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http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/81826完整後設資料紀錄
| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 章浩宏(Hao-Hueng Chang) | |
| dc.contributor.author | Yi-Cheng Chen | en |
| dc.contributor.author | 陳奕誠 | zh_TW |
| dc.date.accessioned | 2022-11-25T03:04:29Z | - |
| dc.date.available | 2024-08-01 | |
| dc.date.copyright | 2021-08-19 | |
| dc.date.issued | 2021 | |
| dc.date.submitted | 2021-07-28 | |
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Dynamic navigation: a prospective clinical trial to evaluate the accuracy of implant placement. Int J Comput Dent. 2019;22(2):139-147. PMID: 31134220. | |
| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/81826 | - |
| dc.description.abstract | "導航系統是現代生活中不可或缺的技術，隨著科技的發展已應用在醫學中。在牙科，導航系統使用於植體植入手術及根管治療等領域。利用導航系統可以協助進行治療計畫擬定、調整、決定植體位置、導引手術進行及術中即時修正。 牙科植體目前廣泛運用在人工植牙、顏面重建及矯正治療過程中。迷你骨釘為暫時性牙科植體，其為矯正治療中常用之暫時錨定裝置 (Temporary anchorage devices, TADs)。暫時錨定裝置置入必須依照矯正原理，並且手術過程中要避免傷及鄰牙牙根及下顎管等解剖構造。傳統上依據手術醫師經驗徒手放置，偶有傷及鄰牙牙根，以致鄰牙需進行根管治療或拔除之併發症。回顧至今文獻，尚無將即時導航系統運用在暫時錨定裝置之研究，為瞭解即時導航系統是否可以應用於臨床上矯正用暫時錨定裝置的置入，我們將以臨床試驗，針對導引手術應用於暫時錨定裝置置入之準確性及安全性進行評估及探討。 其方法為以患者之電腦斷層做術前規劃及術後分析。在導航軟體及手術導板軟體上設計植體，完成術前規劃。術後再次以電腦斷層確認植體之位置。資料分析方面，將以術前及術後之影像進行重疊，分析植體平台中心差距 (platform center deviation)、植體角度差距 （angular deviation）、併發症 （傷害鄰牙、牙根、下顎管或其他解剖構造） 比例。將即時導航系統輔助、手術導板輔助及徒手方法進行比較，即時導航系統輔助之植體平台中心差距平均值為2.99 ± 1.75毫米，角度差距平均值為12.49 ± 4.48度；手術導板輔助之植體平台中心差距平均值為1.17 ± 0.77毫米，度差距平均值為12.43 ± 8.32度；徒手方法之植體平台中心差距平均值為3.10 ± 1.91毫米，角度差距平均值為15.64 ± 5.94度。即時導航系統輔助在植體平台中心控制及植體角度控制，統計上沒有出現較另外兩者精確之表現 (p>0.05)。徒手方法造成牙根傷害的比例約10％，而即時導航系統輔助及手術導板輔助無出現術後立即併發症。 本研究為首篇將即時導航系統運用於暫時錨定裝置置入手術的臨床研究，並藉由合併導航系統及手術導板的特點，探討合併導航系統及手術導板的操作模式，發現其於植體平台中心差距平均值為1.75 ± 1.05毫米，植體角度差距平均值為5.5 ± 1.83度，有較理想表現的趨勢。藉由本研究之結果，我們對於導航系統的臨床應用及暫時錨定裝置植入手術提出改善指引，並探討合併方法的可能性。" | zh_TW |
| dc.description.provenance | Made available in DSpace on 2022-11-25T03:04:29Z (GMT). No. of bitstreams: 1 U0001-2707202114330700.pdf: 7732748 bytes, checksum: 2a60b0e72d71bcb24772da05cc33b6f4 (MD5) Previous issue date: 2021 | en |
| dc.description.tableofcontents | 口試委員會審定書 i 誌謝 ii 中文摘要 iii Abstract v 目錄 vii 圖目錄 x 表目錄 xiv 第一章 序論 1 1.1 前言 1 1.2 研究動機 2 1.3 論文架構 2 第二章 文獻回顧 4 2.1 即時導航系統 4 2.1.1 即時導航系統於醫學之發展與應用 4 2.1.2 即時導航系統於口腔醫學之發展與應用 7 2.1.3 即時導航系統於牙科之發展與應用 13 2.1.4 即時導航系統輔助人工牙根植入之準確度 16 2.2 手術導板 18 2.2.1 手術導板於口腔醫學之應用 18 2.2.2 手術導板輔助人工牙根植入之準確性 19 2.3 牙科植體 20 2.3.1 牙科植體概論 20 2.3.2 暫時錨定裝置概論 21 2.4 暫時錨定裝置植入手術 25 2.4.1 現行暫時錨定裝置放置方法 25 2.4.2 現行暫時錨定裝置置入手術之併發症 27 第三章 實驗設計與方法 33 3.1 實驗設計 