scholarly journals Accuracy Evaluation of a Stereolithographic Surgical Template for Dental Implant Insertion Using 3D Superimposition Protocol

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Corina Marilena Cristache ◽  
Silviu Gurbanescu
Keyword(s):  
Dental Implant ◽  
Treatment Plan ◽  
Entry Point ◽  
Digital Impression ◽  
Accuracy Evaluation ◽  
Angular Deviation ◽  
Surgical Guides ◽  
Surgical Template ◽  
Angle Deviation ◽  
Edentulous Patients

The aim of this study was to evaluate the accuracy of a stereolithographic template, with sleeve structure incorporated into the design, for computer-guided dental implant insertion in partially edentulous patients. Materials and Methods. Sixty-five implants were placed in twenty-five consecutive patients with a stereolithographic surgical template. After surgery, digital impression was taken and 3D inaccuracy of implants position at entry point, apex, and angle deviation was measured using an inspection tool software. Mann–Whitney U test was used to compare accuracy between maxillary and mandibular surgical guides. A p value < .05 was considered significant. Results. Mean (and standard deviation) of 3D error at the entry point was 0.798 mm (±0.52), at the implant apex it was 1.17 mm (±0.63), and mean angular deviation was 2.34 (±0.85). A statistically significant reduced 3D error was observed at entry point p=.037, at implant apex p=.008, and also in angular deviation p=.030 in mandible when comparing to maxilla. Conclusions. The surgical template used has proved high accuracy for implant insertion. Within the limitations of the present study, the protocol for comparing a digital file (treatment plan) with postinsertion digital impression may be considered a useful procedure for assessing surgical template accuracy, avoiding radiation exposure, during postoperative CBCT scanning.

scholarly journals Use of dental MRI for radiation-free guided dental implant planning: a prospective, in vivo study of accuracy and reliability

2020 ◽  
Vol 30 (12) ◽  
pp. 6392-6401 ◽  
Author(s):  
Tim Hilgenfeld ◽  
Alexander Juerchott ◽  
Johann M. E. Jende ◽  
Peter Rammelsberg ◽  
Sabine Heiland ◽  
...  
Keyword(s):  
Treatment Plan ◽  
Three Dimensional ◽  
Entry Point ◽  
Angular Deviation ◽  
Implant Position ◽  
Surgical Guide ◽  
Surgical Guides ◽  
Treatment Plans ◽  
Dental Mri

Abstract Objectives To evaluate the accuracy and reliability of dental MRI for static guided implant surgery planning. Materials and methods In this prospective study, a 0.4-mm isotropic, artifact-suppressed, 3T MRI protocol was used for implant planning and surgical guide production in participants in need of dental implants. Two dentists decided on treatment plan. Surgical guides were placed intraorally during a subsequent reference cone beam computed tomography (CBCT) scan. Inter-rater and inter-modality agreement were assessed by Cohen’s kappa. For each participant, dental MRI and CBCT datasets were co-registered to determine three-dimensional and angular deviations between planned and surgically guided implant positions. Results Forty-five implants among 30 study participants were planned and evaluated (17 women, 13 men, mean age 56.9 ± 13.1 years). Inter-rater agreement (mean κ 0.814; range 0.704–0.927) and inter-modality agreement (mean κ 0.879; range 0.782–0.901) were both excellent for the dental MRI-based treatment plans. Mean three-dimensional deviations were 1.1 ± 0.7 (entry point) and 1.3 ± 0.7 mm (apex). Mean angular deviation was 2.4 ± 1.5°. CBCT-based adjustments of MRI plans were necessary for implant position in 29.5% and for implant axis in 6.8% of all implant sites. Changes were larger in the group with shortened dental arches compared with those for tooth gaps. Except for one implant site, all guides were suitable for clinical use. Conclusion This feasibility study indicates that dental MRI is reliable and sufficiently accurate for surgical guide production. Nevertheless, more studies are needed to increase its accuracy before it can be used for implant planning outside clinical trials. Key Points • An excellent reliability for the dental MRI-based treatment plans as well as agreement between dental MRI-based and CBCT-based (reference standard) decisions were noted. • Ideal implant position was not reached in all cases by dental MRI plans. • For all but one implant site surgical guides derived from dental MRI were sufficiently accurate to perform implant placement (mean three-dimensional deviations were 1.1 ± 0.7 (entry point) and 1.3 ± 0.7 mm (apex); mean angular deviation was 2.4 ± 1.5°).

