本研究目的在於開發一套友善化的植牙導引件設計工具，輔助植牙手術之術前計劃與臨床植體定位。本研究可分為兩大部分，分別為術前植體方位計劃與植牙導引板設計方法。在植體方位計劃中結合個人咬合面的建立提出自動化植體分佈方法，分佈上需避免鑽透患者顎骨骨壁，避開神經血管，並保持植體與植體間距。本研究根據植體方位計劃提出手術用鑽孔導引板的設計方法，根據齒顎解剖學規劃鑽孔導引環之環座位置，以便後製時搭配可緊配的金屬鈦環(Titanium ring) ，並於導引板設計控制植入深度終止的方法。此外，提供三種支撐型態之鑽孔導引板包覆方法，可避免干涉(Undercut)性包覆，最後應用於臨床手術並驗證其精度。

In this research, we focused on developing a user-friendly tool in dental implantology to assist surgical planning and implant position in implant surgery. This research includes implant position planning and surgery guide template generation. The planning involves patient’s occlusal surface for the purpose of automatically distributing implants so that the safety distances are maintained among bone boundary, nerve and other implants. We provided three types of surgery guide templates to provide maximum support stability and to avoid undercut. A titanium ring was embedded in the template to guide the orientation and drill depth.

[1]"Branemark", 2005, Branemark, "http://www.branemark.com/," 30th June, 2009.
[2]林子源，"實體模型與電腦輔助技術於口腔顎面術前計劃之應用"，國立成功大學機械工程學系研究所碩士論文，2000。
[3]李俊毅，"實體模型與電腦輔助技術於口腔顎面術前計劃之應用"，國立成功大學機械工程學系研究所碩士論文，2002。
[4]郭泰宏，"醫療影像軟體開發－基礎介面與三維實體模型開發"，國立成功大學機械工程學系研究所碩士論文，2002。
[5]鄭元愷，"醫療影像軟體開發－三維醫療影像物間之擷取與處理"，國立成功大學機械工程學系研究所碩士論文，2003。
[6]Fang, J.J. and Kuo, T.H., "Modelling of Mandibular Movement," Computers in Biology and Medicine," Vol.38, No.11-12, pp.1152-1162, 2008.
[7]Fang, J.J. and Kuo, T.H., "Tracked Motion-Based Dental Occlusion Surface Estimation for Crown Restoration," Computer-Aided Design, Vol.41, No.4, pp.315-323, 2009.
[8]Taipei congress of oral implantologists, "New Vision of 3D Dental Implantology", Taipei congress of oral implantologists, 2008.
[9]Steenberghe, D., Glauser, R., Blombäck, U., Andersson, M., Schutyser, F., Pettersson, A. and Wendelhag, I., "A Computed Tomographic Scan-Derived Customized Surgical Template and Fixed Prosthesis for Flapless Surgery and Immediate Loading of Implants in Fully Edentulous Maxillae: A Prospective Multicenter Study," Clinical Implant Dentistry and Related Research, Vol.7, No.s1, pp.s111-s120, 2005.
[10]Marchack, C.B., "An Immediately Loaded CAD/CAM-Guided Definitive Prosthesis: A Clinical Report," The Journal of Prosthetic Dentistry, Vol.93, No.1, pp.8-12, 2005.
[11]Kupeyan, H.K., Shaffner, M., and Armstrong, J., "Definitive CAD/CAM-Guided Prosthesis for Immediate Loading of Bone-Grafted Maxilla: A Case Report," Clinical Implant Dentistry and Related Research, Vol.8, No.3, pp.161-167, 2006.
[12]Balshi, S.F., Wolfinger, G.J. and Balshi, T.J., "Surgical Planning and Prosthesis Construction Using Computed Tomography, CAD/CAM Technology, and The Internet for Immediate Loading of Dental Implants," Journal of Esthetic and Restorative Dentistry, Vol.18, No.6, pp.312-323, 2006.
[13]"Materialise", 2009, Materialise, "http://www.materialise.com," 30th June,2009.
[14]Valente F. and Sbrenna A., "CAD CAM Drilling Guides for Transferring CT-based Digital Planning to Flapless Placement of Oral Implants in Complex Cases," International Journal of Computer Assisted Rasiology and Surgery, Vol. 1, No.1, pp.413-414, 2006.
[15]Mischkowski, R.A., Zinser, M.J., Neugebauer, J., Kubler, A.C. and Zoller, J.E., "Comparison of Static and Dynamic Computer-Assisted Guidance Methods in Implantology," International Journal of Computerized Dentistry, Vol.9, No.1, pp.23-35, 2006.
