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 Comparison of Dental Surface Image Registration and Fiducial Marker Registration: An In Vivo Accuracy Study of Static Computer-Assisted Implant Surgery

2021 ◽  
Vol 10 (18) ◽  
pp. 4183
Author(s):  
Yen-Ting Han ◽  
Wei-Chun Lin ◽  
Fang-Yu Fan ◽  
Chih-Long Chen ◽  
Chia-Cheng Lin ◽  
...  
Keyword(s):  
Image Registration ◽  
Fiducial Marker ◽  
Surface Registration ◽  
Computer Assisted ◽  
Implant Surgery ◽  
Surgical Guides ◽  
Surface Image ◽  
Dental Surface ◽  
Dental Casts

This study compared the accuracy of static computer-assisted implant surgery (sCAIS) planned through dental surface image registration and fiducial marker registration. Stone models of 30 patients were converted into digital dental casts by using a desktop scanner. Cone-beam computed tomography (CBCT) was performed and superimposed to the digital dental casts with two methods: matching the dental surface images or matching the fiducial markers on a stereolithographic radiographic template. Following the implant planning, stereolithographic surgical guides were fabricated, and 56 fully guided implants were inserted by the same doctor. Deviations between planned and inserted implants were measured and compared using postoperative CBCT images. After adjustment for other potential influencing factors, compared with the fiducial marker registration group, significantly larger mean lateral deviations were noted in the dental surface registration group at both the implant platform and apex (p = 0.0188 and 0.0371, respectively). However, the mean lateral deviations for the dental surface registration (0.83 ± 0.51 mm at implant platform and 1.24 ± 0.68 mm at implant apex) were comparable to the literature. In conclusion, our findings indicate that although sCAIS planned using dental surface image registration was not statistically as accurate as that using fiducial marker registration, its accuracy was satisfactory for clinical use.

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 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 Digital Workflow to Fabricate Complete Dentures for Edentulous Patients Using a Reversing and Superimposing Technique

2021 ◽  
Vol 11 (13) ◽  
pp. 5786
Author(s):  
Hwa-Jung Lee ◽  
Jeongho Jeon ◽  
Hong Seok Moon ◽  
Kyung Chul Oh
Keyword(s):  
Additive Manufacturing ◽  
Computer Aided Design ◽  
Digital Data ◽  
Complete Dentures ◽  
Intraoral Scanner ◽  
Digital Workflow ◽  
Denture Base ◽  
Scan Data ◽  
Edentulous Patients ◽  
Aided Design

This technical procedure demonstrates a 4-step completely digital workflow for the fabrication of complete dentures in edentulous patients. The digital scan data of the edentulous arches were obtained using an intraoral scanner, followed by the fabrication of modeless trial denture bases using additive manufacturing. Using the trial denture base and a wax rim assembly, the interarch relationship was recorded. This record was digitized using an intraoral scanner and reversed for each maxillary and mandibular section individually. The digital scan data directly obtained using the intraoral scanner were superimposed over the reversed data, establishing a proper interarch relationship. The artificial teeth were arranged virtually and try-in dentures were additively manufactured. Subsequently, the gingival and tooth sections were additively manufactured individually and characterized. Thus, fabrication of digital complete dentures can be accomplished using digital data characteristics. The workflow includes data acquisition using an intraoral scanner, data processing using reverse engineering and computer-aided design software programs, and additive manufacturing.

scholarly journals Digital planning and guided surgery in oral rehabilitation

2020 ◽  
Author(s):  
Larissa Braga dos Santos ◽  
Adriano Relvas Barreira de Oliveira ◽  
Mauro Lefrançois ◽  
Marcos Venício Azevedo ◽  
Pablo Sotelo ◽  
...  
Keyword(s):  
Surgical Planning ◽  
Three Dimensional ◽  
Oral Rehabilitation ◽  
Digital Workflow ◽  
Surgical Guide ◽  
Surgical Guides ◽  
Digital Planning ◽  
Cad Cam ◽  
Correct Understanding ◽  
Plaster Model

Digital planning of the prosthesis associated with surgical planning increased predictability, since surgical guides indicate the best place for implant installation, thus reducing the number of complications, and the CAD/CAM system provides predictability in the preparation of final restorations, according to the procedure previously planned. Our study reported a digital workflow used for the guided installation of two dental implants in regions 14 and 16, extraction of tooth 15 and installation of a fixed prothesis over implants. After anamnesis and clinical evaluation, intra- and extra-oral photographs of the patient were performed, molding the upper arch with polyvinylsiloxane (2-step putty/light-body technique) and requesting computed tomography. The plaster model obtained was sent to the laboratory and scanned. The generated file (STL) was used to create a diagnostic wax-up that was aligned to the tomography (in DICOM format), enabling the three-dimensional planning of the implants, which generated a partial printed surgical guide after approval of the dentist. After six months, the patient received the provisional fixed prosthesis printed in PMMA (polymethylmethacrylate) on an intermediate in PEEK (polyetheretherketone) aiming to condition an emergency profile to receive a definitive prosthesis two months later, with zirconia-milled infrastructure on a ti-base. The correct understanding of the operator about the steps of the digital workflow (diagnosis, prosthetic planning, surgical planning, guide preparation, temporary and final restorations) gives the operator improved predictability at the time of surgery as well as satisfactory aesthetic and functional result of definitive restorations.

Digital Workflow for Computer-Guided Implant Surgery in Edentulous Patients: A Case Report

2017 ◽  
Vol 75 (12) ◽  
pp. 2541-2549 ◽  
Author(s):  
Ji-Hyeon Oh ◽  
Xueyin An ◽  
Seung-Mi Jeong ◽  
Byung-Ho Choi
Keyword(s):  
Case Report ◽  
Digital Workflow ◽  
Implant Surgery ◽  
Edentulous Patients

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.

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