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中华口腔医学研究杂志(电子版) ›› 2023, Vol. 17 ›› Issue (04) : 244 -252. doi: 10.3877/cma.j.issn.1674-1366.2023.04.003

数字化修复专栏·中青年专家笔谈

数字化技术和人工智能在上颌窦底提升术的临床应用
张辉, 蔡敏, 黄湘雅†()   
  1. 中山大学附属口腔医院，光华口腔医学院，广东省口腔医学重点实验室，广州　510055
    中山大学附属口腔医院，光华口腔医学院，广东省口腔医学重点实验室，广州　510055；瑞典卡罗林斯卡医学院，斯德哥尔摩　17164
  • 收稿日期:2023-06-08 出版日期:2023-08-01
  • 通信作者: 黄湘雅

Clinical application of digital technology and artificial intelligence in maxillary sinus floor augmentation

Hui Zhang, Min Cai, Xiangya Huang†()   

  1. Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510055, China;
    Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510055, China; Karolinska Institutet, Stockholm 17164, Sweden
  • Received:2023-06-08 Published:2023-08-01
  • Corresponding author: Xiangya Huang
  • Supported by:
    National Nature Science Foundation of China(81970974); Guangdong Financial Fund for Highcaliber Hospital Construction(174-2018-XMZC-0001-03-0125/D-04)
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张辉, 蔡敏, 黄湘雅. 数字化技术和人工智能在上颌窦底提升术的临床应用[J]. 中华口腔医学研究杂志(电子版), 2023, 17(04): 244-252.

Hui Zhang, Min Cai, Xiangya Huang. Clinical application of digital technology and artificial intelligence in maxillary sinus floor augmentation[J]. Chinese Journal of Stomatological Research(Electronic Edition), 2023, 17(04): 244-252.

上颌后牙区域骨量严重不足时，上颌窦底提升术是一种常用且可靠的骨增量技术，但该手术操作困难、技术敏感性高，常发生窦膜穿孔、出血和感染等并发症。近年来，计算机视觉、计算机辅助设计和3D打印等数字化技术及人工智能（AI）应用于上颌窦底提升术的术前设计、手术流程和术后管理等多个环节，有效地提高手术效果，减少术后并发症。本文将总结和回顾上颌窦底提升术的数字化工作流程，介绍数字化技术和AI在上颌窦底外提升术的临床应用。

关键词: 窦底增高术, 数字技术, 3D打印, 计算机辅助设计, 人工智能

Maxillary sinus floor augmentation is a commonly used and reliable bone augmentation technique when there is severe bone loss in the posterior maxillary region. However, this procedure is challenging to perform and highly technically sensitive, with potential complications such as sinus membrane perforation, bleeding, and infection. With the rapid advancement of digital technology, various digital techniques such as computer vision, computer-aided design, 3D printing and artificial intelligence have been applied to multiple aspects of preoperative planning, surgical procedures, and postoperative management in sinus floor elevation surgery. These digital technologies have effectively improved surgical outcomes and reduced postoperative complications. In this article, we provided an introduction of the digital workflow of maxillary sinus floor elevation surgery, and presented the research progress and clinical application of digital technology and artificial intelligence in maxillary sinus floor external elevation surgery.

Key words: Sinus floor augmentation, Digital technology, Printing, three-dimensional, Computer-aided design, Artificial intelligence
表1 数字化技术应用于上颌窦底提升术的文献报道
文献作者 报道年份 手术方式 剩余牙槽嵴高度 数字化技术 数字化导板功能 支持方式 术后效果
Mandelaris等[43] 2009 一期（4/8） 未描述 CAD，3D打印（DLP） 定位骨窗边界，或定位种植位点 牙支持式 截骨位置精度<1 mm
    二期（4/8）       未见并发症
Zaniol等[45] 2018 一期（13/22） ≤ 4 mm（14/22） CAD，3D打印 定位骨窗边界 牙支持式 未见并发症
    二期（15/22） >4 mm（8/22）        
Osman等[48] 2018 一期（导板组10/20，非导板组10/20） 4 ~ 6 mm CAD，3D打印（FDM） 定位骨窗边界和窦间隔 黏膜支持式，微型钛螺钉固定 导板组：1/10穿孔
非导板组：3/10穿孔
Goddacre等[49] 2018 一期（14/14） 未描述 CAD，3D打印（DLP） 定位骨窗边界和骨内血管 牙支持式（12/14） 未见并发症
            黏膜支持式（2/14）  
Sun等[40] 2018 一期（1/1） 5 ~ 7 mm 口内光学扫描，CAD，3D打印 定位骨窗边界和种植位点，保护窦膜 牙支持式 未见并发症
Tuce等[22] 2019 制备上颌窦底外提升教学模型 未描述 CAD，3D打印（FDM） 定位骨窗边界 牙支持式 术前练习、医患沟通
Strbac等[42] 2020 一期（1/1） 4 ~ 5 mm 口外模型光学扫描，CAD，3D打印 定位骨窗边界和种植位点 牙支持式 未见并发症
屈依丽等[33] 2020 二期（1/1） 1 mm，右侧上颌窦存在囊肿 口内光学扫描，CAD，3D打印 定位骨窗边界，避开上牙槽前动脉 牙支持式 未见并发症
Cho等[52] 2020 一期（5/5） ≤ 4 mm 口内光学扫描，CAD，3D打印（DLP）；动态导航技术定位骨窗上界 定位骨窗侧边界、下边界和种植位点 牙支持式 未见并发症
Flügge等[20] 2020 未描述 未描述 口外模型光学扫描，CAD，3D打印 定位种植位点 牙支持式 虚拟手术
Wang等[41] 2021 一期（1/1） 未描述 口外模型光学扫描，CAD，3D打印 定位骨窗边界、窦间隔和种植位点 牙支持式 未见并发症
Teixeira等[51] 2021 未描述 未描述 口内光学扫描，CAD，3D打印 定位骨窗边界和窦间隔，导板磁性连接 牙支持式 未描述
林锋等等[47] 2022 二期（1/1） <2 mm 口内光学扫描，CAD，3D打印 定位骨窗边界和窦间隔 牙支持式 未见并发症
Bishbish等[60] 2022 一期（1/1） 4 mm 口内光学扫描，动态导航系统定位骨窗边界 未使用导板 未描述 未见并发症
Yu等[50] 2023 二期（1/1） 未描述 口内光学扫描，CAD，3D打印 定位骨窗边界和窦间隔，导板螺栓连接 牙支持式 未见并发症
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