- 期刊
動態導航系統輔助植體植入：文獻回顧
Dynamic navigation systems in implant placement: A Literature Review
摘要
研究目的：利用贋復導向原則將植體植入理想位置，可降低植體相關併發症，動態導航系統已廣泛運用於輔助植體植入手術中。動態導航系統使用動態追蹤技術，術中可即時同步顯示錐束電腦斷層（Cone-Beam Computed Tomography, CBCT）影像與術前規劃虛擬植體位置，引導手術醫師將植體植入理想位置；此技術可簡化手術步驟且術中隨時更改植體尺寸與預先規畫位置。本文針對動態導航系統輔助植體植入的文獻回顧，探討使用動態導航系統的植體植入準確度與臨床結果及影響植體位置準確度的相關因素。材料與方法：本文使用透過PubMed資料庫，搜尋2006至2023年之動態導航系統文獻，包含臨床研究、體外研究、系統回顧分析。結果：從1141篇搜尋結果中篩選出13篇。文獻回顧結果顯示植牙動態系統準確度優於傳統徒手植體植入技術，與靜態導板系統有相似準確度；比較不同手術方式、完全無牙脊與部分無牙脊、上下顎、不同廠牌等不同條件情況下，準確度皆無顯著差異。而在學習歷程上，手術醫師的手術經驗與植體位置準確度有相關聯。使用動態導航系統手術與使用靜態導板系統手術所花費的時間並無顯著差異。根據術後統計，植體成功率高且沒有與不理想植體位置相關的併發症發生。結論：動態導航系統輔助植體植入可準確輔助植體植入，是可預測且安全的術式，亦可降低併發症發生率。
並列摘要
Prosthetically driven implant surgery has been proven to reduce complications. The surgical navigation systems is widely used in dental implant placement. Surgical navigation systems involve the implant planning on the Cone-Beam Computed Tomography (CBCT) data and use a digital navigation system that can track the real-time position of surgical instruments on the CBCT, displaying it on a monitor. This techniques can offer the advantages of prosthetic-driven implant placement, simplification of surgical procedures and accurate dental implant placement. When using surgical navigation systems, changes can be made at the time of the surgery, including implant size, length, width, shape and changes in positioning as required clinically. The aim of the present article is to summarize available data on the accuracy and clinical outcomes of implants placed with dynamic navigation. The factors related to the use of dynamic navigation that affect the accuracy of implant position were investigated. Materials and Methods : The literature searching strategy was performed in PubMed website. The search was limited to articles published from 2006 to 2023. The Study types were limited to clinical trials、 in vivo studies、 systematic reviews. Results : A total of 1141 articles were identified, 13 articles were included in this study. The result of this review demonstrates that surgical navigation system is an improvement over freehand placement and accuracy is similar to static guided system. The accuracy of surgical navigation system was not affected by the type of edentulism, and the surgical approach had no impact on implant placement errors. The accuracy of this technique was not affected by jaws and different systems. A surgeon's experience with surgical navigation system has a direct correlation with the final accuracy of implant placement. A dynamic computer-assisted implant surgery system doesn't require more surgical time than a static system. The implant success rate was high and there were no complications related to incorrect implant positioning. Conclusion : Navigated implant placement was found to be a precise, predictable and safe procedure. The use of surgical navigation system could reduce the rate of complications.