scholarly journals Accuracy, Labor-Time and Patient-Reported Outcomes with Partially versus Fully Digital Workflow for Flapless Guided Dental Implants Insertion—A Randomized Clinical Trial with One-Year Follow-Up

2021 ◽  
Vol 10 (5) ◽  
pp. 1102
Author(s):  
Corina Marilena Cristache ◽  
Mihai Burlibasa ◽  
Ioana Tudor ◽  
Eugenia Eftimie Totu ◽  
Fabrizio Di Francesco ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Dental Implants ◽  
Entry Point ◽  
Angular Deviation ◽  
Digital Workflow ◽  
Position Information ◽  
Patient Reported ◽  
The Mean ◽  
Edentulous Patients

(1) Background: Prosthetically-driven implant positioning is a prerequisite for long-term successful treatment. Transferring the planned implant position information to the clinical setting could be done using either static or dynamic guided techniques. The 3D model of the bone and surrounding structures is obtained via cone beam computed tomography (CBCT) and the patient’s oral condition can be acquired conventionally and then digitalized using a desktop scanner, partially digital workflow (PDW) or digitally with the aid of an intraoral scanner (FDW). The aim of the present randomized clinical trial (RCT) was to compare the accuracy of flapless dental implants insertion in partially edentulous patients with a static surgical template obtained through PDW and FDW. Patient outcome and time spent from data collection to template manufacturing were also compared. (2) Methods: 66 partially edentulous sites (at 49 patients) were randomly assigned to a PDW or FDW for guided implant insertion. Planned and placed implants position were compared by assessing four deviation parameters: 3D error at the entry point, 3D error at the apex, angular deviation, and vertical deviation at entry point. (3) Results: A total of 111 implants were inserted. No implant loss during osseointegration or mechanical and technical complications occurred during the first-year post-implants loading. The mean error at the entry point was 0.44 mm (FDW) and 0.85 (PDW), p ≤ 0.00; at implant apex, 1.03 (FDW) and 1.48 (PDW), p ≤ 0.00; the mean angular deviation, 2.12° (FDW) and 2.48° (PDW), p = 0.03 and the mean depth deviation, 0.45 mm (FDW) and 0.68 mm (PDW), p ≤ 0.00; (4) Conclusions: Despite the statistically significant differences between the groups, and in the limits of the present study, full digital workflow as well as partially digital workflow are predictable methods for accurate prosthetically driven guided implants insertion.

scholarly journals Fully Digital Workflow for Planning Static Guided Implant Surgery: A Prospective Accuracy Study

2020 ◽  
Vol 9 (4) ◽  
pp. 980 ◽  
Author(s):  
Chia-Cheng Lin ◽  
Ching-Zong Wu ◽  
Mao-Suan Huang ◽  
Chiung-Fang Huang ◽  
Hsin-Chung Cheng ◽  
...  
Keyword(s):  
Fiducial Marker ◽  
Surface Registration ◽  
Digital Data ◽  
Angular Deviation ◽  
Digital Workflow ◽  
Implant Surgery ◽  
Surgical Guides ◽  
Digital Planning ◽  
Clinical Accuracy ◽  
Edentulous Patients

The accuracy of static guided implant surgery (sGIS) using conventional planning workflow has been extensively examined; however, more information is required to justify the application of fully digital planning protocol. The purpose of this study was to investigate the clinical accuracy of sGIS with a fully digital planning workflow. Twenty-one partially edentulous patients were enrolled in this prospective study. Cone-beam computed tomography (CBCT) and intraoral scans were taken and superimposed by matching the dental surface images directly (surface registration protocol) or by matching fiducial markers on a stereolithographic (SLA) radiographic template fabricated from the digital data of the intraoral scan (fiducial marker registration protocol). Virtual implant treatment plans were then determined, and tooth-supported SLA surgical guides were fabricated according to the plans. Twenty-six implant surgeries were performed via the surgical guide by one surgeon. Pre- and post-operative CBCT images were superimposed, and the positional and angular deviations between placed and planned implants were measured with metrology software. A total of 43 fully guided implants were placed, in which 25 implants were planned with the surface registration protocol. Implants planned based on the surface registration protocol had a larger mean angular deviation than the fiducial marker registration protocol. No significant differences were found for any deviations of the examined variables. Within the limits of this study, we concluded that the clinical accuracy of the sGIS planned with a fully digital workflow was consistent with the conventional workflow for partially edentulous patients.

scholarly journals In Vitro Comparison of Surgical Implant Placement Accuracy Using Guides Fabricated by Three Different Additive Technologies

