| Summary: | 碩士 === 臺灣大學 === 臨床牙醫學研究所 === 95 === Introduction: Dental implantation is a recently developed treatment since mid 1960s. By placing a titanium fixture into the jaw bone, a predicable union (osseointegration) between bone tissue and the implant could be achieved. There seems an increasing demand in dental implantation due to its excellent performance compared to conventional dental prostheses. However, the position of the implants has decisive effect on the final results in terms of mastication, phonation, and esthetics.
In order to achieve a predicable treatment outcome, a comprehensive diagnostic work-up of the planed implant positions and then precisely transferring to the implant surgery is a paramount before surgery. Image guided navigation surgery or stereographic surgical guide by CAD-CAM technique are developed for this purpose. There are many software and hardware designed by different companies available in the market nowadays. Their convenience and preciseness had been documented in many publications. However, the precision achieved was not tested by other authorities with a standardized method. The high cost of these surgical equipments or products also made them unpopular in routine planning or performing dental implant surgery.
Materials and Methods: In this study, we used a simulated dental cast model to test the precision between the planned pre-operative implant position and the actual placed implant position using metal tube guided surgical templates. The radiographic examination and analysis of the implant position were performed with cone-beam CT (i-CAT) and ImplantMax software respectively.
Results: The results shown that through high image resolution and precise reference markers, the positions of the implant could be predictably reported repeatedly. The pre-operative implant positions can be precisely transferred with metal tube guided surgical template. The major influencing factor in causing transfer error was the stability of the surgical guide used. That is to say, in performing dental implantation using techniques in this study, the main error was from the repeatability of the position of the surgical guide placed on the model during pre-operative planning and the position placed during surgery. The mean translation deviation were 0.3 and 0.4mm and mean angle deviation were 2.9 and 4.8 degrees in bilateral and unilateral tooth supported surgical guides respectively, which were similar to other systems reported. The mean translation and angle deviation were 0.45 mm and 3.54 degree with Simplant SurgiGuide using our study design.
Conclusion: The preoperative planning of implant position could be predictably transferred to the operative field using metal tube guided surgical template. The main source of the error would be caused by the stability of the surgical guide. Using the techniques described in our study, the implant could be placed as accurately as other commercialized products like SimPlant SurgiGuide.
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