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La Rosa GRM, Peditto M, Venticinque A, Marcianò A, Bianchi A, Pedullà E. Advancements in guided surgical endodontics: A scoping review of case report and case series and research implications. AUST ENDOD J 2024; 50:397-408. [PMID: 38887152 DOI: 10.1111/aej.12865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 05/15/2024] [Accepted: 06/08/2024] [Indexed: 06/20/2024]
Abstract
This scoping review examined current case series and reports on guided surgical endodontic applications in order to provide a critical platform for future research. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews guidelines were followed. A search on PubMed and Scopus yielded 611 articles, with 17 case reports and 1 series meeting inclusion criteria. Overall, guided surgery addressed anatomical complexities, with 15 articles employing static protocols and 3 dynamic. Results showed minimal iatrogenic errors and reduced chair time, with no postoperative issues reported. Within the cases described, guided endodontic surgery exhibited satisfactory results in management of anatomical complex cases. Cost-effectiveness, the need for adequate follow-up, procedure's reproducibility and accuracy, and objective measurement of the reduction in operative times and iatrogenic errors are some of the limitations in the current reports that need to be considered for planning of future experimental and cohort studies.
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Affiliation(s)
- Giusy Rita Maria La Rosa
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Matteo Peditto
- Postgraduate School of Oral Surgery, Department of Biomedical, Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Andrea Venticinque
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Antonia Marcianò
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Alberto Bianchi
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Eugenio Pedullà
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
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Salem D, Reher P, Evans JL, Mansour MH. Exploring digital technologies used in the design and manufacture of craniofacial implant surgical guides: A scoping review. J Prosthet Dent 2024; 131:1264-1270. [PMID: 36801144 DOI: 10.1016/j.prosdent.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 01/05/2023] [Accepted: 01/06/2023] [Indexed: 02/19/2023]
Abstract
STATEMENT OF PROBLEM Unlike intraoral implants, digitally planned surgical templates used for guiding the ideal position of the craniofacial implants are not well established, and clear methods and guidelines for their design and construction are lacking. PURPOSE The purpose of this scoping review was to identify the publications that used a full or partial computer-aided design and computer-aided manufacture (CAD-CAM) protocol to create a surgical guide that achieves the correct positioning of craniofacial implants to retain a silicone facial prosthesis. MATERIAL AND METHODS A systematic search was conducted in MEDLINE/PubMed, Web of Science, Embase, and Scopus for articles published before November 2021 in the English language. Articles needed to satisfy the eligibility criterion of in vivo articles that created a surgical guide with digital technology for inserting titanium craniofacial implants to hold a silicone facial prosthesis. Articles that inserted implants in the oral cavity or upper alveolus only and articles that did not describe the structure and retention of the surgical guide were excluded. RESULTS Ten articles were included in the review; all were clinical reports. Two of the articles used a CAD-only approach alongside a conventionally constructed surgical guide. Eight articles described applying a complete CAD-CAM protocol for the implant guides. The digital workflow varied considerably depending on the software program, design, and retention of guides. Only 1 report described a follow-up scanning protocol to verify the accuracy of the final implant positions compared with the planned positions. CONCLUSIONS Digitally designed surgical guides can be an excellent adjunct to accurately place titanium implants in the craniofacial skeleton for support of silicone prostheses. A sound protocol for the design and retention of the surgical guides will enhance the use and accuracy of craniofacial implants in prosthetic facial rehabilitation.
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Affiliation(s)
- Doaa Salem
- PhD student, School of Medicine and Dentistry, Griffith University, Gold Coast, QLD, Australia.
| | - Peter Reher
- Professor, School of M edicine and Dentistry, Griffith University, Gold Coast, QLD, Australia
| | - Jane L Evans
- Professor, School of M edicine and Dentistry, Griffith University, Gold Coast, QLD, Australia
| | - Mohammed H Mansour
- Adjunct Associate Professor, School of Dentistry, University of Queensland, Brisbane, QLD, Australia
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Michelinakis G, Apostolakis D, Nikolidakis D, Blum IR. A comprehensive review and update on the current state of computer-assisted rehabilitation in implant dentistry. Prim Dent J 2024; 13:64-73. [PMID: 38424692 DOI: 10.1177/20501684241231672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
AIM This paper provides a comprehensive review of the established concepts and newer developments related to computer-assisted implant rehabilitation. METHODS Two independent researchers searched the English literature published to 31st December 2023 in the PubMed/Medline database for primary and secondary research and related publications on computer-assisted implant planning, computer-assisted implant placement and computer-assisted implant restoration. RESULTS A total of 58,923 papers were identified, 198 relevant papers were read in full text and 110 studies were finally included. Computer-assisted implant rehabilitation was found to result in more precise implant positioning than freehand placement. Advantages include reduced trauma and surgery time; disadvantages include reduced primary implant stability and higher cost. CONCLUSION Computer-assisted surgery is particularly indicated in cases of critical anatomy, but may encounter limitations in terms of cost, restricted mouth opening, visibility and adjustment of the surgical guides and the need for prior familiarisation with the procedure. Nonetheless, this surgical technique reduces the post-implant placement complication rate.
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Affiliation(s)
- George Michelinakis
- George Michelinakis DDS, MSc, MPhil Prosthodontist, Crete Implants Private Dental Practice, Heraklion, Crete, Greece
- Dimitrios Apostolakis DDS, MSc, MSc Radiologist, Dental Radiology in Crete, Heraklion, Crete, Greece
- Dimitrios Nikolidakis DDS, MSc, PhD Periodontist, Clinic Perio, Private Dental Practice, Heraklion, Crete, Greece
- Igor R. Blum DDS, PhD, Dr Med Dent, MSc, MA (Educ), MFDS RCS (Eng), MFDS RCS (Edin), FDS (Rest Dent) RCS (Eng), FFDRCSI, FCGDent, PGCHE, FHEA, FICD, LLM (Medico-Legal Law) Professor/Consultant & Specialist in Restorative Dentistry, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Dimitrios Apostolakis
- George Michelinakis DDS, MSc, MPhil Prosthodontist, Crete Implants Private Dental Practice, Heraklion, Crete, Greece
- Dimitrios Apostolakis DDS, MSc, MSc Radiologist, Dental Radiology in Crete, Heraklion, Crete, Greece
- Dimitrios Nikolidakis DDS, MSc, PhD Periodontist, Clinic Perio, Private Dental Practice, Heraklion, Crete, Greece
- Igor R. Blum DDS, PhD, Dr Med Dent, MSc, MA (Educ), MFDS RCS (Eng), MFDS RCS (Edin), FDS (Rest Dent) RCS (Eng), FFDRCSI, FCGDent, PGCHE, FHEA, FICD, LLM (Medico-Legal Law) Professor/Consultant & Specialist in Restorative Dentistry, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Dimitrios Nikolidakis
- George Michelinakis DDS, MSc, MPhil Prosthodontist, Crete Implants Private Dental Practice, Heraklion, Crete, Greece
- Dimitrios Apostolakis DDS, MSc, MSc Radiologist, Dental Radiology in Crete, Heraklion, Crete, Greece
- Dimitrios Nikolidakis DDS, MSc, PhD Periodontist, Clinic Perio, Private Dental Practice, Heraklion, Crete, Greece
- Igor R. Blum DDS, PhD, Dr Med Dent, MSc, MA (Educ), MFDS RCS (Eng), MFDS RCS (Edin), FDS (Rest Dent) RCS (Eng), FFDRCSI, FCGDent, PGCHE, FHEA, FICD, LLM (Medico-Legal Law) Professor/Consultant & Specialist in Restorative Dentistry, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Igor R Blum
- George Michelinakis DDS, MSc, MPhil Prosthodontist, Crete Implants Private Dental Practice, Heraklion, Crete, Greece
- Dimitrios Apostolakis DDS, MSc, MSc Radiologist, Dental Radiology in Crete, Heraklion, Crete, Greece
- Dimitrios Nikolidakis DDS, MSc, PhD Periodontist, Clinic Perio, Private Dental Practice, Heraklion, Crete, Greece
- Igor R. Blum DDS, PhD, Dr Med Dent, MSc, MA (Educ), MFDS RCS (Eng), MFDS RCS (Edin), FDS (Rest Dent) RCS (Eng), FFDRCSI, FCGDent, PGCHE, FHEA, FICD, LLM (Medico-Legal Law) Professor/Consultant & Specialist in Restorative Dentistry, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
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Markovic J, Peña-Cardelles JF, Pedrinaci I, Hamilton A, Gallucci GO, Lanis A. Considerations for predictable outcomes in static computer- aided implant surgery in the esthetic zone. J ESTHET RESTOR DENT 2024; 36:207-219. [PMID: 38018396 DOI: 10.1111/jerd.13171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 10/21/2023] [Accepted: 11/07/2023] [Indexed: 11/30/2023]
Abstract
OBJECTIVE To provide technical and clinical recommendations for implementing a digital workflow in Static Computer-Aided Implant Surgery in the anterior maxilla. CLINICAL CONSIDERATIONS An optimal 3D implant position is crucial for achieving satisfying results in implant rehabilitation in the esthetic area. Due to its complexity, implant placement in the esthetic zone should be executed with precision and predictability. Static Computer-Aided Implant Surgery requires thorough planning and detailed attention to every step of the digital workflow protocol. CONCLUSIONS Implant positioning in the esthetic zone using Static Computer-Aided Implant Surgery is a technique-sensitive procedure that requires precise execution of each step. This approach ensures accurate prosthetically driven 3D implant placement and prevents potential errors that could lead to inaccurate positioning. CLINICAL SIGNIFICANCE The proper implementation of Static Computer-Aided Implant Surgery may increase the level of agreement between the planned and definitive implant 3D positions in the esthetic zone, thus enhancing the esthetic outcomes of implant rehabilitation.
