口腔种植学是口腔教育中较新的学科。虽然现在我们都有共识，种植⽛相关的理论知识，⽆论是治疗⽅案的规划，还是后期的随访和维护，对于每⼀个职业⽛医都⾮常重要。然⽽，在当下全球的口腔医学本科培养体系中，它的覆盖程度还远远落后于其重要性。 在此背景下，香港大学口腔医学院联合⾹港⼤学的线上教育专业团队，历时⼀年有余，设计并制作了这门为期五周的⽹络公开课，旨在传播以循证医学为基础的，客观、全⾯的⽛种植学相关知识。这门课程⾯向全球，双语教学，完全免费。学员将在20 多位全球领先的种植学专家的带领下，完成五个模块，系统地学习⽛种植学。
导航技术在种植牙中的运用
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From the course by The University of Hong Kong
口腔种植学 （Implant Dentistry）
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From the lesson
种植牙的术后、未来的发展
种植体毫无疑问是“高维护”设备！在这个模块中，我们将讨论如何设计个性化，循证的策略，以保持种植体的长期健康和功能。我们还将回顾最常见的技术和生物学并发症，并讨论预防策略，早期诊断和管理技术。同时，我们将探讨一些尖端的技术和新趋势，包括在组织工程和再生中使用数字技术，在植入程序中使用动态导航和数字化工作流程等，这些趋势可能改变种植牙的未来。
Meet the Instructors
Nikos MattheosClinical Associate Professor in Implant Dentistry
The University of Hong Kong
Welcome to the lecture
on dynamic navigation in implant dentistry.
In this series, we will discuss
about the use of dynamic navigation
in implant dentistry in daily practice.
First of all, why accurate implant placement
is important in practicing implant therapy?
Accurate position of the dental implant is required
to achieve best functional and aesthetic result.
Furthermore, to avoid the risk for biomechanical overload.
The accuracy of the implant position can be achieved
with the use of a static surgical guide.
There are some some new tools and techniques
available in implant dentistry that were
developed to facilitate our procedures.
New tools are available to assist the
digital implant planning and aid in implant placement.
There are a few techniques to facilitate this transfer:
Computer guided implant surgery,
computer navigated (dynamic) implant surgery,
and last, robotic implant dentistry.
This slide shows a static surgical guide.
After the digital implant planning is complete,
the information from the software
is transferred to the laboratory technician.
The radiographic guide can then be
converted into a surgical guide
by placing the appropriate surgical guide sleeves
to facilitate proper implant placement.
The surgeon, later on, will utilize the surgical guide
at the time of the surgery to place the dental implant
in the 3-dimensional ideal position.
There are some limitations that we should be aware of
regarding the static surgical guide.
Although the static surgical guide is a great tool
that can help us in the positioning accurately
the implant during the surgery,
there are some limitations that need to be considered.
Limited posterior clearance,
drill site visibility,
access for proper irrigation,
fit and retention of the stent,
especially after the flap elevation,
additional cost, and the time required to fabricate it.
Dynamic surgical guide.
The dynamic navigation system is a technology
designed to guide the placement of dental implants
in real time by a computer, and based on information
generated from the patient's computed tomography.
These systems are empowered by a motion-tracking technology,
which tracks the position of the dental drill
and the position of the patient
throughout the implant placement procedure.
Inliant Clinical Component is one of the systems.
It's a dynamic surgical guidance system,
and it's composed of four different parts.
A handpiece with markers that directly
laser-engraved on the handpiece.
No attachment on the handpiece.
Patient tracker with Inliant markers,
that is attached to patient during surgery.
Two Inliant cameras attached directly
to your existing dental light.
And also, an intuitive software
with integrative surgical protocol and planning.
There is some advantages that we might want to consider.
Surgical guides direct the bone entry point
and angulations of the drill, but they neither reference
the underlying anatomical structures
nor provide exact 3-dimensional guidance.
The navigation system, on the other hand,
allows the surgeon to guide instrument freely,
as in conventional treatment.
It allows intra-operative changes for the implant position.
The virtual surgical plan can be altered or modified
during surgery, and the clinician can
use the navigation system to
concurrently visualize the patient's anatomy.
These benefits directly impact
patient's chair-time during surgery.
Patient will spend less chair-time,
decreasing the amount of physical strain
on the patient and able to leave the surgery
with a better overall experience.
On the other hand, the decreased chair-time
allows the surgeon to
increase the number of cases performed per day.
One may believe that increasing the number of surgeries
performed in one day may actually
increase the physical strain on the surgeon,
but the dynamic navigation system
improves the surgeon's ergonomics.
It can decrease the physical strain on the surgeon,
especially for the maxillary arch, as it is very difficult
to maintain proper ergonomics and maintain visibility,
and can increase the quality of life.
There are certain disadvantages.
For example, pre-surgical virtual surgery planning
can be very time-consuming for the surgeon.
One of the major challenges with this system
is the need for additional space in the operatory.
The high cost for the purchase, updates, and maintenance of the system,
may not make it financially feasible
to purchase the system.
A lack of the communication between the sensors
and the handpiece due to sensor error or
sensors being blocked can also be expected during the procedure.
Some future thoughts that we might want to emphasize.
Advancements in dental technology can offer
modern solutions to traditional dental problems.
Through the technological advancements
in digital implant dentistry,
the workflow will be streamlined,
and enhance the overall interdisciplinary collaboration.
Computerized navigation implant surgery is a promising technology,
although certain challenges, such as cost and accuracy
will still remain to be addressed.
The use of this technology in dentistry
may substantially contribute to increase in to increasing
the quality of treatment rendered, similar to the medical field.
Adequate clinical skills are expected from the surgeon.
Intra-operative application can be significantly longer
than with the static method,
partially due to setting up of the navigation device.
That's all we want to discuss
about the dynamic navigation in implant dentistry.
Thank you for your attention.
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