By: Yi Xiaofeng
Following the U.S. GPS and EU Galileo, China's self-developed Beidou satellite navigation system has become one of the world's three major satellite navigation systems. In the era of no navigation, people are relying on maps to guide them in the field or when traveling, or relying on their memory to identify the direction to travel, so they often get lost and go astray.
The same is true for our traditional implant surgery. Before being empowered by "digital black technology", oral implant surgeons can only understand the details of the patient's preoperative bone tissue and neurovascular distribution through imaging technology; they also need to know the local anatomy of the oral cavity like the back of their hands and must have a strong sense of space; and at the same time, they need to visualize a 2D image in their head to create an image of the patient's body, which can be used as a guide. At the same time, it is necessary to transform the two-dimensional image into a three-dimensional image in the brain, and repeatedly outline the surgical link of implant implantation in the alveolar bone in the mind, and each step needs to be simulated and deduced, and it is difficult to realize accurate implantation without long-term training and experience accumulation, and this kind of traditional unarmed "blind implantation" surgery, which relies solely on experience, is called This is a traditional unarmed "blind" surgery that relies solely on experience and is called "freehand" implantation.
Nowadays, a change in black technology has enabled oral implantation to have its own "navigation system". Recently in an interview with the media, the Chinese Stomatological Association of Oral Prosthetics Specialized Committee of young members of the Association for the promotion of international exchanges of health care in Heilongjiang Province, oral health branch of the vice-chairman of the first hospital of Harbin Medical University, associate professor of oral prosthodontics, deputy director of the physician, doctor of medicine, Liu Xin, said that with the increasingly close link between digital technology and oral implant science, the traditional implantation of the behavioral model of diagnosis and treatment has undergone a profound change, has gradually changed from the empirical to the biological and physical. Profound change, has been gradually from empirical, bulk, contouring to standardization, precision, personalization, digital direction. Cone beam CT, light digital impression and other intraoral scanning systems and oral digital software, 3D printing technology, dynamic navigation system "stunning debut" for the realization of oral implantation and restorative surgery personalized, precise to provide technical support and safety assurance.
Relying on the new technology of "Oral Compass System", Prof. Liu Xin's team has been working hard in the field of digital oral implantation, and has successfully completed hundreds of digital dental implant surgeries so far. Compared with the traditional "free hand" oral implant technology, digital oral implant surgery is safer, more accurate, minimally invasive, efficient and comfortable. At the same time, the personalized surgical design is presented in front of the patient in an intuitive, three-dimensional form with the help of digitization, which facilitates direct face-to-face communication between the doctor and patient and enhances the accuracy and success rate of implantation surgery, as well as saves surgical time, reduces surgical trauma, and lowers post-operative complications.
Practical experience shows that digital implantation is fully consistent with the future development trend. With the digital oral implant technology, the doctor in the process of dental implants has been from the past "know it all", into the current "visual". Liu Xin pointed out that the accuracy of the three-dimensional location of the implant is an important factor affecting the function and aesthetics of the restoration, the accuracy of the three-dimensional location of the previous implant is mainly dependent on the surgeon's clinical experience, and the surgical program relies only on the experience and the brain formed by the three-dimensional space and imagine the construction of the implant to design the position of the implant placement, as well as the design of the crown restoration in the late stage. At the same time, it is difficult to guarantee the accuracy of the later crown restoration results in the brain to form a three-dimensional image, and the implant embedded in the initial stage of matching each other.
Prof. Liu said, in the actual clinical work, often encountered a variety of complex cases, such as continuous multiple tooth loss, full mouth edentulous jaw, severe atrophy of the jawbone and special anatomical structures and other thorny problems, the operator's "free hand" operation is often "not even a fraction of the difference, the error is a thousand miles! "This requires a higher degree of surgical precision, and the digital static guide can provide a visualized pre-operative planning scheme, which allows the surgeon to design the implant in the ideal position according to the principle of "restoration-oriented", predicting the difficulty of the treatment in advance and avoiding surgical risks, so that the implantation process and post-operative results can be more predictable. This makes the implant process and postoperative results more predictable. Liu Xin's experience is that, as a new digital hologram technology, the "digital design system + digital guide plate" simulates the preoperative planning, ranging, angle measurement, blood vessel distance, blood vessel diameter, volume, area measurement and other operational steps through the 3D visualization film reading software on the computer side, so that the doctor can easily rotate and zoom in on every detail, making the patient's surgical process and postoperative results more predictable. detail, allowing the patient's surgical procedure and implant position to be seen and understood at a glance.