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Affiliation(s)
- Jovana Markovic
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts, USA
- Department for Prosthodontics, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Juan Francisco Peña-Cardelles
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts, USA
| | - Ignacio Pedrinaci
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts, USA
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - Adam Hamilton
- Division of Oral Restorative and Rehabilitative Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - German O Gallucci
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts, USA
| | - Alejandro Lanis
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts, USA
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Wu J, Wu Q, Yu H. Virtual Implant Treatment Planning Using the Existing Denture With Metal Frameworks as a Radiographic Guide: A Technique Note. J ORAL IMPLANTOL 2023; 49:573-577. [PMID: 38279642 DOI: 10.1563/aaid-joi-d-23-00142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2024]
Affiliation(s)
- Jiacheng Wu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Dental Technology, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
| | - Qin Wu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
| | - Haiyang Yu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
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Sakkas A, Westendorf S, Thiele OC, Schramm A, Wilde F, Pietzka S. Prosthetically guided oral implant surgery. A retrospective cohort study evaluating the 5-year surgical outcome. GMS INTERDISCIPLINARY PLASTIC AND RECONSTRUCTIVE SURGERY DGPW 2023; 12:Doc06. [PMID: 37693294 PMCID: PMC10486885 DOI: 10.3205/iprs000176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
Purpose This study primarily evaluated the 5-year implant survival and success rate of prosthetically guided inserted implants. The secondary aim was to evaluate the impact of clinical variables on the development of mucositis, peri-implant bone resorption, peri-implantitis, as well as early and late implant failure. Materials and methods An observational retrospective single-centre study was conducted on patients who were treated with dental implants in the department of oral and plastic maxillofacial surgery of the military hospital of Ulm University between 2008 and 2010. In all patients, computer-assisted 3D planning after wax-up of the prosthetic restoration and template-guided surgery with titanium implants were performed. Bone augmentation procedures were performed primarily if needed. Intraoperative and postoperative complications as well as technical and mechanical complications after prosthesis loading were evaluated. In a 5-year clinical and radiological follow-up, implant success and implant survival were assessed using descriptive statistics. A multivariable regression analysis evaluated the potential impact of augmentation procedures, wound healing complications, smoking, history of periodontitis, and preoperative API (approximal plaque index) and SBI (sulcus bleeding index) values on peri-implant mucositis, peri-implant bone resorption, peri-implantitis, as well as early and late implant failure. Results In this study, 466 implants in 283 patients were considered for inclusion, and sufficient data were obtained for analysis from 368 (78.9%) implants in 229 (80.9%) patients. An overall implant survival rate of 98.1% (n=361/368) at the 5-year follow-up was revealed. According to the success criteria of the study, the 5-year success rate was 97.04% (n=263/271). An early implant failure of 1.07% (n=5/466) was recorded. 48.2% of the implants were affected by peri-implant mucositis (n=122/253), while peri-implant bone resorption was detected in 21.7% of the radiologically examined implants (n=59/271). Fifteen cases of peri-implantitis (5.5%) were detected. Peri-implant bone resorption increased significantly after bone augmentation procedures (p=0.028). Wound healing complications after implantation significantly increased the prevalence of late implant failure in the maxilla (p<0.001). Peri-implant bone resorption and peri-implantitis were significantly more prevalent in smokers (p=0.022/p=0.043). Implants in patients with API>20% presented significantly higher rates of peri-implant mucositis (p=0.042). Wound healing complications after augmentation, history of periodontitis, and SBI>20% had no significant impact on the study parameters. Conclusions The study confirms the reliability of prosthetically guided implant surgery, showing a high implant survival and success rate in a 5-year follow-up. Intraoperative complications and technical or mechanical complications after prosthesis loading remain within acceptable clinical limits. The rate of peri-implant mucositis, peri-implant bone resorption, and peri-implantitis was within the current literature range. Optimizing periodontal health and reducing smoking would improve the outcome. Further studies need to clarify the clinical indications and investigate the long-term surgical outcome of this treatment concept.
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Affiliation(s)
- Andreas Sakkas
- Department of Cranio-Maxillo-Facial-Surgery, German Armed Forces Hospital Ulm, Germany
- Department of Cranio-Maxillo-Facial-Surgery, University Hospital Ulm, Germany
| | - Stefan Westendorf
- Department of Cranio-Maxillo-Facial-Surgery, German Armed Forces Hospital Ulm, Germany
| | - Oliver Christian Thiele
- Department of Oral and Plastic Maxillofacial Surgery, Ludwigshafen Hospital, Ludwigshafen, Germany
| | - Alexander Schramm
- Department of Cranio-Maxillo-Facial-Surgery, German Armed Forces Hospital Ulm, Germany
- Department of Cranio-Maxillo-Facial-Surgery, University Hospital Ulm, Germany
| | - Frank Wilde
- Department of Cranio-Maxillo-Facial-Surgery, German Armed Forces Hospital Ulm, Germany
- Department of Cranio-Maxillo-Facial-Surgery, University Hospital Ulm, Germany
| | - Sebastian Pietzka
- Department of Cranio-Maxillo-Facial-Surgery, German Armed Forces Hospital Ulm, Germany
- Department of Cranio-Maxillo-Facial-Surgery, University Hospital Ulm, Germany
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Jia S, Wang G, Zhao Y, Wang X. Accuracy of an autonomous dental implant robotic system versus static guide-assisted implant surgery: A retrospective clinical study. J Prosthet Dent 2023:S0022-3913(23)00284-6. [PMID: 37291043 DOI: 10.1016/j.prosdent.2023.04.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 04/28/2023] [Accepted: 04/28/2023] [Indexed: 06/10/2023]
Abstract
STATEMENT OF PROBLEM The accuracy of implant placement is a prerequisite for prosthetically driven implant surgery and is necessary to ensure the long-term stability of dental implants. Imprecise implant position may bring difficulties for restoration, damage anatomic structures, affect peri-implant tissues, and lead to ultimate implant failure. PURPOSE The purpose of this retrospective clinical study was to compare the accuracy of implants placed with an autonomous dental implant robotic (ADIR) system with those placed with static computer assisted implant surgery (sCAIS). MATERIAL AND METHODS Thirty-nine participants were enrolled in this retrospective study: 20 participants had received implant surgery with the ADIR system and 19 participants had implants placed with sCAIS. The preoperative plans and postoperative cone beam computed tomography (CBCT) scans after implant placement were matched during the study. The coronal, apical, and angular deviations were measured and analyzed. A linear regression model was established to analyze the source of deviation. MANOVA was used to compare differences in the major outcome variables (α=.05). RESULTS A total of 60 implants were placed in 39 participants (30 in each of the 2 groups). The mean ±standard deviation coronal, apical, and angular deviation of the ADIR system group and sCAIS group were 0.43 ±0.18 mm versus 1.31 ±0.62 mm (P<.001), 0.56 ±0.18 mm versus 1.47 ±0.65 mm (P<.001), and 1.48 ±0.59 degrees versus 2.42 ±1.55 degrees (P=.003), respectively. In addition, there was no significant difference in accuracy in the different implant regions (anterior, premolar, molar, maxilla, mandible) (P>.05). No complications were observed. CONCLUSIONS The accuracy of the implant position using the ADIR system was significantly higher than with sCAIS, suggesting that the ADIR system can achieve minimally invasive and excellent accuracy. In addition, implant regions had no significant influence on the accuracy of implant placement. (Keywords: Robotic system, Implant surgery, Static guide, Autonomous, Accuracy).
