| Objective:In edentulous jaw patients,alveolar bone atrophy is caused by tooth loss for a long time,which is easy to cause deviation of implant position and damage to important anatomical structures during implantation,resulting in increased postoperative complications and even failure of implantation.Digital template can improve the accuracy of implant surgery for edentulous jaw.Most clinical studies comparing flap and flapless surgery for edentulous jaw implant are based on soft tissue aesthetics,marginal bone resorption,postoperative satisfaction,etc.,and there are few studies comparing the accuracy of the two surgical methods.Intraoral scanning was used to obtain the post-surgery implantation position,which can reduce the amount of postoperative CBCT radiation and provide impression base for prosthetics.The purpose of the vitro study was to measure the accuracy comparing flap and flapless operation by the method of intraoral scanning.Materials and Methods:CBCT data and intraoral data of patients with dentition loss who underwent All-on-4 implant prosthesis in the Stomatology Department of the First Affiliated Hospital of Nanchang University from February 2019 to June 2020 were selected.There were 3 maxillary and 3 mandibular,6 edentulous jaws in total,and 24 implants in total.Resin jaw was made according to the CBCT 3D reconstruction image of the patient with radiation template,and artificial gum was injected into the interspace to make the resin jaw model with gingiva.Each toothless jaw resin produced two models,respectively,points into the flap and flapless group for all-on-4 implantation,a total of 24 implant.In vitro simulated implant surgery was performed under the guidance of template fabricated with CAD/CAM method,and the postoperative implant position was obtained through the oral scanning.The planned position and the actual postoperative position were registered in the CAD software.The accuracy of the two surgical methods was compared with four parameters,angle deviation,depth deviation,implant neck deviation and implant tip deviation.In the preliminary experiment,the first 12 implants were selected in the flapless group,and the postoperative CBCT scan and postoperative intraoral scan measurement were compared and analyzed.P ≦0.05 was considered to be statistically significant.Results:1.For the first 12 implants in the flapless group,neck deviation(t=-2.26,P=0.045),tip deviation(t=-1.95,P =0.078),depth deviation(t=-2.85,P =0.016),Angle deviation(t=-2.71,P =0.020),CBCT was compared with the measurement method of intraoral scanning.The results were statistically different,and the intraoral scanning method was more accurate than CBCT.2.In the flapless group,the deviation of neck,tip,depth and Angle were respectively(0.80±0.28)mm,(0.65±0.23)mm,(0.51±0.21)mm and(2.67±1.20)°.3.The deviation of the neck,the tip,the depth and the Angle were respectively(0.91±0.27)mm,(0.77±0.28)mm,(0.61±0.18)mm and(2.84±1.19)° in the flap operation group.4.There was no statistical difference in the neck deviation(t=1.72,P =0.099),tip deviation(t=1.85.P =0.077),depth deviation(t=2.06,P =0.051)and Angle deviation(t=0.57,P =0.573)of the implant.Conclusions:In the limitations of this study,the guided edentulous implatation with fully navigation can improve the precision of implant implantation,The measurement method of intraoral scan is more accurate than CBCT.two surgery methods have no statistical differences in the neck,tip,depth,the angle deviation. |
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