This study selected 29 patients with missing the upper anterior teeth in June 2017 to February 2019 in Shenzhen People's Hospital(the Second Clinical College of Jinan University),and 29 digital implant surgical guides were applied,which designed by 3Shape software and shaped by 3D printing production,which were full-guided and teeth-supported type,and all completed in maxillary aesthetic area 43 implant position.Then postoperative CBCT data imported in 3 Shape guide design software,and preoperative design position matching with postoperative actual position in the shoulder ? apex and Angle deviations.Analyze whether there are statistical differences in accuracy between Nobel Active and Ankylos C/X implant systems,flap and flapless surgery,immediate and delayed implantation.Results were analyzed by SPSS20.0 statistical analysis software,and each data wasdescribed by(`X±S),Each groups were compared with the two independent samples t-test,and inspection level of ?= 0.05,P<0.05 was considered difference was statistically significant.Results:1.In this study,the digital surgical guides,designed by 3 Shape software and produced by3 D printing production,supported by tooth and full type,helped planting implants in the esthetic zone of anterior maxilla,overall average deviation of 43 implants was :shoulder1.13±0.54 mm,apex1.27±0.57 mm,angular2.40±1.06 degree,and the latest Meta analysis results for statistical analysis,the shoulder deviation,apex deviation and angular deviation had no statistical significance.2.To analyse the 28 flap surgery and 15 flapless surgery,two different surgery ways of statistic analysis shown that the flap surgery error in mesiodistal direction: shoulder 1.45 ±0.52 mm,apex 1.88 ± 1.04 mm,angular 3.27±1.43 degree;In labial-palatal direction: shoulder1.62 ± 0.67 mm,apex 1.84 ± 0.26 mm,angular 2.58±2.01 degree.For flapless surgery,the error in mesiodistal direction: shoulder 1.57 ± 0.77 mm,apex 1.76± 0.99 mm,angular 4.15±1.06degree;In labial-palatal direction: shoulder 1.44± 0.79 mm,apex 1.73 ± 0.43 mm,angular2.71±2.85 degree.By comparing the results of two different surgical methods,flap surgery and flapless surgery,the difference was not statistically significant.3.To analyse to the 17 immediate placement implants and 26 delayed placement implants,two different placement period of statistic analysis shows that the immediate placement error in mesiodistal direction: shoulder1.33 ± 0.25 mm,apex 1.29 ± 0.67 mm,angular2.86±2.97degree;In labial-palatal direction : shoulder 1.32 ± 0.42 mm,apex 1.65 ± 0.34 mm,angular2.54±2.18 degree.For delayed placement implants,the error in mesiodistal direction: shoulder0.85 ± 0.47 mm,apex 1.23± 0.99 mm,angular 2.16±2.42 degree;In labial-palatal direction:shoulder 0.95 ± 0.85 mm,apex 1.37 ±0.84 mm,angular 2.06±2.11 degree.By comparing the results of immediate placement surgery and delayed placement surgery in different implantation periods,the difference was statistically significant.Conclusion:1.In the esthetic zone of anterior maxilla,the accuracy of the full-guide localized digital surgical guides is acceptable,which can provide technical guidance for clinical practice.2.In this study,the implantation error of immediate placement surgery was greater than thatof delayed surgery.3.In this study,The implantation error of flap surgery was not considered to be different from that of flapless surgery. |
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