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Affiliation(s)
- Shasha Jia
- Post-Graduate, Department of Oral Implantology, The Affiliated Hospital of Qingdao University, Qingdao, PR China; Post-Graduate, Oral and Maxillofacial Surgery Teaching and Research Section, School of Stomatology, Qingdao University, Qingdao, PR China
| | - Guowei Wang
- Associate Professor, Department of Stomatology, No. 971 Hospital of the Chinese Navy, Qingdao, Shandong, PR China
| | - Yimin Zhao
- Professor, State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Digital Dentistry, Center, School of Stomatology, The Fourth Military Medical University, Xi'an, PR China
| | - Xiaojing Wang
- Associate Professor, Department of Oral Implantology, The Affiliated Hospital of Qingdao University, Qingdao, PR China; Associate Professor, Oral and Maxillofacial Surgery Teaching and Research Section, School of Stomatology, Qingdao University, Qingdao, PR China.
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Elnashoukaty HM, ElDakkak S, Abdelhakim A. Accuracy of a custom two-piece surgical guide for all-on-four dental implant placement: An in vitro study. J Prosthet Dent 2023:S0022-3913(23)00279-2. [PMID: 37230911 DOI: 10.1016/j.prosdent.2023.04.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 03/31/2023] [Accepted: 04/04/2023] [Indexed: 05/27/2023]
Abstract
STATEMENT OF PROBLEM Although fully guided dental implant surgery has been reported to provide a high degree of accuracy, it has disadvantages including the lack of external irrigation during osteotomy formation and the need for special drills and equipment. Whether a custom 2-piece surgical guide has sufficient accuracy is unclear. PURPOSE The purpose of this in vitro study was to design and fabricate a new surgical guide concept that fully guides the placement of implants to the desired position and angulation without affecting the external irrigation during osteotomy preparation, to eliminate the need for a special armamentarium, and to determine the accuracy of the guide. MATERIAL AND METHODS A 2-piece surgical guide was 3-dimensionally designed and fabricated. Implants were placed according to the all-on-4 concepts in laboratory casts using the newly fabricated surgical guide. Placement accuracy was determined from a postoperative cone beam computed tomography scan that was superimposed over the preplanned implant positions to calculate the degree of angular deviation and position of placement. Adopting 5% alpha error and 80% study power in estimating sample size, a total of 88 implants were placed according to the all-on-4 concept in 22 mandibular laboratory casts. These were divided into 2 groups: with the newly fabricated surgical guide and with a traditional fully guided protocol. Deviations at the point of entry, at the apex horizontally, the vertical apical depth, and angular deviations from the proposed plan were measured from the superimposed scans. Differences in apical depth, horizontal deviation at the apex, and horizontal deviation in the hexagon measurements were compared with the independent t test, while differences in angular deviation were assessed with the Mann-Whitney U test (α=.05). RESULTS No statistically significant difference was found in the apical depth deviation (P>.05), but significant differences were found in the apex (P=.002), hexagon (P<.001), and angular deviation (P<.001) between the new guide and the traditional guide. CONCLUSIONS The new surgical guide showed potential for higher accuracy in implant placement when compared with the fully guided sleeveless surgical guide. In addition, it provided an undisturbed flow of irrigation around the drill throughout the drilling procedure, with the advantage of eliminating the special armamentarium usually required.
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Affiliation(s)
- Hassan M Elnashoukaty
- Postgraduate student, Prosthodontic Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
| | - Sherif ElDakkak
- Assistant Professor, Prosthodontic Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Ahmed Abdelhakim
- Professor and Dean, Prosthodontic Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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Otaghsara SST, Joda T, Thieringer FM. Accuracy of dental implant placement using static versus dynamic computer-assisted implant surgery: An in vitro study: Accuracy of static vs. dynamic CAIS. J Dent 2023; 132:104487. [PMID: 36948382 DOI: 10.1016/j.jdent.2023.104487] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 03/06/2023] [Accepted: 03/19/2023] [Indexed: 03/24/2023] Open
Abstract
OBJECTIVES This in-vitro study compared the accuracy of implant placement using static versus dynamic computer-assisted implant surgery (CAIS) at two implant sites. METHODS Partially edentulous maxillary models were 3D-printed, and two implants (Straumann TL RN4.1 × 10mm) were inserted in FDI positions 15 and 16 per model using two CAIS approaches (10 models per approach). A three-dimensional (3D) reconstruction tool was used for implant planning, surgical guide design, and measuring implant positioning accuracy. In static CAIS, the implants were placed with 3D-printed surgical guides (n=20); in dynamic CAIS, real-time navigation was performed (n=20). Primary outcomes were defined as coronal and apical global deviation as well as angular deviations and deviation comparison between implants placed at positions 15 and 16; the secondary outcome was the bi-directional deviation in mesial-distal, buccal-palatal, and apical-coronal direction. RESULTS The mean±SD 3D-deviation at implant platform and apex levels for static CAIS in position 15 was 0.81±0.31mm, 1.41±0.37mm, and in position 16 was 0.67±0.31mm, 1.07±0.32mm. PRIMARY OUTCOMES buccal-palatal deviation is higher using static CAIS, and mesial-distal deviation is higher in dynamic CAIS. In position 15, mesial-distal deviation at the apex and the platform were lower in static approaches than in dynamic ones. In implant position 16, buccal-palatal deviation at the apex was lower in the dynamic group than with static ones. SECONDARY OUTCOMES for bi-directional analysis, buccal-palatal deviation at the platform (P=0.0028) and mesial-distal deviation at the apex (P=0.0056) were significantly lower in molar sites using static CAIS. Mesial-distal deviation at the apex (P=0.0246) revealed significantly lower values in position 16 following dynamic CAIS. CONCLUSIONS Both static and dynamic CAIS resulted in accurate implant placement. However, dynamic CAIS exhibited higher deviation in the mesial direction in an in-vitro setting. In addition, the implant site affects the accuracy of both CAIS approaches. CLINICAL SIGNIFICANCE Static CAIS demonstrates the highest accuracy for guided implant placement today.
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Affiliation(s)
- Seyedeh Sahar Taheri Otaghsara
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland; Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, Basel, Switzerland; Department of Reconstructive Dentistry, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland
| | - Tim Joda
- Department of Reconstructive Dentistry, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland; Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Florian Markus Thieringer
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland; Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, Basel, Switzerland.
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Influence of the Printing Orientation on Parallelism, Distance, and Wall Thickness of Adjacent Cylinders of 3D-Printed Surgical Guides. PROSTHESIS 2023. [DOI: 10.3390/prosthesis5010023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
This in-vitro study aimed to evaluate the influence of the printing orientation on parallelism, distance, and thickness between adjacent cylinders of 3D-printed surgical guides. CAD software was used to design a surgical guide with two adjacent parallel cylinders (reference); the design was saved as standard tessellation software (STL) and 63 samples were printed using three different orientations (0, 45, and 90 degrees). A metrology digital microscope was used to measure the distance, the angle and the thickness of the guides cylinders. Afterwards, the printed guides were scanned and cloud comparison software was used to compare STL files from the printed guides against the reference CAD model. One-way analysis of variance and Tukey test were used for multiple comparisons between groups and significance was p < 0.05. The printing orientation affected the distance between cylinders, the parallelism and the wall thickness. In addition, there were global deviations in all printing orientations. Printing with 90 degrees orientation produced almost-parallel cylinders but walls thicker than the reference model; all the cylinders converged toward the coronal but printing at 0 degrees produced the closest distance to the reference value. Within the limitations of this experimental in-vitro study it can be concluded that all the printing orientations influence the angle, the distance, and the thickness between adjacent cylinders of a surgical guide. Printing at 90 degrees produces the best global correspondence with the master model.
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Wu Q, Wu J, Tan Y, Sun J, Yu H. A chairside digital radiographic guide for registering digital casts to cone beam computed tomography scans with strong metallic artifacts. J Prosthet Dent 2023:S0022-3913(22)00758-2. [PMID: 36610844 DOI: 10.1016/j.prosdent.2022.11.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 11/07/2022] [Accepted: 11/07/2022] [Indexed: 01/06/2023]
Abstract
Accurate registration of digital casts and cone beam computed tomography (CBCT) scans with strong metallic artifacts is essential for the accuracy of guided implant surgery. This article describes a procedure for mapping digital casts onto CBCT scans containing significant scatter artifacts in the virtual implant planning stage. The technique uses a chairside segmented occlusal wing-like radiographic guide, which is constructed of digital splints fabricated using a desktop 3-dimensional printer and composite resin spheres as markers to accurately superimpose the bimaxillary digital scans onto the CBCT scans in a single procedure. This cost-effective technique is timesaving for clinicians and patients, and the digital information for implant planning can be collected in a single visit.
