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.

scholarly journals 3D Guided Dental Implant Placement: Impact on Surgical Accuracy and Collateral Damage to the Inferior Alveolar Nerve

2021 ◽  
Vol 9 (9) ◽  
pp. 99
Author(s):  
Amit Mistry ◽  
Cemal Ucer ◽  
John D. Thompson ◽  
Rabia Sannam Khan ◽  
Emina Karahmet ◽  
...  
Keyword(s):  
Three Dimensional ◽  
Inferior Alveolar Nerve ◽  
Mean Deviation ◽  
Maximum Deviation ◽  
Angular Deviation ◽  
Optimal Position ◽  
Surgical Guides ◽  
Close Proximity ◽  
The Mean

An increase in the number of implants placed has led to a corresponding increase in the number of complications reported. The complications can vary from restorative complications due to poor placement to damage to collateral structures such as nerves and adjacent teeth. A large majority of these complications can be avoided if the implant has been placed accurately in the optimal position. Therefore, the aim of this in vitro pilot study was to investigate the effect of freehand (FH) and fully guided (FG) surgery on the accuracy of implants placed in close proximity to vital structures such as the inferior alveolar nerve (IAN). Cone-beam computed tomography (CBCT) and intraoral scans of six patients who have had previous dental implants in the posterior mandible were used in this study. The ideal implant position was planned. FG surgical guides were manufactured for each case. In this study, the three-dimensional 3D printed resin models of each of the cases were produced and the implants placed using FG and FH methods on the respective models. The outcome variables of the study, angular deviations were calculated and the distance to the IAN was measured. The mean deviations for the planned position observed were 1.10 mm coronally, 1.88 mm apically with up to 6.3 degrees’ angular deviation for FH surgery. For FG surgical technique the mean deviation was found to be at 0.35 mm coronally, 0.43 mm apically with 0.78 degrees angularly respectively. The maximum deviation from the planned position for the apex of the implant to the IAN was 2.55 mm using FH and 0.63 mm FG. This bench study, within its limitations, demonstrated surgically acceptable accuracy for both FH and FG techniques that would allow safe placement of implants to vital structures such as the IAN when a safety zone of 3 mm is allowed. Nevertheless, a better margin of error was observed for FG surgery with respect to the angular deviation and controlling the distance of the implant to the IAN using R2 Gate® system.

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°).

Guided surgery with 3D printed device: a case report

2020 ◽  
Author(s):  
Michelle Carvalho de Sales ◽  
Rafael Maluza Flores ◽  
Julianny da Silva Guimaraes ◽  
Gustavo Vargas da Silva Salomao ◽  
Tamara Kerber Tedesco ◽  
...  
Keyword(s):  
Operating Time ◽  
Three Dimensional ◽  
Conventional Technique ◽  
Cervical Region ◽  
Mean Deviation ◽  
Apical Region ◽  
Virtual Planning ◽  
Surgical Guide ◽  
Surgical Guides ◽  
High Level

Dental surgeons need in-depth knowledge of the bone tissue status and gingival morphology of atrophic maxillae. The aim of this study is to describe preoperative virtual planning of placement of five implants and to compare the plan with the actual surgical results. Three-dimensional planning of rehabilitation using software programs enables surgical guides to be specially designed for the implant site and manufactured using 3D printing. A patient with five teeth missing was selected for this study. The patient’s maxillary region was scanned with CBCT and a cast model was produced. After virtual planning using ImplantViewer, five implants were placed using a printed surgical guide. Two weeks after the surgical procedure, the patient underwent another CBCT scan of the maxilla. Statistically significant differences were detected between the virtually planned positions and the actual positions of the implants, with a mean deviation of 0.36 mm in the cervical region and 0.7 mm in the apical region. The surgical technique used enables more accurate procedures when compared to the conventional technique. Implants can be better positioned, with a high level of predictability, reducing both operating time and patient discomfort.

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.

scholarly journals The Effect of Heat Treatment toward Glycerol-Based, Photocurable Polymeric Scaffold: Mechanical, Degradation and Biocompatibility

Polymers ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 1960
Author(s):  
Wai-Sam Ao-Ieong ◽  
Shin-Tian Chien ◽  
Wei-Cheng Jiang ◽  
Shaw-Fang Yet ◽  
Jane Wang
Keyword(s):  
Thermal Treatment ◽  
Impact Resistance ◽  
Three Dimensional ◽  
Fold Increase ◽  
Crosslinking Density ◽  
Mechanical Degradation ◽  
Digital Light Processing ◽  
In Vitro Biocompatibility ◽  
Polymeric Scaffold

