Implant Tribune China No. 3, 2019
3D打印引导和非引导种植体植入精度比较的口外研究（第一部分）
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[1] =>
种植论坛
IMPLANT TRIBUNE
香港，2019年5月28日出版
会员资料
第19卷第5期
3D打印引导和非引导种植体植入精度比较的口外研究（第一部分）
【波兰】Łukasz Zadrozny, Marta Czajkowska & Leopold Wagner
前言
牙科种植术正成为一种越来越流行的牙
齿修复方法。种植体植入的准确性和精度是
实现长期治疗效果和美学效果的关键因素，
是进行之后的修复工作的基础。由于现代数
字技术的发展，我们可以预先进行种植体植入
的模拟。然后评估治疗计划并可以通过3D打
印制作种植导板。该导板可提供种植体植入
位置、深度和角度的精确信息，可以保证所
有参数同治疗计划一致，从而降低植入过程
中出错的风险。使用3D打印技术，不仅可以
图1a
图1b
图1a&b：种植体定位的虚拟计划。
制作种植导板，还可以制取准确反映患者真
实临床状况的研究模型。这使得我们可以在
口外进行精度的对比，这样操作安全而且符
合实际需求。在手术过程中，临床条件往往
阻碍手术视野的精确定位，因此种植体的定
位精度较差。根据文献资料，无论经验丰富
与否，临床医生都面临着这个问题。在进行
手术准备时引入基于CBCT的虚拟计划是非
常有用的；但是，完全控制种植区窝洞预备
的前提是将治疗计划结果转移到实施定位的
种植导板上。实际上可以使用3D打印机进行
种植导板的打印，然后进行消毒并应用在种
植手术中。使用种植导板会提高种植体植入
的精度并缩短手术时间。
研究目的
本研究的目的是准备3D模型分析比较在
使用虚拟治疗计划的前提下，使用和不使用
种植导板进行种植手术的精度差别。
研究方法
在对下颌骨进行种植手术的患者进行
CBCT扫描，在 DDS-Pro软件（www.ddspro.com.pl）中创建了一个与种植前实际骨
和粘膜状况相对应的3D模型。然后将这个
模型3D打印20次。采用选择性激光烧结技
术，在TPM Elite P3600 SLS系统打印机（
Solveere）上使用聚酰胺粉末进行打印。得
到了10对相同的下颌模型。种植体定位和植
入（TSIII, OSSTEM IMPLANT）的模拟治
疗计划（DDS-Pro；图1）和使用喷射技术（
Projet MP 3000打印机，3D系统）3D打印的
种植体导板，导板上有之前临床使用的常规
平台的三个种植体的常用种植体预留孔洞（
图2
消毒），用于将种植体使用OsstemGuide工具
图2：手术前的一对模型示范：左侧不使用种植导板，右侧使用种植导板。
www.dentistx.com
[2] =>
IMPLANT TRIBUNE
16 种植临床
图3
图4
图3：使用种植导板的模型和植入后的种植体。种植导板由两个固位钉进行固定。
图4：材料堆积在连接延长杆的钻头上。
套装（锥形）植入到再次打印的模型中去。
导板），使用相同的种植体钻孔工具，并且
结果
钻孔速度设定为1200转/分。没有使用水进行
在其他条件都相同的情况下进行。由于试验
使用 3D打印模型允许我们在与临床实
很难达到足够的种植体深度。插入种植体
冷却。根据厂家说明进行种植窝洞制备。其
是在口外进行，我们使用了尺寸为4×10 mm的
际情况一致的条件下进行种植体植入。然
时需要使用比临床更大的扭矩。据观察，
他模型也是根据模拟计划进行种植体植入，
TSIII培训用种植体。我们假设所有十个种植
而，在本研究中由于打印的模型是硬的。
当在保存牙齿附近进行种植窝洞制备时，
但没有使用额外的辅助措施（没有使用种植
体手术结果均相同。
在进行种植窝洞制备时切削出的模型材料
需要使用钻头延长杆，以避免种植手机接
www.dentistx.com
都堆积在种植钻头和种植体上，从而导致
[3] =>
IMPLANT TRIBUNE
种植临床 17
图5
IT
作者信息
˙
Łukasz Zadrozny医生，
DDS（口腔外科博士），PhD (博士
学位)
Leopold Wagner医生，DDS（口腔外科博士），PhD (博士
图6
图5：通过导板套环连接到延长杆上的钻头。使用延长杆可以正确引导钻头，同时可以避免种植手机接触到邻牙上的种植导板。而在临
床上，由于开口受限，可能无法使用钻头延长杆，尤其是在进行磨牙区的种植手术时。
图6：使用种植导板完成种植手术后的模型。可以看到植入的种植体角度一样。
学位)
均就职于华沙医科大学牙科系的牙科教育与预防科。
触导板或牙齿。由于OsstemGuide工具包（锥形）中
联系方式分别为：lukasz.zadrozny@wum.edu.plleopold. wag-
缺少此工具，因此在临床使用时必须另外配备一个种
编者按：这项研究是科学发展研究领域中一个项
植工具包。与无导板的相同手术相比，使用种植导板
目的一部分，科学发展研究旨在培养年轻科学家和博
缩短了手术时间。
士研究生，由波兰华沙医科大学科学活动项目提供资
ner@wum.edu.pl
Marta Czajkowska是华沙医科大学牙科系牙科专业和预防学
系学生科学协会的成员。
接下来对模型进行光学扫描，并对其重复性、准确性
和与模拟治疗目标的一致性进行对比分析。
金赞助。 IT
www.dentistx.com
[4] =>
18 种植临床
www.dentistx.com
IMPLANT TRIBUNE
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