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Affiliation(s)
- Qin Wu
- Doctoral candidate, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
| | - Jiacheng Wu
- Graduate student, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
| | - Ying Tan
- Graduate student, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
| | - Jikui Sun
- Graduate student, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
| | - Haiyang Yu
- Professor, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China.
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12
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Alhossaini SJ, Neena AF, Issa NO, Abouelkheir HM, Gaweesh YY. Accuracy of markerless registration methods of DICOM and STL files used for computerized surgical guides in mandibles with metal restorations: An in vitro study. J Prosthet Dent 2022:S0022-3913(22)00636-9. [PMID: 36372586 DOI: 10.1016/j.prosdent.2022.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/28/2022] [Accepted: 09/28/2022] [Indexed: 11/12/2022]
Abstract
STATEMENT OF PROBLEM Digital imaging and communications in medicine (DICOM) files together with surface scans must be accurately registered in virtual implant planning software programs to match real-life dimensions and ensure correct plan transfer through computer-aided manufactured surgical guides. PURPOSE The purpose of this in vitro study was to evaluate the accuracy of 3 different registration methods of DICOM data with and without metal restorations and a metal artifact reduction (MAR) tool for surface scans. MATERIAL AND METHODS Thirteen dentate mandibles were assigned to each group of this study (n=39). Baseplate wax was adapted to the bone surfaces of each mandible, and 5 radiopaque markers were attached. A desktop scanner was used to obtain control scans. The groups of metal-free mandibles (MFM) and mandibles with metal restorations (MRM) were scanned to obtain DICOM data without a MAR tool. Additional DICOM data for the MRM were obtained with the MAR tool (MRM-MAR). Point-based registration (PBR), best-fit registration (BFR), and automatic registration (AR) were used to align standard tessellation language (STL) and DICOM data, and 3 data sets were exported. Radiographic markers on each data set were compared with those on the control scan, and positional deviations were calculated and statistically evaluated with 1-way ANOVA followed by multiple pairwise comparisons, independent samples t test, and 2-way ANOVA (α=.05). RESULTS Within each group, PBR had the lowest deviation values with statistical significance in the MFM and the MRM-MAR groups (P<.001). AR showed failure in the MRM and the MRM-MAR groups. Statistically significant differences were found on comparing the average deviations among the 3 groups for PBR only (P<.001). No association was found between deviation values and the presence or absence of metal restoration, while a positive association was found with the type of registration method (P<.001). CONCLUSIONS PBR had the highest accuracy level compared with AR and BFR methods. An increase in the number of calculations resulted in more deviation values. The MAR tool had a positive effect on PBR in mandibles with metal restorations.
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Affiliation(s)
- Sara J Alhossaini
- Postgraduate student, Department of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Faculty of Dentistry, University of Alexandria, Alexandria, Egypt
| | - Akram F Neena
- Lecturer of Prosthodontics, Department of Prosthodontics, Faculty of Dentistry, University of Alexandria, Alexandria, Egypt.
| | - Noha O Issa
- Associate Professor of Oral and Maxillofacial Radiology, Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, University of Cairo, Cairo, Egypt
| | - Hassan M Abouelkheir
- Professor of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Department of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Faculty of Dentistry, University of Alexandria, Alexandria, Egypt
| | - Yasmine Y Gaweesh
- Lecturer of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Department of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Faculty of Dentistry, University of Alexandria, Alexandria, Egypt
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13
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Brain structure segmentation and 3D printed individual craniometric rulers for cortex brain lesions. ANNALS OF 3D PRINTED MEDICINE 2022. [DOI: 10.1016/j.stlm.2022.100079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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14
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Pop SI, Dudescu M, Mihali SG, Păcurar M, Bratu DC. Effects of Disinfection and Steam Sterilization on the Mechanical Properties of 3D SLA- and DLP-Printed Surgical Guides for Orthodontic Implant Placement. Polymers (Basel) 2022; 14:polym14102107. [PMID: 35631989 PMCID: PMC9144921 DOI: 10.3390/polym14102107] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/18/2022] [Accepted: 05/19/2022] [Indexed: 02/01/2023] Open
Abstract
Three-dimensional printed surgical guides increase the precision of orthodontic mini-implant placement. The purpose of this research was to investigate the effects of disinfection and of two types of autoclave sterilization on the mechanical properties of 3D printed surgical guides obtained via the SLA (stereolithography) and DLP (digital light processing) printing methods. A total of 96 standard specimens (48 SLA and 48 DLP) were printed to analyze the tensile and flexural properties of the materials. A total of 80 surgical guide (40 SLA and 40 DLP) specimens from each printing method were classified into four groups: CG (control group); G1, disinfected with 4% Gigasept (Gigasept Instru AF; Schülke & Mayer Gmbh, Norderstedt, Germany); G2, autoclave-sterilized (121 °C); and G3, autoclave-sterilized (134 °C). Significant differences in the maximum compressive load were determined between the groups comprising the DLP-(p < 0.001) and the SLA- (p < 0.001) printed surgical guides. Groups G2 (p = 0.001) and G3 (p = 0.029) showed significant parameter modifications compared with the CG. Disinfection with 4% Gigasept (Gigasept Instru AF; Schülke & Mayer Gmbh, Norderstedt, Germany) is suitable both for SLA- and DLP-printed surgical guides. Heat sterilization at both 121 °C and 134 °C modified the mechanical properties of the surgical guides.
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Affiliation(s)
- Silvia Izabella Pop
- Orthodontic Department, Faculty of Dental Medicine, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 38 Gh. Marinescu Str., 540139 Târgu Mureș, Romania; (S.I.P.); (M.P.)
| | - Mircea Dudescu
- Department of Mechanical Engineering, Technical University of Cluj-Napoca, 28 Memorandumului Street, 400114 Cluj-Napoca, Romania
- Correspondence: (M.D.); (S.G.M.)
| | - Sorin Gheorghe Mihali
- Department of Prosthodontics, Faculty of Dentistry, “Vasile Goldis” Western University of Arad, 94 Revolutiei Blvd, 310025 Arad, Romania
- Correspondence: (M.D.); (S.G.M.)
| | - Mariana Păcurar
- Orthodontic Department, Faculty of Dental Medicine, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 38 Gh. Marinescu Str., 540139 Târgu Mureș, Romania; (S.I.P.); (M.P.)
| | - Dana Cristina Bratu
- Department of Orthodontics and Dento-Facial Orthopedics, Orthodontic Research Center, Faculty of Dental Medicine, Victor Babeș University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timișoara, Romania;
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15
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A Novel Method for Digital Reconstruction of the Mucogingival Borderline in Optical Scans of Dental Plaster Casts. J Clin Med 2022; 11:jcm11092383. [PMID: 35566508 PMCID: PMC9099921 DOI: 10.3390/jcm11092383] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 04/22/2022] [Accepted: 04/22/2022] [Indexed: 12/14/2022] Open
Abstract
Adequate soft-tissue dimensions have been shown to be crucial for the long-term success of dental implants. To date, there is evidence that placement of dental implants should only be conducted in an area covered with attached gingiva. Modern implant planning software does not visualize soft-tissue dimensions. This study aims to calculate the course of the mucogingival borderline (MG-BL) using statistical shape models (SSM). Visualization of the MG-BL allows the practitioner to consider the soft tissue supply during implant planning. To deploy an SSM of the MG-BL, healthy individuals were examined and the intra-oral anatomy was captured using an intra-oral scanner (IOS). The empirical anatomical data was superimposed and analyzed by principal component analysis. Using a Leave-One-Out Cross Validation (LOOCV), the prediction of the SSM was compared with the original anatomy extracted from IOS. The median error for MG-BL reconstruction was 1.06 mm (0.49–2.15 mm) and 0.81 mm (0.38–1.54 mm) for the maxilla and mandible, respectively. While this method forgoes any technical work or additional patient examination, it represents an effective and digital method for the depiction of soft-tissue dimensions. To achieve clinical applicability, a higher number of datasets has to be implemented in the SSM.