Under the huge wave of the world's industrial revolution 4.0 and Made in China 2025, digital technology has also greatly broken through the limitations of traditional diagnosis and treatment. Among them, the development of digital light impression technology and the progress of oral restoration technology, so that the patient in the dental implant treatment process to obtain a comfortable experience, completely lifted the psychological burden and mental fear. Liu Xin explained that, because each tooth has a different shape, such as each person's fingerprints are different, the tooth production process requires 1:1 replica "fingerprints", by the denture processing plant in the replica of the model to make dentures, and the traditional means of impression of the tray and impression materials placed in the patient's oral cavity, the pharynx strong sense of foreign body, the person is very prone to nausea, regurgitation, stomach pain, and the patient will have a good impression. For those who feel a strong sense of foreign body in their throat, it is very easy to produce nausea, regurgitation, vomiting and other serious reactions, and some of them therefore refuse to continue treatment. In addition to shortening the waiting time for the tray and the mixing of the impression material, the digital impression technology can also effectively reduce the steps and processes of disinfecting the impression, curing the material, instilling and transporting the model, which makes the patient's experience easier and more comfortable.
At the same time, the traditional silicone rubber, alginate and other impression models in addition to the need to occupy a large amount of storage space, but also to consume more alternative body and other consumables, part of the relatively complex implant restoration model must be kept for a long time, so the stomatology department to store the model is more difficult. In contrast, intraoral digital impression only need to store the relevant data in the CD-ROM, hard disk can save a lot of space at the same time, but also conducive to random access, to avoid the potential contamination caused by long-term storage of impression materials. And digital impression technology not only can show the three-dimensional shape of the oral tissues, but also clear color information, digital colorimetry of the teeth, simulating a specific restoration process, but also allows patients to restoration program and the expected overall restoration effect of intuitive understanding, at any time to communicate with the doctor to express their personal demands, to protect the restoration effect.
Professor Liu Xin commented: no matter difficult implantation or routine implantation surgery, precision, high efficiency, and comfort have always been the dream and pursuit of experts in the field of oral implantation. The popularization and application of digital technology is bound to accelerate this trend, making implant surgery simpler and easier to be accepted by the masses. However, behind this "simplicity" is a strict and cumbersome standard, from the acquisition of preoperative 3D image data, computer-assisted implant surgery to the design and processing of post-operative implant restorations, each step is interlocked. At the same time, in digital implant surgery, the operator still plays a leading role, and requires the cooperation of a professional team of physicians with extensive clinical experience, combined with a large number of simulation training, to improve the entire medical procedure, from data acquisition, surgical design, until the implementation of accurate surgery, forming the entire digital closed-loop, in order to truly achieve the purpose of precision implantation.
At this stage, it is an indisputable fact that the long training cycle and high cost of stomatologists, coupled with the varying medical standards around the world, and the low accuracy of "freehand" implantation of implants, has brought a great deal of resistance to grassroots hospitals to carry out implantation of dental technology. The innovative development of artificial intelligence technology, digital implantation of new business background, undoubtedly for the unlocking of the above problems cast a "golden key".
Looking to the future, Dr. Liu Xin believes that people will not only develop more accurate alignment and algorithms to further enhance the accuracy of static and dynamic navigation and navigation system responsiveness, while there is also expected to use the Internet to transmit data to frame interactive remote consultation or remote consultation "Golden Bridge", and even with the aid of Telemedicine can even be used to guide and execute the entire implant surgery planning process. In the era of digital implantation, it is no longer a dream to efficiently, comfortably, quickly, and safely "plant" a satisfactory "new tooth".
Dr. Liu Xin
Dr. Liu Xin is a Doctor of Stomatology and Deputy Chief Physician.
Young member of the Oral Restoration Committee of the Chinese Stomatological Association, candidate young member of the Oral General Practice Committee of the Chinese Stomatological Association, and vice-chairman of the Oral Health Branch of the Society for the Promotion of International Exchange of Healthcare in Heilongjiang Province. He has published two SCI papers as the first author with an impact factor of 3.0, and many papers in national core journals. She has presided over one scientific research project of Heilongjiang Provincial Health Commission, and one horizontal project of centralized guidance of local scientific and technological development special project. He is the chief editor of a monograph entitled "Guide to Clinical Oral Disease Diagnosis and Treatment" and a textbook entitled "New Progress in the Diagnosis and Treatment of Pentacarpal Diseases". He was awarded the Second Prize of Science and Technology Progress by Heilongjiang Provincial Government.