[16]Sudbrink, S.D., "Computer-Guided Implant Placement With Immediate Provisionalization: A Case Report," Journal of Oral and Maxillofacial Surgery, Vol.63, No.6, pp.771-774, 2005.
[17]Ganz, S.D., "Presurgical Planning with CT-Derived Fabrication of Surgical Guides," Journal of Oral and Maxillofacial Surgery, Vol.63, No.9, Supplement 1, pp.59-71, 2005.
[18]Rosenfeld, A.L., Mandelaris, G.A. and Tardieu, P.B., "Prosthetically Directed Implant Placement Using Computer Software to Ensure Precise Placement and Predictable Prosthetic Outcomes. Part 1: Diagnostics, Imaging, and Collaborative Accountability," International Journal of Periodontics and Restorative Dentistry, Vol.26, No.3, 2006.
[19]Rosenfeld, A.L., Mandelaris, G.A. and Tardieu, P.B., "Prosthetically Directed Implant Placement Using Computer Software to Ensure Precise Placement and Predictable Prosthetic Outcomes. Part 2: Rapid-Prototype Medical Modeling and Stereolithographic Drilling Guides Requiring Bone Exposure," International Journal of Periodontics and Restorative Dentistry, Vol.26, No.4, 2006.
[20]Lal, K., White, G.S., Morea, D.N. and Wright, R.F. "Use of Stereolithographic Templates for Surgical and Prosthodontic Implant Planning and Placement. Part I. The Concept," Journal of Prosthodontics, Vol.15, No.1, pp.51-58, 2006.
[21]Lal, K., White, G.S., Morea, D. N. and Wright, R.F. "Use of Stereolithographic Templates for Surgical and Prosthodontic Implant Planning and Placement. Part II. A Clinical Report," Journal of Prosthodontics, Vol.15, No.2, pp.117-122, 2006.
[22]Hassfeld, S., and Muhling, J., "Computer Assisted Oral and Maxillofacial Surgery - A Review and An Assessment of Technology," International Journal of Oral Maxillofacl Surgery, Vol.30, Issue 1, pp.2-13. 2001.
[23]Verstreken, K., Van, C.J., Martens, K., Marchal, G., Van, S.D. and Suetens, P., "An Image-Guided Planning System for Endosseous Oral Implants," IEEE Transactions on Medical Imaging, Vol.17, No.5, pp.842-852, 1998.
[24]Lemmens, C., Faul, D., Hamill, J., Stroobants, S. and Nuyts, J., "Suppression of Metal Streak Artifacts in CT Using A MAP Reconstruction Procedure," in IEEE Nuclear Science Symposium Conference Record, pp.3431-3437, 2006.
[25]Zhao, S., Bae, K.T., Whiting, B. and Wang, G., "A Wavelet Method for Metal Artifact Reduction with Multiple Metallic Objects in the Field of View," X-Ray Science and Tech., Vol.10, pp.67-76, 2002.
[26]Yazdi, M. and Beaulieu, L., "A Novel Approach for Reducing Metal Artifacts Due to Metallic Dental Implants," IEEE Nuclear Science Symposium Conference Record, pp.2260-2263, 2006.
[27]Tsuji, M., Noguchi, N., Shigematsu, M., Yamashita, Y., Ihara, K., Shikimori, M. and Goto, M., "A New Navigation System Based on Cephalograms and Dental Casts for Oral and Maxillofacial Surgery," International Journal of Oral and Maxillofacial Surgery, Vol.35, No.9, pp.828-836, 2006.
[28]Georg, E. and Muhling, J., "Template-based Registration for Image-guided Skull Base Surgery," Otolaryngology - Head and Neck Surgery, Vol.136, No.6, pp.907-913, 2007.
[29]Chapuis, J., Schramm, A., Pappas, I., Hallermann, W.,Schwenzer-Zimmerer, K., Langlotz, F. and Caversaccio, M., "A New System for Computer-Aided Preoperative Planning and Intraoperative Navigation During Corrective Jaw Surgery," IEEE Transactions on Information Technology in Biomedicine, Vol.11, No.3, pp.274-287, 2007.
[30]Swennen, G.R., Barth, E.L., Eulzer, C. and Schutyser, F.A.C., "The Use of a New 3D Splint and Double CT Scan Procedure to Obtain an Accurate Anatomic Virtual Augmented Model of The Skull," International Journal of Oral and Maxillofacial Surgery, Vol.36, No.2, pp.146-152, 2007.