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Comparison of Implant Placement Accuracy in Healed and Fresh Extraction Sockets between Static and Dynamic Computer-Assisted Implant Surgery Navigation Systems: A Model-Based Evaluation. MATERIALS 2022; 15:ma15082806. [PMID: 35454496 PMCID: PMC9030091 DOI: 10.3390/ma15082806] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 03/10/2022] [Accepted: 04/07/2022] [Indexed: 02/01/2023]
Abstract
The aim of this model-base study was to compare the accuracy of implant placement between static and dynamic computer-assisted implant surgery (CAIS) systems in a fresh extraction socket and healed ridge. A randomized in vitro study was conducted. Twenty 3D-printed maxillary models and 80 implants were used. One experienced researcher placed the implants using either the static navigation or dynamic navigation system. Accuracy was measured by overlaying the real position in the postoperative CBCT on the virtual presurgical placement of the implant in a CBCT image. Descriptive and bivariate analyses of the data were performed. In the fresh sockets, the mean deviation was 1.24 ± 0.26 mm (entry point), 1.69 ± 0.34 mm (apical point), and 3.44 ± 1.06° (angle discrepancy) in the static CAIS group, and 0.60 ± 0.29 mm, 0.78 ± 0.33 mm, and 2.47 ± 1.09° in the dynamic CIAS group, respectively. In the healed ridge, the mean deviation was 1.09 ± 0.17 mm and 1.40 ± 0.30 mm, and 2.12 ± 1.11° in the static CAIS group, and 0.80 ± 0.29 mm, 0.98 ± 0.37 mm, and 1.69 ± 0.76° in the dynamic CIAS group, respectively. Compared with the static CAIS system, the dynamic CAIS system resulted in significantly lower entry and apical errors in both fresh sockets and healed ridges. Differences in bone morphology therefore seem to have little effect on accuracy in the dynamic CAIS group.
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Matsumura A, Nakano T, Ono S, Kaminaka A, Yatani H, Kabata D. Multivariate analysis of causal factors influencing accuracy of guided implant surgery for partial edentulism: a retrospective clinical study. Int J Implant Dent 2021; 7:28. [PMID: 33870473 PMCID: PMC8053739 DOI: 10.1186/s40729-021-00313-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 03/01/2021] [Indexed: 11/10/2022] Open
Abstract
Abstract Background In dental implant treatment, the placement position of the implant body is important. The hypothesis is that there are factors that have a greater impact than the factors that have been studied so far. Material and Methods The deviation between planned and actually placed implants was measured three-dimensionally by modified treatment evaluation method in 110 patients who underwent implant placement with guided surgery for partial edentulism. Ten factors that seemed to affect errors in placement were selected: the type of tooth, type of edentulism, distance from the remaining teeth, the type of implant, implant length, number of implants, method of guidance, the number of teeth supporting the surgical guide, number of anchor pins, and presence or absence of a reinforcement structure. The effect of each factor that corrected each confounding was calculated using multivariate analysis. Results In this study, 188 implant bodies were set to target, and the errors measurement data of the implant position were as follows: average Angle, 2.5 ± 1.6° (95% CI 2.25–2.69); Base, 0.67 ± 0.37 mm (95% CI 0.62–0.72); and Apex, 0.92 ± 0.47 mm (95% CI 0.86–0.98). As the result of multivariate analysis, larger errors were present in the partially guided group than the fully guided group. The number of teeth supporting the surgical guide significantly influenced the error in placement position. The error caused by the number of anchor pins was significantly different for the Angle. Similarly, the presence of the reinforcement structure influenced the error significantly for the Angle. Conclusions It was suggested that the smaller errors could be present by performing guided surgery with full guidance and devising the design of the guide such as the number of teeth supporting the surgical guide, the setting of the anchor pin, and the reinforcement structure.
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Affiliation(s)
- Atsushi Matsumura
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Tamaki Nakano
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - Shinji Ono
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Akihiro Kaminaka
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Hirofumi Yatani
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Daijiro Kabata
- Department of Medical Statistics, Osaka City University Graduate School of Medicine, 1-4-3 Asahi, Abeno-ku, Osaka, 545-8585, Japan
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18
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Wu D, Zhou L, Yang J, Zhang B, Lin Y, Chen J, Huang W, Chen Y. Accuracy of dynamic navigation compared to static surgical guide for dental implant placement. Int J Implant Dent 2020; 6:78. [PMID: 33230662 PMCID: PMC7683639 DOI: 10.1186/s40729-020-00272-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 10/27/2020] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES To compare the accuracy of dynamic navigation (DN) with a static surgical guide (SSG) for dental implant placement and the influence factors such as the experience of the surgeon and the implant sites. METHODS AND MATERIALS A total of 38 implants, which underwent the dynamic navigation, and 57 implants which underwent a static surgical guide were enrolled in the retrospective study. Coronal deviation, apical deviation, and angular deviation were compared between the DN and SSG groups, along with the different experience level of surgeons and implant sites in the DN group. RESULTS There were no statistically significant differences between the DN and SSG groups, and the experience level of the surgeons and implant sites in the DN group. However, the apical deviation of the DN was slightly higher than the SSG group in the anterior teeth (P = 0.028), and the angular deviation of DN was smaller than the SSG group in the molar. CONCLUSION Dynamic navigation can achieve accurate implant placement as well as the static surgical guide. Additionally, the experience level of the surgeon and implant site do not influence the accuracy of dynamic navigation, while the accuracy of DN seems higher than the SSG in molar.
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Affiliation(s)
- Dong Wu
- Research Center of Dental and Craniofacial Implants, Fujian Medical University, Fujian, 350001, China
| | - Lin Zhou
- Department of Oral Implantology, Affiliated Stomatological Hospital of Fujian Medical University, Fujian, 350001, China
| | - Jin Yang
- Fujian Provincial Engineering Research Center of Oral Biomaterial, Fujian Medical University, Fujian, 350001, China
| | - Bao Zhang
- MDS, Stomatological Key lab of Fujian College and University, Fujian Medical University, Fujian, 350001, China
| | - Yanjun Lin
- MDS, Stomatological Key lab of Fujian College and University, Fujian Medical University, Fujian, 350001, China
| | - Jiang Chen
- MDS, Stomatological Key lab of Fujian College and University, Fujian Medical University, Fujian, 350001, China
| | - Wenxiu Huang
- Department of Oral Implantology, Affiliated Stomatological Hospital of Fujian Medical University, Fujian, 350001, China.
| | - Yonghui Chen
- Department of Stomatology, Zhangzhou Affiliated Hospital of Fujian Medical University, Fujian, 363000, China.
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Abstract
Guides used in dental implant surgery add accuracy and an overall predictability. Successful guided implant workflow depends on 3-dimensional image acquisition and precise medical model fabrication. The contemporary process blends acquired images to existing dentition to create implant-specific precise guides. We discuss the overall process, types of guides, and complications to expect during surgery.
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Affiliation(s)
- Peter Chen
- Department of Oral and Maxillofacial Surgery, Woodhull Hospital, 760 Broadway, Brooklyn, NY 11206, USA; Department of Dentistry, Woodhull Hospital, 760 Broadway, Brooklyn, NY 11206, USA.
| | - Levon Nikoyan
- Department of Oral and Maxillofacial Surgery, Woodhull Hospital, 760 Broadway, Brooklyn, NY 11206, USA; Department of Dentistry, Woodhull Hospital, 760 Broadway, Brooklyn, NY 11206, USA; Private Practice, Forward Oral Surgery, 248-62 Jericho Tpke, Floral Park, NY 11001, USA
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20
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Putra RH, Yoda N, Iikubo M, Kataoka Y, Yamauchi K, Koyama S, Cooray U, Astuti ER, Takahashi T, Sasaki K. Influence of bone condition on implant placement accuracy with computer-guided surgery. Int J Implant Dent 2020; 6:62. [PMID: 32951152 PMCID: PMC7502099 DOI: 10.1186/s40729-020-00249-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 08/12/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The impact of the jaw bone condition, such as bone quantity and quality in the implant placement site, affecting the accuracy of implant placement with computer-guided surgery (CGS) remains unclear. Therefore, this study aimed to evaluate the influence of bone condition, i.e., bone density, bone width, and cortical bone thickness at the crestal bone on the accuracy of implant placement with CGS. METHODS A total of 47 tissue-level implants from 25 patients placed in the posterior mandibular area were studied. Implant placement position was planned on the simulation software, Simplant® Pro 16, by superimposing preoperative computed tomography images with stereolithography data of diagnostic wax-up on the dental cast. Implant placement surgery was performed using the surgical guide plate to reflect the planned implant position. The post-surgical dental cast was scanned to determine the position of the placed implant. Linear and vertical deviations between planned and placed implants were calculated. Deviations at both platform and apical of the implant were measured in the bucco-lingual and mesio-distal directions. Intra- and inter-observer variabilities were calculated to ensure measurement reliability. Multiple linear regression analysis was employed to investigate the effect of the bone condition, such as density, width, and cortical bone thickness at the implant site area, on the accuracy of implant placement (α = 0.05). RESULT Intra- and inter-observer variabilities of these measurements showed excellent agreement (intra class correlation coefficient ± 0.90). Bone condition significantly influenced the accuracy of implant placement using CGS (p < 0.05). Both bone density and width were found to be significant predictors. CONCLUSIONS Low bone density and/or narrow bucco-lingual width near the alveolar bone crest in the implant placement site might be a risk factor influencing the accuracy of implant placement with CGS.