2020 ◽  
Vol 10 (21) ◽  
pp. 7791 ◽  
Author(s):  
Chuchai Anunmana ◽  
Chananchida Ueawitthayasuporn ◽  
Sirichai Kiattavorncharoen ◽  
Prakan Thanasrisuebwong
Keyword(s):  
Processing Time ◽  
Three Dimensional ◽  
Clinical Situation ◽  
Entry Point ◽  
Mean Deviation ◽  
Angular Deviation ◽  
Digital Light Processing ◽  
Guided Surgery ◽  
Surgical Guides

Various three-dimensional (3D) printing technologies are commercially available on the market, but the influence of different technologies on the accuracy of implant-guided surgery is unclear. Thus, three printing technologies: Stereolithographic (SLA), Digital light processing (DLP), and Polyjet were evaluated in this study. An entire 30 polyurethane models replicated the clinical situation. Ten surgical guides were printed by SLA, DLP, and PolyJet. Then, implant-guided surgery was performed, and their accuracy outcomes were measured concerning angular deviation, 3D deviation at the entry point, and apex. On top of that, the total processing time was also compared. For the angular deviation, the mean deviation was not statistically significant among all technologies. For the 3D deviation, PolyJet was statistically more accurate than DLP (p = 0.002) and SLA (p = 0.017) at the entry point. PolyJet was also statistically more accurate than DLP (p = 0.007) in regards to 3D deviation at the apex. Within the limitation of this study, the deviations from the experiment showed that PolyJet had the best outcome regarding the 3D deviations at the entry point and at the apex, meanwhile, the DLP printer had the shortest processing time.

Accuracy Evaluation of Computed Tomography–Derived Stereolithographic Surgical Guides in Zygomatic Implant Placement in Human Cadavers

2010 ◽  
Vol 36 (5) ◽  
pp. 345-355 ◽  
Author(s):  
Bruno R. Chrcanovic ◽  
Davidson R. Oliveira ◽  
Antônio L. Custódio
Keyword(s):  
Computed Tomography ◽  
Computer Aided Design ◽  
Accuracy Evaluation ◽  
Angular Deviation ◽  
Implant Placement ◽  
Surgical Guides ◽  
Zygomatic Implants ◽  
Computer Aided ◽  
Human Cadavers ◽  
Zygomatic Implant

Abstract Presurgical planning is essential to achieve esthetic and functional implants. For implant planning and placement, the association of computer-aided design (CAD) and computer-aided manufacturing (CAM) techniques furnishes some advantages regarding tridimensional determination of the patient's anatomy and fabrication of both anatomic models and surgical guides. The goal of this clinical study was to determine the angular deviations between planned and placed zygomatic implants using stereolithographic surgical guides in human cadavers. A total of 16 zygomatic implants were placed, 4 in each cadaver, with the use of stereolithographic (SLA) surgical guides generated by computed tomography (CT). A new CT scan was made after implant insertion. The angle between the long axis of the planned and actual implants was calculated. The mean angular deviation of the long axis between the planned and placed implants was 8.06 ± 6.40 (mean ± SD) for the anterior-posterior view, and 11.20 ± 9.75 (mean ± SD) for the caudal-cranial view. Use of the zygomatic implant, in the context of this protocol, should probably be reevaluated because some large deviations were noted. An implant insertion guiding system is needed because this last step is carried out manually. It is recommended that the sinus slot technique should be used together with the CT-based drilling guide to enhance final results. Further research to enhance the precision of zygomatic implant placement should be undertaken.

A STUDY ON CLINICAL AND X - RAY FEATURES OF PARTIALLY&NBSP; EDENTULOUS PATIENTS WITH DENTAL IMPLANT

2011 ◽  
pp. 96-103
Author(s):  
Quang Hai Nguyen ◽  
Toai Nguyen
Keyword(s):  
Dental Implants ◽  
Dental Implant ◽  
Tooth Loss ◽  
Permanent Teeth ◽  
Missing Teeth ◽  
X Ray ◽  
Lower Jaw ◽  
Molar Teeth ◽  
Edentulous Patients ◽  
Missing Tooth