33 3.2 受試者 35 3.3 暫時錨定裝置植入位置 35 3.4 控制組 37 3.4.1 手術導板製作 37 3.4.2 手術導板輔助之暫時錨定裝置植入手術 41 3.5 實驗組 43 3.5.1 植體即時影像系統IRIS® (Implant Real-time Imaging System) 43 3.5.2 IRIS®使用流程 44 3.5.3 導航系統準確性驗證 50 3.5.4 即時導航系統輔助暫時錨定裝置植入手術 53 3.6 負控制組 57 3.7 數據蒐集 58 3.7.1 流程 58 3.7.2 分析方法 60 3.7.3 資料收集紀錄 62 3.8 實驗統計方法 62 第四章 實驗結果 64 4.1 受試者分析 64 4.2 控制組 65 4.2.1 控制組資料整理 65 4.3 實驗組 66 4.3.1 實驗組資料整理 66 4.4 負控制組 67 4.4.1 負控制資料整理 67 4.5 統計 68 4.5.1 控制組分析 68 4.5.2 實驗組分析 70 4.5.3 負控制組分析 72 4.5.4 樣本常態分佈檢測 74 4.5.5 控制組與實驗組之比較 76 4.5.6 控制組與負控制組之比較 78 4.5.7 實驗組與負控制組之比較 80 第五章 討論 82 5.1 徒手方法之暫時錨定裝置植入回溯性探討 82 5.2 即時導航系統輔助暫時錨定裝置置入及手術導板輔助暫時錨定裝置置入之比較 84 5.3 導引裝置輔助暫時錨定裝置植入與徒手方法之比較 89 5.4 即時導航系統輔助暫時錨定裝置置入之安全性及準確性評估 91 5.5 實驗設計探討 92 第六章 即時導航系統合併手術導板輔助暫時錨定裝置植入 93 6.1 流程 93 6.2 合併組資料整理 94 6.3 統計 95 6.3.1 合併組分析 95 6.3.2 合併組與控制組之比較 95 6.3.3 合併組與實驗組之比較 95 6.3.4 合併組與負控制組之比較 96 6.4 合併組之結論 96 第七章 結論 97 第八章 未來展望 98 8.1 暫時錨定裝置置入手術之臨床指引 98 8.2 即時導航系統於臨床應用之優化 98 8.3 電腦輔助手術的發展 99 第九章 參考文獻 102 | |
| dc.language.iso | zh-TW | |
| dc.subject | 暫時錨定裝置 | zh_TW |
| dc.subject | 植體角度差距 | zh_TW |
| dc.subject | 植體平台中心差距 | zh_TW |
| dc.subject | 合併方法 | zh_TW |
| dc.subject | 手術導板 | zh_TW |
| dc.subject | 即時導航系統 | zh_TW |
| dc.subject | 迷你骨釘 | zh_TW |
| dc.subject | temporary anchorage devices | en |
| dc.subject | angular deviation | en |
| dc.subject | platform center deviation | en |
| dc.subject | combined technique | en |
| dc.subject | surgical stent | en |
| dc.subject | real-time navigation | en |
| dc.subject | mini-screws | en |
| dc.title | 即時導航系統輔助暫時錨定裝置置入手術之準確性及安全性評估 | zh_TW |
| dc.title | Evaluation of accuracy and safety of real-time navigation in TAD insertion surgery | en |
| dc.date.schoolyear | 109-2 | |
| dc.description.degree | 碩士 | |
| dc.contributor.oralexamcommittee | 林俊彬(Hsin-Tsai Liu),謝明發(Chih-Yang Tseng) | |
| dc.subject.keyword | 暫時錨定裝置,迷你骨釘,即時導航系統,手術導板,合併方法,植體平台中心差距,植體角度差距, | zh_TW |
| dc.subject.keyword | temporary anchorage devices,mini-screws,real-time navigation,surgical stent,combined technique,platform center deviation,angular deviation, | en |
| dc.relation.page | 107 | |
| dc.identifier.doi | 10.6342/NTU202101801 | |
| dc.rights.note | 同意授權(全球公開) | |
| dc.date.accepted | 2021-07-29 | |
| dc.contributor.author-college | 醫學院 | zh_TW |
| dc.contributor.author-dept | 臨床牙醫學研究所 | zh_TW |
| dc.date.embargo-lift | 2024-08-01 | - |
| 顯示於系所單位： | 臨床牙醫學研究所 | |
文件中的檔案：
| 檔案 | 大小 | 格式 | |
|---|---|---|---|
| U0001-2707202114330700.pdf | 7.55 MB | Adobe PDF | 檢視/開啟 |
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