Photocurable polymers have become increasingly important for their quick prototyping and high accuracy when used in three dimensional (3D) printing. However, some of the common photocurable polymers are known to be brittle, cytotoxic and present low impact resistance, all of which limit their applications in medicine. In this study, thermal treatment was studied for its effect and potential applications on the mechanical properties, degradability and biocompatibility of glycerol-based photocurable polymers, poly(glycerol sebacate) acrylate (PGSA). In addition to the slight increase in elongation at break, a two-fold increase in both Young’s modulus and ultimate tensile strength were also observed after thermal treatment for the production of thermally treated PGSA (tPGSA). Moreover, the degradation rate of tPGSA significantly decreased due to the increase in crosslinking density in thermal treatment. The significant increase in cell viability and metabolic activity on both flat films and 3D-printed scaffolds via digital light processing-additive manufacturing (DLP-AM) demonstrated high in vitro biocompatibility of tPGSA. The histological studies and immune staining indicated that tPGSA elicited minimum immune responses. In addition, while many scaffolds suffer from instability through sterilization processes, it was proven that once glycerol-based polymers have been treated thermally, the influence of autoclaving the scaffolds were minimized. Therefore, thermal treatment is considered an effective method for the overall enhancement and stabilization of photocurable glycerol-based polymeric scaffolds in medicine-related applications.

scholarly journals Accuracy of Customized Prefabricated Screw-Type Immediate Provisional Restorations after Single-Implant Placement

2019 ◽  
Vol 8 (4) ◽  
pp. 490 ◽  
Author(s):  
Kyung Chul Oh ◽  
Jee-Hwan Kim ◽  
Chang-Woo Woo ◽  
Hong Seok Moon
Keyword(s):  
Computer Aided Design ◽  
Computer Assisted ◽  
Angular Deviation ◽  
Intraoral Scanner ◽  
Planning Stage ◽  
Implant Placement ◽  
Surgical Guides ◽  
Planning Software ◽  
Single Implant

Limited evidence is available comparing the differences between pre-operative and post-operative 3D implant positions from the viewpoint of prosthetics. We aimed to investigate the differences between preplanned positions of virtual provisional restorations and their actual positions following fully guided single-implant placement. Ten maxillary typodonts with missing right central incisors were imaged using cone-beam computed tomography, and digital impressions were obtained using an intraoral scanner. These data were imported into implant-planning software, following which the provisional restorations were designed. After data superimposition, an appropriate implant position was determined, and a computer-assisted implant surgical guide was designed for each typodont. Orders generated from the implant-planning software were imported into relevant computer-aided design software to design the custom abutments. The abutments, provisional restorations, and surgical guides were fabricated, and each restoration was cemented to the corresponding abutments, generating a screw-type immediate provisional restoration. The implants were placed using the surgical guides, and the screw-type provisional restorations were engaged to the implants. The typodonts were then rescanned using the intraoral scanner. The restorations designed at the treatment planning stage were compared with those in the post-operative scan using metrology software. The angular deviation around the central axis of the implant was measured, and the differences in the crown position were converted to root mean square (RMS) values. The post-operative provisional restorations exhibited an absolute angular deviation of 6.94 ± 5.78° and an RMS value of 85.8 ± 20.2 µm when compared with their positions in the pre-operative stage. Within the limitations of the present in vitro study, the results highlight the potential application of customized prefabricated immediate provisional restorations after single-implant placement.

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 A Proposed In Vitro Methodology for Assessing the Accuracy of Three-Dimensionally Printed Dental Models and the Impact of Storage on Dimensional Stability

2021 ◽  
Vol 11 (13) ◽  
pp. 5994
Author(s):  
Li Hsin Lin ◽  
Joshua Granatelli ◽  
Frank Alifui-Segbaya ◽  
Laura Drake ◽  
Derek Smith ◽  
...  
Keyword(s):  
Dimensional Stability ◽  
Reference Model ◽  
Three Dimensional ◽  
Posterior Region ◽  
Digital Light Processing ◽  
Dental Models ◽  
3D Printed ◽  
T1 And T2 ◽  
The Impact

The objective of this study was to propose a standardised methodology for assessing the accuracy of three-dimensional printed (3DP) full-arch dental models and the impact of storage using two printing technologies. A reference model (RM) comprising seven spheres was 3D-printed using digital light processing (MAX UV, MAX) and stereolithography (Form 2, F2) five times per printer. The diameter of the spheres (n = 35) represented the dimensional trueness (DT), while twenty-one vectors (n = 105) extending between the sphere centres represented the full-arch trueness (FT). Samples were measured at two (T1) and six (T2) weeks using a commercial profilometer to assess their dimensional stability. Significant (p < 0.05) contraction in DT occurred at T1 and T2 with a medium deviation of 108 µm and 99 µm for MAX, and 117 µm and 118 µm for F2, respectively. No significant (p > 0.05) deviations were detected for FT. The detected median deviations were evenly distributed across the arch for MAX at <50 µm versus F2, where the greatest error of 278 µm was in the posterior region. Storage did not significantly impact the model’s DT in contrast to FT (p < 0.05). The proposed methodology was able to assess the accuracy of 3DP. Storage significantly impacted the full-arch accuracy of the models up to 6 weeks post-printing.

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