Kouqiang yixue (Jul 2024)

Analysis of the impact of bone quality on the accuracy of computer-aided design of implant guide plate

  • QIAN Yuxin, LI Jian, ZHANG Jianlan, ZHANG Shixuan, GU Yangqian, LU Mengmeng, TANG Chunbo

DOI
https://doi.org/10.13591/j.cnki.kqyx.2024.07.005
Journal volume & issue
Vol. 44, no. 7
pp. 508 – 514

Abstract

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Objective To explore the influence of different bone quality around the implant on the implantation accuracy, the computer-aided design of implant guide plate was used for patients with poor bone quality to evaluate its accuracy. Methods Retrospective analysis of relevant clinical data from 29 single-tooth implant patients with relatively poor bone quality meeting inclusion criteria was conducted. Using 3Shape Implant Studio software, implant plans were designed and fully guided digital templates were fabricated before surgery. Implantation was guided by the templates throughout, with torque and ISQ values recorded to evaluate the initial stability of the implant. Postoperative implant positions were reconstructed using CBCT images, and the three-dimensional deviation of implant placement was evaluated in conjunction with the preoperative design. Bone quality around the implants was also recorded and analyzed before and after surgery. Results In this study, digital guide plates were used in patients with poor bone quality, and the initial stability of implants was ≥ 20 N·cm except for three cases. In cases of poor bone quality, the accuracy of the fully guided digital templates was as follows: cervix deviation (0.94±0.59)mm, apex deviation (1.40±0.81)mm and angle deviation 4.10°±2.99°. Bone quality had a greater impact on angle deviation (P<0.05). The higher the proportion of D3 bone was around the implant body 1/3, the smaller the deviation of neck, apex and angle was, while the higher the proportion of D5 bone, the greater the deviation of implantation. Conclusion For patients with poor bone quality, under the premise of restoration-oriented, the proportion of D3 bone around the implant can be increased by computer-aided design, and the initial stability of the implant can be improved by guiding the implantation with digital guide plate. Attention should be paid to the influence of bone on the angle deviation of implant during the application of guide plate.

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