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Affiliation(s)
- Ramadhan Hardani Putra
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1, Seiryo-machi, Sendai, Miyagi, 980-8575, Japan.,Department of Dentomaxillofacial Radiology, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Nobuhiro Yoda
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1, Seiryo-machi, Sendai, Miyagi, 980-8575, Japan.
| | - Masahiro Iikubo
- Division of Oral Diagnosis, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Yoshihiro Kataoka
- Division of Oral and Maxillofacial Surgery, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Kensuke Yamauchi
- Division of Oral and Maxillofacial Surgery, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Shigeto Koyama
- Maxillofacial Prosthetics Clinic, Tohoku University Hospital, Sendai, Japan
| | - Upul Cooray
- Division of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Eha Renwi Astuti
- Department of Dentomaxillofacial Radiology, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Tetsu Takahashi
- Division of Oral and Maxillofacial Surgery, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Keiichi Sasaki
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1, Seiryo-machi, Sendai, Miyagi, 980-8575, Japan
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Kalaivani G, Balaji VR, Manikandan D, Rohini G. Expectation and reality of guided implant surgery protocol using computer-assisted static and dynamic navigation system at present scenario: Evidence-based literature review. J Indian Soc Periodontol 2020; 24:398-408. [PMID: 33144766 PMCID: PMC7592620 DOI: 10.4103/jisp.jisp_92_20] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 05/15/2020] [Accepted: 06/14/2020] [Indexed: 11/25/2022] Open
Abstract
In the field of modern dentistry, ideal three-dimensional positioning of dental implant with optimal prosthetic fit offers successful long-term outcomes. To achieve such accurate implant placement, presurgical evaluation of hard and soft tissue matters the most. Their efforts can be attained using various application programs such as digital imaging, implant planning software, laboratory- or computer-assisted surgical guides, and dynamic navigation approach. To overcome different opinions and choices regarding guided surgery, this article explains an evidence-based literature review to assess its various outcomes and allowing informed choices before using various guided surgical techniques based on its expectation and reality outcomes. This highlights a clinician's choice to guide his successful implant surgery without causing distress in the midway of treatment. An online search was done on PubMed/Medline database to bring in accuracy to the expertise. This review includes reference of publications from 2000 to 2019, which is related to promising outcomes using computer-assisted static or dynamic navigation system for the placement of implant. Out of these, 809 were related to the computer-guided implant placement. Relevant papers were chosen in accordance with the inclusion and exclusion criteria. This review article contemplates to reflect the fact that computer-guided approach is considered to offer more predictable, safer, and faster implant placement with the predetermined final prosthetic outfit. Thus, digital planning and placing of dental implants in the correct position keep escalating to a higher achievement levels than a classical freehand approach. Nevertheless, this guided surgical approach also holds some errors and risks, which must be identified and rectified.
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Affiliation(s)
- Gunalan Kalaivani
- Department of Periodontology and Implant Dentistry, CSI College of Dental Sciences and Research, Madurai, Tamil Nadu, India
| | | | - Dhanasekaran Manikandan
- Department of Periodontology and Implant Dentistry, CSI College of Dental Sciences and Research, Madurai, Tamil Nadu, India
| | - Govindasamy Rohini
- Department of Periodontology and Implant Dentistry, CSI College of Dental Sciences and Research, Madurai, Tamil Nadu, India
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Talmazov G, Bencharit S, Waldrop TC, Ammoun R. Accuracy of Implant Placement Position Using Nondental Open-Source Software: An In Vitro Study. J Prosthodont 2020; 29:604-610. [PMID: 32495453 DOI: 10.1111/jopr.13208] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 05/29/2020] [Accepted: 05/31/2020] [Indexed: 12/01/2022] Open
Abstract
PURPOSE To evaluate the accuracy of implant placement position using two different dental implant planning software. MATERIALS AND METHODS A set of Digital Imaging and Communications in Medicine (DICOM) files from a cone beam computed tomography of a patient missing maxillary right first premolar was used. Implant planning was done using two open-source programs: A nondental 3D Slicer/Blender (3DSB) software and a commercial dental implant treatment planning program: Blue Sky Plan 4 (BSP4). An intraoral scan of the same patient was used to create a standard tessellation language (STL) file of the maxillary arch and later printed into 20 identical casts. Ten surgical guides were printed for each group as well. A dental implant (3.8 mm × 12 mm, Biohorizons) was placed into each cast using fully guided surgical protocol. The horizontal displacements at the implant cervical platform and at the implant apex as well as the angulation displacements were measured using digital scanning of the implant scan bodies and were analyzed using a 3D compare software. Statistical analyses were conducted (⍺ = 0.05) using t-test and F-test to examine differences in trueness and precision, respectively. RESULTS The average horizontal deviations for the platform and the apex, respectively, were 0.33 ± 0.12 mm and 0.76 ± 0.30 mm for 3DSB and 0.44 ± 0.21 mm and 0.98 ± 0.48 mm for BSP4. The average angulation deviations for 3DSB and BSB4 were 2.34 ± 0.93° and 3.07 ± 1.57°, respectively. There were no statistical differences in the means (t-test) of the platform, apex, and angulation deviations (p = 0.16, p = 0.19, and p = 0.18, respectively). There were statistical differences in the variances (F test) of the platform (p = 0.043) and angulation (p = 0.049) deviations but not the apex (p = 0.059) deviations. CONCLUSIONS The combination of nondental open-source software, 3D Slicer/Blender can be used to plan implant guided surgery with an accuracy similar to commercial dental software with slightly higher precision. Open-source nondental software can be considered as an alternative in dental implant treatment planning and guided surgery.
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Affiliation(s)
- Georgi Talmazov
- Department of General Practice, School of Dentistry, Virginia Commonwealth University, Richmond, VA
| | - Sompop Bencharit
- Department of General Practice, School of Dentistry, Virginia Commonwealth University, Richmond, VA.,Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, VA.,Department of Oral & Maxillofacial Surgery, School of Dentistry Commonwealth University, Richmond, VA
| | | | - Rami Ammoun
- Department of Prosthodontics, School of Dentistry, Virginia Commonwealth University, Richmond, VA
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Kim U, Kim S, Kim E. The application of "bone window technique" using piezoelectric saws and a CAD/CAM-guided surgical stent in endodontic microsurgery on a mandibular molar case. Restor Dent Endod 2020; 45:e27. [PMID: 32839708 PMCID: PMC7431938 DOI: 10.5395/rde.2020.45.e27] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 02/25/2020] [Accepted: 02/25/2020] [Indexed: 11/25/2022] Open
Abstract
Apical surgery for a mandibular molar is still challenging for many reasons. This report describes the applications of computer-guided cortical ‘bone-window technique’ using piezoelectric saws that prevented any nerve damage in performing endodontic microsurgery of a mandibular molar. A 49-year-old woman presented with gumboil on tooth #36 (previously endodontically treated tooth) and was diagnosed with chronic apical abscess. Periapical lesions were confirmed using cone-beam computed tomography (CBCT). Endodontic microsurgery for the mesial and distal roots of tooth #36 was planned. Following the transfer of data of the CBCT images and the scanned cast to an implant surgical planning program, data from both devices were merged. A surgical stent was designed, on the superimposed three-dimensional model, to guide the preparation of a cortical window on the buccal side of tooth #36. Endodontic microsurgery was performed with a printed surgical template. Minimal osteotomy was required and preservation of the buccal cortical plate rendered this endodontic surgery less traumatic. No postoperative complications such as mental nerve damage were reported. Window technique guided by a computer-aided design/computer-aided manufacture based surgical template can be considerably useful in endodontic microsurgery in complicated cases.