1. Background: Loss of permanent teeth is very common, affected chewing function, speech and aesthetics; restoration of missing teeth with dental implant has several advantages, but we need thoroughly study the clinical and X ray features at the position at missing teeth, then to select the type of implant and make the best plan for the dental implant patients. 2. Materials and method: Cross-section descriptive study. From January 2009 to November 2010, study with 56 patients with 102 implants of MIS and Megagen systems at the Faculty of Odonto-Stomatology, Hue College of Medicine and Pharmacy and Vietnam-Cuba Hospital in Ha Noi. 3. Results: Distributed equally in male and female, common ages 40 – 59 (55,4%), the majority of missing teeth occurs in the lower jaw (63,8%) and especially, the teeth 36 and 46 (25,4%). The majority of missing teeth due to dental caries, dental pulp and apical diseases (64,7%) of the molar teeth (51,9%); the most position of missing tooth have enough bone for dental implants (87,3%), time of tooth loss and bone status in the position of tooth loss are related to each other (p < 0,01). Diameter and length of implant usually used 4.0 – 6.0 mm (63,7%) and 8.5 – 13.0 mm (83,3%). 4. Conclusion: Clinical and X ray features of edentulous patients has an important role in determining the type of implants and treatment planning of dental implants. Key words: Loss of permanent teeth, X ray and clinical features, Dental implant.

scholarly journals Variations in vertical mucosal thickness at edentulous ridge according to site and gender measured by cone-beam computed tomography

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Motohiro Munakata ◽  
Koudai Nagata ◽  
Minoru Sanda ◽  
Ryota Kawamata ◽  
Daisuke Sato ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Treatment Plan ◽  
Cone Beam ◽  
Alveolar Ridge ◽  
Marginal Bone Loss ◽  
Mandibular Molar ◽  
Mucosal Thickness ◽  
And Gender ◽  
Edentulous Patients

Abstract Background The vertical thickness of the peri-implant mucosa is associated with the amount of post treatment marginal bone loss. However, the variations in mucosal thickness at the different edentulous sites have been sparsely documented. The purpose of the study was to conduct a survey of the frequency distribution of variations in mucosal thickness at the different sites of the edentulous alveolar ridge and to compare them according to gender. Our study included 125 partially edentulous patients having a total of 296 implant sites. Cone-beam computed tomography (CBCT) scans were obtained by placing a diagnostic template with a radiopaque crown indicator on the ridge to determine the mucosal thickness at the crest of the alveolar ridge. Results The mucosal thickness was 3.0±1.3 mm in the maxilla, which was significantly greater than the mucosal thickness of 2.0±1.0 mm in the mandible (p<0.001). In both the maxilla and the mandible, the mucosa was the thickest in the anterior region, followed by the premolar and molar regions. Sites were further classified into two groups based on whether the mucosal thickness was greater than 2 mm. In the mandible, more than half of the sites showed a mucosal thickness of 2 mm or less. Conclusions Although this study was a limited preoperative study, the vertical mucosal thickness at the edentulous ridge differed between the maxillary and mandibular regions. The majority of sites in the mandibular molar region had a mucosal thickness of less than 2 mm. Practitioners might be able to develop an optimal dental implant treatment plan for long-term biologic and esthetic stability by considering these factors.

scholarly journals Accuracy of Guided Implant Surgery in the Edentulous Jaw Using Desktop 3D-Printed Mucosal Supported Guides

2021 ◽  
Vol 10 (3) ◽  
pp. 391
Author(s):  
Rani D’haese ◽  
Tom Vrombaut ◽  
Geert Hommez ◽  
Hugo De Bruyn ◽  
Stefan Vandeweghe
Keyword(s):  
In Vitro Study ◽  
Angular Deviation ◽  
Implant Surgery ◽  
Implant Position ◽  
Surgical Guides ◽  
Negative Effect ◽  
Bone Level ◽  
3D Printed ◽  
Implant Alignment

Purpose: The aim of this in vitro study is to evaluate the accuracy of implant position using mucosal supported surgical guides, produced by a desktop 3D printer. Methods: Ninety implants (Bone Level Roxolid, 4.1 mm × 10 mm, Straumann, Villerat, Switzerland) were placed in fifteen mandibular casts (Bonemodels, Castellón de la Plana, Spain). A mucosa-supported guide was designed and printed for each of the fifteen casts. After placement of the implants, the location was assessed by scanning the cast and scan bodies with an intra-oral scanner (Primescan®, Dentsply Sirona, York, PA, USA). Two comparisons were performed: one with the mucosa as a reference, and one where only the implants were aligned. Angular, coronal and apical deviations were measured. Results: The mean implant angular deviation for tissue and implant alignment were 3.25° (SD 1.69°) and 2.39° (SD 1.42°) respectively, the coronal deviation 0.82 mm (SD 0.43 mm) and 0.45 mm (SD 0.31 mm) and the apical deviation 0.99 mm (SD 0.45 mm) and 0.71 mm (SD 0.43 mm). All three variables were significantly different between the tissue and implant alignment (p < 0.001). Conclusion: Based on the results of this study, we conclude that guided implant surgery using desktop 3D printed mucosa-supported guides has a clinically acceptable level of accuracy. The resilience of the mucosa has a negative effect on the guide stability and increases the deviation in implant position.

