ObjectivesTo evaluate the influence of the three‐dimensional (3D) printing technology, material, sterilization, and disinfection on the accuracy of guided surgical templates.Material and MethodsFifty printed resin surgical templates were designed and fabricated using a digital light processing 3D printer with a photopolymerizing resin, and 50 printed metal surgical templates were designed and fabricated using a selective laser melting 3D printer with a titanium alloy. Templates from both groups were randomly divided into five subgroups involving different sterilization and disinfection procedures. The group without any sterilization or disinfection procedure served as the control group, whereas the other groups were used as the study groups (hydrogen peroxide gas plasma sterilization, 5% povidone‐iodine disinfection, 75% ethyl alcohol disinfection, and steam autoclave sterilization). Implant simulations were performed on the 3D‐printed resin models, and postoperative impressions were acquired with scan bodies attached to the implants. All surgical templates were digitally scanned. The root mean square was used to determine and quantify fabrication accuracy and reproducibility, and the definitive and planned implant positions were compared.ResultsThe printed resin templates exhibited lower fabrication accuracy and reproducibility, as well as higher 3D deviations, after steam autoclave sterilization (p < 0.001); however, the printed metal templates were not affected by the different sterilization or disinfection procedures (p > 0.05).ConclusionsPrinted metal surgical templates are viable alternatives for guided implant surgery. Preoperative steam or gas plasma sterilization is recommended, especially for metal templates, as resin templates show deformation and decreased accuracy after steam sterilization.Trial Registrationchictr.org.cn number: ChiCTR2400081334

中文翻译：

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材料、灭菌和消毒对 3D 打印手术模板准确性的影响：一项体外研究


目的评价三维 （3D） 打印技术、材料、灭菌和消毒对引导手术模板准确性的影响。材料和方法使用光聚合树脂的数字光处理 3D 打印机设计和制造了 50 个打印树脂手术模板，并使用钛合金选择性激光熔化 3D 打印机设计和制造了 50 个打印金属手术模板。将两组的模板随机分为 5 个亚组，涉及不同的灭菌和消毒程序。没有任何灭菌或消毒程序的组作为对照组，而其他组作为研究组（过氧化氢气体等离子灭菌、5% 聚维酮碘消毒、75% 乙醇消毒和蒸汽高压灭菌器灭菌）。在 3D 打印树脂模型上进行种植体模拟，并使用连接到种植体的扫描体获取术后印模。所有手术模板都经过数字扫描。均方根用于确定和量化制造精度和可重复性，并比较确定和计划的植入物位置。结果蒸汽高压灭菌后，打印的树脂模板表现出较低的制造精度和重现性，以及较高的 3D 偏差 （p < 0.001）;然而，打印的金属模板不受不同灭菌或消毒程序的影响 （p > 0.05）。结论打印金属手术模板是引导式种植体手术的可行替代方案。 建议术前进行蒸汽或气体等离子体灭菌，尤其是对于金属模板，因为树脂模板在蒸汽灭菌后会出现变形和准确性降低。试用 Registrationchictr.org。CN号：ChiCTR2400081334