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Affiliation(s)
- Ukseong Kim
- Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, Yonsei University College of Dentistry, Seoul, Korea
| | - Sunil Kim
- Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, Yonsei University College of Dentistry, Seoul, Korea
| | - Euiseong Kim
- Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, Yonsei University College of Dentistry, Seoul, Korea.,Department of Electrical & Electronic Engineering, Yonsei University College of Engineering, Seoul, Korea
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Henprasert P, Dawson DV, El-Kerdani T, Song X, Couso-Queiruga E, Holloway JA. Comparison of the Accuracy of Implant Position Using Surgical Guides Fabricated by Additive and Subtractive Techniques. J Prosthodont 2020; 29:534-541. [PMID: 32147893 DOI: 10.1111/jopr.13161] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2020] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To evaluate the accuracy of implant position using surgical guides fabricated by additive and subtractive techniques. MATERIALS AND METHODS A partially edentulous standardized mandibular implant model with different bone densities and soft tissue was duplicated and a diagnostic wax-up was performed for the #30 area. A reference radiographic guide was fabricated and cone beam computed tomography (CBCT) was made with the reference radiographic guide in place. A surgical guide was designed using BlueSky Plan 4 software and a reference implant was placed in the #30 region. The STL file of the surgical guide was exported and specimens (n = 15) were fabricated by two different techniques: additive (3D printing) and subtractive (milling). The standardized mandibular model was surface-scanned and duplicated with printed dental model resin (n = 30). Each surgical guide was used to place an implant in thirty duplicate printed models. Differences in implant position as compared to the reference were measured from digital scans with scan bodies in place. The angular deviations, differences in depth, coronal and apical deviations were measured using GeoMagic Control X software. Results were analyzed by Wilcoxon-Mann-Whitney test and PERMANOVA (Permutational Multivariate Analysis of Variance). Intraclass correlation was used to assess measurement reproducibility with Bonferroni adjustment for multiple testing as needed (α = 0.05). RESULTS There were no significant differences in accuracy of implant placement using guides fabricated using additive vs subtractive techniques. The mean angular deviations between the reference and actual position of implant in mesio-distal cross-section were 0.780 ± 0.80° for printed group and 0.77 ± 0.72° for the milled group. The differences in bucco-lingual cross-section were 1.60 ± 1.22° in in printed group and 1.77 ± 0.76° in the milled group. The differences in depth (mm) were measured at the top of the scan body at four locations: mesial, distal, buccal and lingual. The mean differences in depth for the group that used printed surgical guides were (mesial) 0.37 ± 0.29 mm, (distal) 0.32 ± 0.23 mm, (buccal) 0.24 ± 0.23 mm, and (lingual) 0.25 ± 0.17 mm. The mean differences in depth for the group that used milled surgical guides were (mesial) 0.51 ± 0.33 mm, (distal) 0.40 ± 0.32 mm, (buccal) 0.22 ± 0.23 mm, and (lingual) 0.23 ± 0.12 mm in those four aspects, respectively. The mean coronal deviation showed 0.32 mm in the printed group and 0.27 mm in the milled group. For the apical deviation, the results of this study showed mean apical deviation 0.84 mm in the printed group and 0.80 mm in the milled group. CONCLUSIONS Results indicate that 3D-printed surgical guides are statistically as accurate as milled guides for guided-implant surgery with the benefits of high accuracy, ease of fabrication, less waste compared to subtractive techniques, and reduction of laboratory time thereby increasing cost-effectiveness.
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Affiliation(s)
- Pantip Henprasert
- Department of Prosthodontics, University of Iowa College of Dentistry, Iowa City, IA
| | - Deborah V Dawson
- Iowa Institute for Oral Health Research, The University of Iowa College of Dentistry & Dental Clinics, Iowa City, IA
| | - Tarek El-Kerdani
- Department of Prosthodontics, University of Iowa College of Dentistry, Iowa City, IA
| | - Xuan Song
- Department of Mechanical and Industrial Engineering, University of Iowa, Iowa City, IA
| | | | - Julie A Holloway
- Department of Prosthodontics, University of Iowa College of Dentistry, Iowa City, IA
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25
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2D/3D accuracies of implant position after guided surgery using different surgical protocols: A retrospective study. J Prosthodont Res 2020; 64:424-430. [PMID: 32063539 DOI: 10.1016/j.jpor.2019.11.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 09/25/2019] [Accepted: 11/26/2019] [Indexed: 11/21/2022]
Abstract
PURPOSE To compare the 2D and 3D positional accuracy of four guided surgical protocols using an analysis of linear and angular deviations. METHODS DICOM and .STLs files obtained from a CBCT and a digital impression were superimposed with software to plan implant position. Fifty-six patients were subdivided into 4 groups: FGA group (template support [Ts]: teeth [T]; bed preparation [Bp]: fully guided [FG]; implant insertion [Ii]: 3D template [3Dt]; device [D]: manual adapter [MA], FGM group (Ts: T; Bp: FG; Ii: 3Dt; D: fully guided mounter [FGM]), PG group (Ts: T; Bp: FG; Ii: manual; D: none) and MS group (Ts: mucosa; Bp: FG; Ii: 3Dt; D: FGM). The position of 120 implants was assessed by superimposing the planned and final position recorded with a digital impression. RESULTS In FGA group, 3D deviations were 0.92 ± 0.52 mm at the implant head and 1.14 ± 0.54 mm at the apex, and the angular deviation (ang. dev.) was 2.45 ± 1.24°. In FGM group, were 0.911 ± 0.44 mm (head) and 1.11 ± 0.54 mm (apex), and the ang. dev. was 2.73 ± 1.96°. In PG group, were 0.95 ± 0.47 mm (head) and 1.17 ± 0.488 mm (apex), and the ang. dev. was 3.71 ± 1.67°. In MS group, were 1.15 ± 0.45 mm (head) and 1.42 ± 0.45 mm (apex), and the ang. dev. was 4.19 ± 2.62°. Ang. dev. of MS group was different from the other groups (P < 0.05). CONCLUSIONS Guided surgery showed a sufficient accuracy.
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26
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Tatakis DN, Chien HH, Parashis AO. Guided implant surgery risks and their prevention. Periodontol 2000 2019; 81:194-208. [PMID: 31407433 DOI: 10.1111/prd.12292] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Ideal implant placement may reduce surgical complications, such as nerve injury and lingual cortical plate perforation, and minimize the likelihood of functional and prosthetic compromises. Guided implant surgery (GIS) has been used as the means to achieve ideal implant placement. GIS refers to the process of digital planning, custom-guide fabrication, and implant placement using the custom guide and an implant system-specific guided surgery kit. GIS includes numerous additional steps beyond the initial prosthetic diagnosis, treatment planning, and fabrication of surgical guide. Substantial errors can occur at each of these individual steps and can accumulate, significantly impacting the final accuracy of the process with potentially disastrous deviations from proper implant placement. Pertinent overall strategies to reduce or eliminate these risks can be summarized as follows: complete understanding of the possible risks is fundamental; knowledge of the systems and tools used is essential; consistent verification of both diagnostic and surgical procedures after each step is crucial; proper training and surgical experience are critical. This review article summarizes information on the accuracy and efficacy of GIS, provides insight on the potential risks and problems associated with each procedural step, and offers clinically relevant recommendations to minimize or eliminate these risks.
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Affiliation(s)
- Dimitris N Tatakis
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, Ohio, USA
| | - Hua-Hong Chien
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, Ohio, USA
| | - Andreas O Parashis
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, Ohio, USA.,Private Practice Limited to Periodontology and Implant Surgery, Athens, Greece
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Paulo SF, Relvas F, Nicolau H, Rekik Y, Machado V, Botelho J, Mendes JJ, Grisoni L, Jorge J, Lopes DS. Touchless interaction with medical images based on 3D hand cursors supported by single-foot input: A case study in dentistry. J Biomed Inform 2019; 100:103316. [PMID: 31669287 DOI: 10.1016/j.jbi.2019.103316] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 09/22/2019] [Accepted: 10/20/2019] [Indexed: 10/25/2022]
Abstract
Feet input can support mid-air hand gestures for touchless medical image manipulation to prevent unintended activations, especially in sterile contexts. However, foot interaction has yet to be investigated in dental settings. In this paper, we conducted a mixed methods research study with medical dentistry professionals. To this end, we developed a touchless medical image system in either sitting or standing configurations. Clinicians could use both hands as 3D cursors and a minimalist single-foot gesture vocabulary to activate manipulations. First, we performed a qualitative evaluation with 18 medical dentists to assess the utility and usability of our system. Second, we used quantitative methods to compare pedal foot-supported hand interaction and hands-only conditions next to 22 medical dentists. We expand on previous work by characterizing a range of potential limitations of foot-supported touchless 3D interaction in the dental domain. Our findings suggest that clinicians are open to use their foot for simple, fast and easy access to image data during surgical procedures, such as dental implant placement. Furthermore, 3D hand cursors, supported by foot gestures for activation events, were considered useful and easy to employ for medical image manipulation. Even though most clinicians preferred hands-only manipulation for pragmatic purposes, feet-supported interaction was found to provide more precise control and, most importantly, to decrease the number of unintended activations during manipulation. Finally, we provide design considerations for future work exploring foot-supported touchless interfaces for sterile settings in Dental Medicine, regarding: interaction design, foot input devices, the learning process and camera occlusions.
