In Vitro Accuracy Assessment of a Surgical Navigation System for Dental Implantology

手術導航系統之體外實驗精準度評估

陳昶愷(Chang-Kai Chen) ； 喻大有(Da-Yo Yuh) ； 蔡政峰(Cheng-Feng Tsai) ； 郭博仁(Po-Jan Kuo) ； 江正陽(Cheng-Yang Chiang)

《臺灣牙周病醫學會雜誌》 20卷4期 (2015/12) Pp. 276-287

https://doi.org/10.6121/TAP.2015.20.4.03

摘要

目的：在人工植牙的手術流程中，錯誤的使用手術器械鑽孔可能導致損害重要的解剖結構，因此使用電腦輔助來避免錯誤成為許多牙醫師的選擇。因此手術導航系統本身的精準度是需要知悉的，更是牙醫師在臨床使用上重要的誤差範圍參考數值。材料與方法：本實驗對手術導航系統與徒手鑽孔，在體外測試的環境下進行系統的精準度測試，在兩模型上分別進行12個植牙規劃，並使用手術導航系統與徒手鑽孔來進行模擬的植牙手術。評估計畫植入的位置與實際植入的位置的精準度。結果：手術導航系統與徒手鑽孔的進入點橫向誤差為0.73 ± 0.45 mm 和1.18 ± 0.25 mm，頂點橫向誤差為0.71 ± 0.51 mm和1.12 ± 0.49 mm，頂點軸向誤差為0.25 ± 0.17 mm和0.63 ±0.43 mm，頂點絕對誤差為0.78 ± 0.48 mm 和1.36 ± 0.44 mm，角度誤差為2.09 ± 1.03 度和8.58 ± 3.57 度。結果顯示使用手術導航系統的誤差較徒手鑽孔的誤差小。結論：本研究在石膏模型上對手術導航系統進行鑽孔精準度的評估，顯示使用手術導航系統較徒手鑽孔精準，然而石膏模型與實際患者仍有許多差異之處，因此在未來應可進行實際臨床的試驗以得到更有參考價值的數據。

關鍵字

影像導引手術 ； 電腦斷層攝影術 ； 精準度 ； 植牙手術 ； 導航

並列摘要

Objective: During the process of dental implantation, mistaken use of a surgical drill may cause damage to important anatomical structures. As a result, the use of computer-assisted systems to prevent damage has become commonplace among many dentists. Therefore, it is necessary to be aware of the accuracy of the surgical navigation system, and system accuracy is also an important reference for error range used by dentists in clinical practice. Materials and Methods: This study included the carrying out of an accuracy test on surgical navigation system and freehand drilling under an in vitro environment. Twelve dental implant plans were separately performed in two models; in addition, a surgical navigation system and freehand drilling were used in a simulated dental implant surgery. Furthermore, the accuracy of the planned and actual positions of the implants was assessed. Results: The entry lateral error of the surgical navigation system and freehand drilling was 0.73 ± 0.45 mm and 1.18 ± 0.25 mm, respectively; the apex lateral error was 0.71 ± 0.51 mm and 1.12 ± 0.49 mm, respectively; the apex longitudinal error always 0.25 ± 0.17 mm and 0.63 ± 0.43 mm, respectively; the total error was 0.78 ± 0.48 mm and 1.36 ± 0.44 mm, respectively; and the angular error was 2.09 ± 1.03 degrees and 8.58 ± 3.57 degrees, respectively. The results indicate that the error while using the surgical navigation system was smaller than the error of freehand drilling. Conclusion: This study included the assessment of drilling accuracy of the surgical navigation system in a gypsum model which revealed that the surgical navigation system was more accurate than freehand drilling; however, there are significant differences between the gypsum model and actual patients. Therefore, future clinical studies are warranted in order to provide more valuable data for reference.

並列關鍵字

image-guided surgery (IGS) ； computed tomography (CT) ； accuracy ； dental implant surgery ； navigation