Objective : The purpose of this study is to determine the accuracy of implant placement in the edentulous jaw using computer planning and fully-guided mucosa-supported surgical template by Simplant software. Methods: 63 implants were placed in 9 patients (11 fully edentulous jaws), 26 implants were placed in upper edentulous jaw and 37 implants in lower edentulous jaw. Preoperatively, first, a cone beam CT was required for patients with radiographic template and radiographic template respectively. Therefore, the data of CBCT was inputted in Simplant software by DICOM format, followed by virtual implant planning. Hereafter, a mucosa-supported surgical template was designed by dentist and made by Masterilise company to allow implant placement using the template as a guide. To investigate the accuracy of implant placement, a postoperative CBCT scan was obtained and matched to the preoperative scan. The accuracy of implant placement was validated three-dimensionally including divations of implant shoulder, apical point, axial angulation and depth. Results: The survival rate of 63 implamts for a 6 month to 10 year observation period was 100%. The mean divation of implant shoulder was 0.73 ± 0.53 mm, implant apical point was 1.15 ± 0.62 mm, implant depth was 0.95 ± 0.64 mm and implant axial angulationwas 4.10 ° ± 3.23°. Conclusion Divation between virtual and actual implant was existed and it should be considered preoperatively when virtual implant was planned to avoid injuring anatomic structure and keeping surgery safely. Correct manipulation during implant operation are helpful to decrease the divation of implant placement.

OBJECTIVE: To evaluate effectiveness of proximal femur bionic nail (PFBN) in treatment of intertrochanteric fractures in the elderly compared to the proximal femoral nail antirotation (PFNA). METHODS: A retrospective analysis was made on 48 geriatric patients with intertrochanteric fractures, who met the selection criteria and were admitted between January 2020 and December 2022. Among them, 24 cases were treated with PFBN fixation after fracture reduction (PFBN group), and 24 cases were treated with PFNA fixation (PFNA group). There was no significant difference in baseline data such as age, gender, cause of injury, side and type of fracture, time from injury to operation, and preoperative mobility score, American Society of Anesthesiologists (ASA) score, Alzheimer's disease degree scoring, self-care ability score, osteoporosis degree (T value), and combined medical diseases between the two groups ( P>0.05). The operation time, intraoperative blood loss, number of blood transfusions, transfusion volume, length of hospital stay, occurrence of complications, weight-bearing time after operation, and postoperative visual analogue scale (VAS) score, walking ability score, mobility score, self-care ability score were recorded and compared between the two groups. And the radiographic assessment of fracture reduction quality and postoperative stability, and fracture healing time were recorded. RESULTS: The operations in both groups were successfully completed. All patients were followed up 6-15 months with an average time of 9.8 months in PFBN group and 9.6 months in PFNA group. The operation time was significantly longer in PFBN group than in PFNA group ( P<0.05), but there was no significant difference in intraoperative blood loss, number of blood transfusions, transfusion volume, length of hospital stay, change in activity ability score, and change in self-care ability score between the two groups ( P>0.05). The weight-bearing time after operation was significantly shorter in PFBN group than in PFNA group ( P<0.05), and the postoperative VAS score and walking ability score were significantly better in PFBN group than in PFNA group ( P<0.05). Radiographic assessment showed no significant difference in fracture reduction scores and postoperative stability scores between the two groups ( P>0.05). All fractures healed and there was no significant difference in fracture healing time between the two groups ( P>0.05). The incidence of complications was significantly lower in PFBN group (16.7%, 4/24) than in PFNA group (45.8%, 11/24) ( P<0.05). CONCLUSION Compared with PFNA, PFBN in the treatment of elderly intertrochanteric fractures can effectively relieve postoperative pain, shorten bed time, reduce the risk of complications, and facilitate the recovery of patients' hip joint function and walking ability.
Humans ; Aged ; Retrospective Studies ; Fracture Fixation, Intramedullary ; Bionics ; Blood Loss, Surgical ; Treatment Outcome ; Bone Nails ; Hip Fractures/surgery* ; Femur