[31]Holst, S., Blatz, M.B. and Eitner, S., "Precision for Computer-Guided Implant Placement: Using 3D Planning Software and Fixed Intraoral Reference Points," Journal of Oral and Maxillofacial Surgery, Vol.65, No.3, pp.393-399, 2007.
[32]Nikzad, S. and Azari, A., "A Novel Stereolithographic Surgical Guide Template for Planning Treatment Involving a Mandibular Dental Implant," Journal of Oral and Maxillofacial Surgery, Vol.66, No.7, pp.1446-1454, 2008.
[33]Galanis, C.C., Sfantsikopoulos, M.M., Koidis, P.T., Kafantaris, N.M. and Mpikos, P.G., "Computer Methods for Automating Preoperative Dental Implant Planning: Implant Positioning and Size Assignment," Computer Methods and Programs in Biomedicine, Vol.86, No.1, pp.30-38, 2007.
[34]Solow, R.A., "Simplified Radiographic-surgical Template for Placement of Multiple, Parallel Implants," The Journal of Prosthetic Dentistry, Vol.85, No.1, pp.26-29, 2001.
[35]Al-Harbi, S.A. and Verrett, R.G., "Fabrication of a Stable Surgical Template Using Staged Tooth Extraction for Immediate Implant Placement," The Journal of Prosthetic Dentistry, Vol.94, No.4, pp.394-397, 2005.
[36]Bedrossian, E., "Laboratory and Prosthetic Considerations in Computer Guided Surgery and Immediate Loading," Journal of Oral and Maxillofacial Surgery, Vol.65, No.7, Supplement 1, pp.47-52, 2007.
[37]Ganz, S.D., "Techniques for the Use of CT Imaging for the Fabrication of Surgical Guides," Atlas of the Oral and Maxillofacial Surgery Clinics, Vol.14, No.1, pp.75-97, 2006.
[38]Widmann, G., Widmann, R., Widmann, E., Jaschke, W. and Bale, R.J., "A New Concept of Image Guided Template Production Reducing Costs and Effort," International Congress Series, Vol.1268, pp.1209-1214, 2004.
[39]Kopp, K.C., Koslow, A.H. and Abdo, O.S., "Predictable Implant Placement with a Diagnostic/Surgical Template and Advanced Radiographic Imaging," The Journal of Prosthetic Dentistry, Vol.89, No.6, pp.611-615, 2003.
[40]Westendorff, C., Hoffmann, J.G., Gomez-Roman, G., Bartz, D., Herberts, T. and Reinert, S., "Accuracy and Interindividual Outcome of Navigation Guided Dental Implant Socket Drilling in an Experimental Setting," International Congress Series, Vol.1281, pp.1205-1210, 2005.
[41]Wexler, A., Tzadok, S. and Casap, N., "Computerized Navigation Surgery for the Safe Placement of Palatal Implants," American Journal of Orthodontics and Dentofacial Orthopedics, Vol.131, No.4, Supplement 1, pp.S100-S105, 2007.
[42]Nickenig, H.J. and Eitner, S., "Reliability of Implant Placement after Virtual Planning of Implant Positions Using Cone Beam CT Data and Surgical (Guide) Templates," Journal of Cranio-Maxillofacial Surgery, Vol.35, No.4-5, pp.207-211, 2007.
[43]Ewers, R., Schicho, K., Truppe, M., Seemann, R., Reichwein, A., Figl, M. and Wagner, A., "Computer-aided Navigation in Dental Implantology: 7 Years of Clinical Experience," Journal of Oral and Maxillofacial Surgery, Vol.62, No.3, pp.329-334, 2004.
[44]Ozan, O., Turkyilmaz, I., Ersoy, A.E., McGlumphy, E.A. and Rosenstiel, S.F., "Clinical Accuracy of 3 Different Types of Computed Tomography-Derived Stereolithographic Surgical Guides in Implant Placement," Journal of Oral and Maxillofacial Surgery, Vol.67, No.2, pp.394-401, 2009.
[45]Kwakman, J.M., Voorsmit, R.A.C.A., Freihofer, H.P.M., Van Waas, M.A.J. and Geertman, M.E., "Randomized Prospective Clinical Trial of Two Implant Systems for Overdenture Treatment: a Comparison of the 2-year and 5-year Results Using the Clinical Implant Performance Scale: Trauma; Oral Surgery; Implantology," International Journal of Oral and Maxillofacial Surgery, Vol.27, No.2, pp.94-98, 1998.
[46]Gottschalk, S., Lin, M.C. and Manocha, D., "OBBTree: a Hierarchical Structure for Rapid Interference Detection," Proc. of SIGGRAPH‘96, pp. 171-180, 1996.