구강스캐너를 이용하여 제작된 CT 가이드 임플란트 수술용 형판의 무치악 거리에 따른 정확도 분석
Accuracy of the CT guided implant template by using an intraoral scanner according to the edentulous distance
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목적: 이 연구의 목적은 구강스캐너를 이용하여 제작된 임플란트 수술용 형판의 무치악 거리에 따른 정확성을 비교하는 것이다. 재료 및 방법: 방사선불투과성 아크릴 레진을 이용하여 상악 좌우 제2소구치, 제1대구치, 제2대구치 부위를 치아상실 상태로 5개의 상악 모형을 제작하고 각각의 모형을 구강스캐너를 이용하여 가상 모형을 획득하였다. 모형의 술전 CT DICOM file과 가상의 모형을 중첩 후 치아 상실 부위에 임플란트 식립을 계획하였고 제작된 수술용 형판을 이용하여 임플란트 식립 후 술후 CT 촬영을 시행하였다. 술전 CT와 술후 CT를 software상에서 중첩 후 X, Y, Z축을 이용하여 임플란트의 platform과 apex 부위에서, 계획된 임플란트와 실제 식립된 임플란트의 거리 및 각 오차를 측정하고 Kruskall-Wallis test와 Mann-Whitney test를 사용하여 통계분석을 시행하였다. 결과: 임플란트 식립 각도 오차는 제2소구치에서 제2대구치로 갈수록 커졌으나 통계적 차이를 보이지 않았고 platform 부위와 apex부위에서의 식립거리 오차 또한 제2소구치에서 제2대구치로 갈수록 커지나 제2대구치에서는 통계적으로 유의성 있는 큰 오차를 보였다. 결론: 임플란트 식립 각도에서는 계획된 임플란트와 식립된 임플란트간 통계적 차이는 없었으나 platform과 apex 부위에서의 식립 거리는 제2대구치 부위의 임플란트에서 더 큰 오차를 보였으며 통계적으로 유의할 만한 차이를 보였다.
Abstract
Purpose: The purpose of this study is to compare the accuracy of the CT guided implant template that was produced by using an intraoral scanner according to the edentulous distance. Materials and methods: Five maxillary casts were fabricated using radiopaque acrylic resin with the second premolars, first molars, and second molars missing. Then a virtual cast was acquired by scanning each resin cast. Implant treatment was planned on the missing sites by superimposing the presurgical CT DICOM file and the virtual cast. Then the implants were placed using a surgical template followed by postsurgical CT scan. The distance and angle of the platform and apex between the presurgical implant and postsurgical implant were measured using the X, Y, and Z axis of the superimposed presurgical CT and postsurgical CT via software followed by statistical analysis using Kruskall-Wallis test and Mann-Whitney test. Results: The implant placement angle error increased towards the second molars but there was no statistically significant difference. The implant placement distance error at the platform and apex also increased towards the second molars and there was a statistically significant error at the second molars. Conclusion: Although the placement angle had no statistically significant difference between the presurgical implant and postsurgical implant, the placement distance at the platform and apex showed a larger error and a statistically significant difference at the second molar implant.
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