临床口腔医学杂志2026，Vol.42Issue(7)：413-418,6.DOI:10.3969/j.issn.1003-1634.2026.07.008
下颌第一磨牙区种植三维定位的修复导向标准化训练与量化评价
Prosthetically driven standardized training and quantitative assessment of three-dimensional implant positioning in the mandibular first molar region
摘要
Abstract
Objective:To develop and evaluate a standardized,prosthetically driven training pathway and a quantita-tive assessment system for three-dimensional(3D)implant positioning at a mandibular first molar edentulous site among gen-eral practice residents,and to examine its effects on placement quality and the distribution of positioning errors.Methods:This single-group pre-post study consecutively enrolled implant-inexperienced general practice residents.Participants comple-ted a baseline(T0)and a post-training(T1)assessment on a standardized mandibular first molar edentulous model;those with complete paired assessments and 3D measurement data were included in the analysis(n=32).The intervention followed a standardized workflow comprising"positioning-depth/axis control-intraoperative verification-correction".Outcomes included continuous deviation metrics(mesiodistal[MD],buccolingual[BL],vertical depth[Z],and axial angular deviation),a binary pass/fail outcome,and an I～IV error classification.Passing required meeting all thresholds:|MD|≤1 mm,|BL|≤1 mm,|Z|≤2 mm,and angular deviation≤5°.Paired tests and the McNemar test were used for pre-post comparisons.Reliability was evaluated using intraclass correlation coefficients(ICC)for continuous measures and linearly weighted Kappa for error classification.Results:The pass rate increased significantly from T0 to T1(15.6%vs 62.5%,P<0.001),with an absolute improvement of 46.9%.MD,BL,Z,and axial angular deviations all decreased significantly at T1(P<0.01).The error profile shifted from predominantly severe type III/IV errors to mainly correctable type I/II deviations(type III:50.0%→6.3%;type IV:18.8%→0%).ICCs ranged from 0.743 to 0.973,and the linearly weighted kappa for classification was 0.913.Conclusion:The proposed standardized training pathway and assessment system significantly improved residents'3D implant positioning performance at a mandibular first molar edentulous site and favorably shifted the error profile,with good measurement reproduc-ibility.This framework may support quality assurance and continuous improvement in posterior implant simulation training.关键词
口腔种植教学/全科规培医生/三维定位/标准化教学路径/错误分型/质量控制Key words
Dental implant education/General practice residency/Three-dimensional positioning/Standardized training pathway/Error classification/Quality assurance分类
医药卫生引用本文复制引用
冯楠,许庭翔,刘琪,高原,彭琳..下颌第一磨牙区种植三维定位的修复导向标准化训练与量化评价[J].临床口腔医学杂志,2026,42(7):413-418,6.基金项目
国家自然科学基金面上项目(82571065) （82571065）
