Ultrasonography-Guided Dental Implant Surgery: A Feasibility Study.

Paolo Nava, Hamoun Sabri, Javier Calatrava, Jacob Zimmer, Zhaozhao Chen, Junying Li, Hom-Lay Wang
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Abstract

Objective: To evaluate the feasibility of ultrasound-image-based computer-assisted implant planning and placement.

Materials and methods: Intraoral scans, cone-beam computerized tomography (CBCT), and ultrasound (US) scans with a custom positioning device were acquired in nine patients. Prosthetic-driven surgical guides were planned and fabricated based on ultrasound images and intraoral scans. Implants were then placed. Postoperative implant position was obtained intra-surgically by intraoral scan. Aside from the ultrasound-based plan, conventional implant planning was performed by the same operator on a pre-surgical CBCT for comparison. Linear deviations between ultrasound and CBCT-planned implant positions were measured and compared with the intra-surgical implant position, and the position deviations between two consecutive plannings were performed on the same CBCT by the same operator. The linear deviation between the 3D scan surface of the edentulous region and the ultrasonographic soft tissue profile segmentation was also assessed with reverse-engineering software. Means, standard deviations, and root mean square differences (RMSD) were calculated for every variable.

Results: All the ultrasound-planned implants were successfully placed, and no complications were recorded. The mean deviations in angles, shoulders, and apexes were 5.27 ± 1.75° (RMSD: 5.53°), 0.92 ± 0.26 mm (RMSD: 0.95 mm), and 1.41 ± 0.61 mm (RMSD: 1.53 mm), respectively, between the US and CBCT-planned implants; 2.63 ± 0.43° (RMSD: 2.66°), 1.16 ± 0.30 mm (RMSD: 1.19 mm), and 1.26 ± 0.27 mm (RMSD: 1.28 mm) between the planned implant and intra-surgically recorded positions; and 2.90 ± 1.36° (RMSD: 3.18°), 0.65 ± 0.27 mm (RMSD: 0.70 mm), and 0.99 ± 0.37 mm (RMSD: 1.05 mm) between two consecutive CBCTs planning performed by the same operator. The mean deviation between the 3D surfaces of model scans and ultrasound-derived soft tissue profile in the edentulous area was 0.19 ± 0.08 mm.

Conclusions: Ultrasound-guided implant surgery represents a feasible non-ionizing alternative to conventional static guided implant surgical protocols for implant placement in sites with favorable characteristics.

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超声波引导下的植牙手术:可行性研究
目的:评估基于超声波图像的计算机辅助种植规划和植入的可行性:评估基于超声图像的计算机辅助种植规划和植入的可行性:对九名患者进行口内扫描、锥束计算机断层扫描(CBCT)和使用定制定位装置的超声波(US)扫描。根据超声波图像和口内扫描结果,规划并制作了修复体驱动的手术导板。然后植入种植体。术后种植体的位置在术中通过口内扫描获得。除了基于超声波的规划外,同一操作者还在手术前的 CBCT 上进行了常规种植规划,以进行比较。测量超声和 CBCT 规划的种植体位置之间的线性偏差,并与手术中的种植体位置进行比较。此外,还使用逆向工程软件评估了缺牙区三维扫描表面与超声软组织轮廓分割之间的线性偏差。计算每个变量的平均值、标准差和均方根差(RMSD):结果:所有超声规划的种植体均成功植入,无并发症记录。美国和 CBCT 计划种植体的角度、肩部和顶点的平均偏差分别为 5.27 ± 1.75°(RMSD:5.53°)、0.92 ± 0.26 mm(RMSD:0.95 mm)和 1.41 ± 0.61 mm(RMSD:1.53 mm);CBCT 计划种植体的角度、肩部和顶点的平均偏差分别为 2.63 ± 0.43°(RMSD:2.66°)、1.16 ± 0.30 mm(RMSD:1.19 mm)和 1.26 ± 0.27 mm(RMSD:1.28 mm);同一操作者进行的两次连续 CBCT 规划之间的偏差分别为 2.90 ± 1.36°(RMSD:3.18°)、0.65 ± 0.27 mm(RMSD:0.70 mm)和 0.99 ± 0.37 mm(RMSD:1.05 mm)。模型扫描的三维表面与超声波得出的缺牙区软组织轮廓之间的平均偏差为 0.19 ± 0.08 毫米:结论:超声引导种植手术是一种可行的非电离种植手术方案,可替代传统的静态引导种植手术方案,在具有良好特征的部位植入种植体。
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