scholarly journals Comparison of implant placement accuracy in two different preoperative digital workflows: navigated vs. pilot-drill-guided surgery

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Johannes Spille ◽  
Feilu Jin ◽  
Eleonore Behrens ◽  
Yahya Açil ◽  
Jürgen Lichtenstein ◽  
...  
Keyword(s):  
Navigation System ◽  
Entry Point ◽  
Angular Deviation ◽  
Guided Surgery ◽  
Implant Placement ◽  
Drill Guide ◽  
Navigation Group ◽  
3D Printed ◽  
The Mean ◽  
Master Model

Abstract Background The aim of the study is to evaluate the accuracy of a new implant navigation system on two different digital workflows. Methods A total of 18 phantom jaws consisting of hard and non-warping plastic and resembling edentulous jaws were used to stimulate a clinical circumstance. A conventional pilot-drill guide was conducted by a technician, and a master model was set by using this laboratory-produced guide. After cone beam computed tomography (CBCT) and 3D scanning of the master models, two different digital workflows (marker tray in CBCT and 3D-printed tray) were performed based on the Digital Imaging Communication in Medicine files and standard tessellation language files. Eight Straumann implants (4.1 mm × 10 mm) were placed in each model, six models for each group, resulting in 144 implant placements in total. Postoperative CBCT were taken, and deviations at the entry point and apex as well as angular deviations were measured compared to the master model. Results The mean total deviations at the implant entry point for MTC (marker tray in CBCT), 3dPT (3d-printed tray), and PDG (pilot-drill guide) were 1.024 ± 0.446 mm, 1.027 ± 0.455 mm, and 1.009 ± 0.415 mm, respectively, and the mean total deviations at the implant apex were 1.026 ± 0.383 mm, 1.116 ± 0.530 mm, and 1.068 ± 0.384 mm. The angular deviation for the MTC group was 2.22 ± 1.54°. The 3dPT group revealed an angular deviation of 1.95 ± 1.35°, whereas the PDG group showed a mean angular deviation of 2.67 ± 1.58°. Although there were no significant differences among the three groups (P > 0.05), the navigation groups showed lesser angular deviations compared to the pilot-drill-guide (PDG) group. Implants in the 3D-printed tray navigation group showed higher deviations at both entry point and apex. Conclusions The accuracy of the evaluated navigation system was similar with the accuracy of a pilot-drill guide. Accuracy of both preoperative workflows (marker tray in CBCT or 3D-printed tray) was reliable for clinical use.

scholarly journals Accuracy of guided surgery using the silicon impression and digital impression method for the mandibular free end: a comparative study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Koudai Nagata ◽  
Kei Fuchigami ◽  
Noriyuki Hoshi ◽  
Mihoko Atsumi ◽  
Katsuhiko Kimoto ◽  
...  
Keyword(s):  
Digital Technology ◽  
Three Dimensional ◽  
Digital Impression ◽  
Angular Deviation ◽  
Dental Practice ◽  
3D Scanner ◽  
Surgical Guide ◽  
Guided Surgery ◽  
Guide Plate ◽  
Implant Treatment

Abstract Background Implant treatment using guided surgery is becoming widespread in clinical dental practice. Furthermore, the development of digital technology has enabled the use of intraoral scanners (IOSs) to fabricate surgical guide plates. The objective of this study was to compare the accuracy of guided surgery using the silicone impression method with a three-dimensional (3D) scanner and the digital impression method with IOS for one side of the mandibular free end. In addition, we compared the accuracy of tooth-supported vs tooth/mucosa-supported surgical guide plates. Results The accuracy of the tooth-supported surgical guide plate using the new IOS method instead of the method of obtaining impressions with conventional silicone resulted in better measurements of 3D deviation at the crest, 3D deviation at the apex, and angular deviation. In terms of the accuracy of the tooth/mucosa-supported surgical guide plate, there were no significant differences in all measurements. The surgical guide plate using an IOS and the tooth/mucosa-supported surgical guide plate may enable more accurate guided surgery. Conclusion Tooth/mucosa-supported guided surgery involving preparation with an IOS may result in more accurate implant surgery.

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