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Affiliation(s)
- Soraia Figueiredo Paulo
- INESC-ID Lisboa, IST Taguspark, Avenida Professor Cavaco Silva, 2744-016 Porto Salvo, Portugal; Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais 1, 1049-001 Lisboa, Portugal
| | - Filipe Relvas
- INESC-ID Lisboa, IST Taguspark, Avenida Professor Cavaco Silva, 2744-016 Porto Salvo, Portugal; Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais 1, 1049-001 Lisboa, Portugal
| | - Hugo Nicolau
- INESC-ID Lisboa, IST Taguspark, Avenida Professor Cavaco Silva, 2744-016 Porto Salvo, Portugal; Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais 1, 1049-001 Lisboa, Portugal
| | - Yosra Rekik
- Université Polytechnique Hauts-de-France, CNRS UMR 8201, LAMIH, France
| | - Vanessa Machado
- Clinical Research Unit, CiiEM, Instituto Universitário Egas Moniz, Portugal
| | - João Botelho
- Clinical Research Unit, CiiEM, Instituto Universitário Egas Moniz, Portugal
| | - José João Mendes
- Clinical Research Unit, CiiEM, Instituto Universitário Egas Moniz, Portugal
| | | | - Joaquim Jorge
- INESC-ID Lisboa, IST Taguspark, Avenida Professor Cavaco Silva, 2744-016 Porto Salvo, Portugal; Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais 1, 1049-001 Lisboa, Portugal
| | - Daniel Simões Lopes
- INESC-ID Lisboa, IST Taguspark, Avenida Professor Cavaco Silva, 2744-016 Porto Salvo, Portugal; Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais 1, 1049-001 Lisboa, Portugal.
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28
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Tavares WLF, Fonseca FO, Maia LM, de Carvalho Machado V, França Alves Silva NR, Junior GM, Ribeiro Sobrinho AP. 3D Apicoectomy Guidance: Optimizing Access for Apicoectomies. J Oral Maxillofac Surg 2019; 78:357.e1-357.e8. [PMID: 31743656 DOI: 10.1016/j.joms.2019.10.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 10/20/2019] [Accepted: 10/21/2019] [Indexed: 10/25/2022]
Abstract
When conventional endodontic treatment resources are depleted, endodontic surgery becomes an alternative treatment for apical periodontitis to remove unreachable infected areas and seal the root canal. Digital workflows have been used more frequently in many dental applications in recent years. In endodontics, virtual 3-dimensional (3D) planning and endodontic guidance are new aspects important for the treatment of complex cases. This report aimed to present 3D Apicoectomy Guidance, a novel method of performing guided ultraconservative endodontic surgery with conventional implant-guided drills, and to describe its application in a case with a complex anatomic scenario and intimate contact with the maxillary sinus. Implantology computer software, as well as cone-beam computed tomography images and a digital scanning 3D impression, enabled virtual planning of the surgical procedure. Subsequently, a 3D template was produced to guide the instruments used in the osteotomy and root resection. The patient was completely asymptomatic at the 1-week follow-up visit. Cone-beam computed tomography scans were performed at 1 and 6 months after surgery and showed that resection of the apex of the root was performed accurately and that a thin dentin slice remained distally, preventing the rupture of the sinus membrane. The patient remained asymptomatic, and the tissue healed normally. The method used was shown to be very straightforward and reliable. This method allowed the patient to be treated expeditiously with very precise tissue removal.
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Affiliation(s)
- Warley Luciano Fonseca Tavares
- Professor, Department of Restorative Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
| | - Francielen Oliveira Fonseca
- Resident, Department of Restorative Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Lucas Moreira Maia
- Resident, Department of Restorative Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Nelson Renato França Alves Silva
- Professor, Department of Restorative Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Antônio Paulino Ribeiro Sobrinho
- Department Head, Department of Restorative Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Hamilton A, Jamjoom F, Doliveux S, Gallucci GO, Friedland B. Radiographic markers for merging virtual data sets. J Prosthet Dent 2019; 122:5-9. [DOI: 10.1016/j.prosdent.2018.08.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 08/21/2018] [Accepted: 08/22/2018] [Indexed: 10/27/2022]
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30
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Jamjoom FZ, Yilmaz B, Johnston WM. Impact of number of registration points on the positional accuracy of a prosthetic treatment plan incorporated into a cone beam computed tomography scan by surface scan registration: An in vitro study. Clin Oral Implants Res 2019; 30:826-832. [PMID: 31161678 DOI: 10.1111/clr.13490] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 04/05/2019] [Accepted: 05/30/2019] [Indexed: 01/05/2023]
Abstract
OBJECTIVES To evaluate the accuracy of a prosthetic treatment plan incorporation into a cone beam computed tomography (CBCT) scan using point-based registration with three registration points selected and to evaluate the impact of number of registration points on prosthetic plan accuracy. MATERIAL AND METHODS A CBCT scan of a completely dentate master model with removable teeth was exposed after removing the mandibular left first premolar, second premolar, and first molar. A digital scan of the master model with all teeth present was made by scanning a stone replica using a laboratory scanner. The digital model was registered onto the three-dimensional (3D) volume rendering of the CBCT scan using implant planning software. The point-based registration was repeated using three, four, five, six, seven, eight, nine, and 10 reference points. Metrology software was used to measure the 3D deviation of the registered models for each reference point group on standard tessellation language (STL) files obtained from the CBCT scans. An STL file of the master model with all teeth present obtained from another CBCT scan was used as reference. RESULTS Using three registration points, the registered prosthetic plan had a mean absolute deviation of 17.63 µm from the reference. Increasing the number of registration points failed to demonstrate statistically significant effects on the deviation (p > 0.05). CONCLUSIONS For this clinical scenario, three registration points provided adequate accuracy for prosthetic plan incorporation into CBCT scans. Increasing the number of registration points had no significant impact on the prosthetic plan accuracy in this study.
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Affiliation(s)
- Faris Z Jamjoom
- Advanced Graduate Program in Implant Dentistry, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts
| | - Burak Yilmaz
- Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, Ohio
| | - William M Johnston
- Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, Ohio
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31
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Kaewsiri D, Panmekiate S, Subbalekha K, Mattheos N, Pimkhaokham A. The accuracy of static vs. dynamic computer-assisted implant surgery in single tooth space: A randomized controlled trial. Clin Oral Implants Res 2019; 30:505-514. [PMID: 31060099 DOI: 10.1111/clr.13435] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 02/21/2019] [Accepted: 03/28/2019] [Indexed: 12/01/2022]
Abstract
OBJECTIVES The aim of this RCT was to compare the accuracy of implant placement between static and dynamic computer-assisted implant surgery (CAIS) systems in single tooth space. MATERIALS AND METHODS A total of 60 patients in need of a single implant were randomly assigned to two CAIS groups (Static n = 30, Dynamic n = 30) and implants were placed by one surgeon. Preoperative CBCT was transferred to implant planning software to plan the optimal implant position. Implants were placed using either stereolithographic guide template (Static CAIS) or implant navigation system (Dynamic CAIS). Postoperative CBCT was imported to implant planning software, and deviation analysis with the planned position was performed. Primary outcomes were the deviation measurements at implant platform, apex, and angle of placement. Secondary outcome was the distribution of the implant deviation into each 3D direction. RESULTS The mean deviation at implant platform and implant apex in the static CAIS group was 0.97 ± 0.44 mm and 1.28 ± 0.46 mm, while that in the dynamic CAIS group was 1.05 ± 0.44 mm and 1.29 ± 0.50 mm, respectively. The angular deviation in static and dynamic CAIS group was 2.84 ± 1.71 degrees and 3.06 ± 1.37 degrees. None of the above differences between the two groups reached statistical significance. The deviation of implants toward the mesial direction in dynamic CAIS group was significantly higher than that of the static CAIS (p = 0.032). CONCLUSIONS Implant placement accuracy in single tooth space using dynamic CAIS appear to be the same to that of static CAIS. (Thai Clinical Trials Registry TCTR20180826001).
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Affiliation(s)
- Dechawat Kaewsiri
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Soontra Panmekiate
- Department of Radiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Keskanya Subbalekha
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Nikos Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.,Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Atiphan Pimkhaokham
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
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Abstract
The advancement of technology often provides clinicians and patients better clinical alternatives to achieve optimal treatment outcomes. Computer-guided options allow clinicians to realize the virtual prosthodontically driven surgical plan, facilitating more predictable implant placement. Although the use of technology does not mean the clinicians can forgo the fundamental treatment principles when treating a patient, proper assessment and diagnostic approach from prosthodontic, surgical, and radiographic perspectives are still essential for a successful clinical outcome. The purpose of this article is to review the fundamental concepts for the use of computer-guided surgery to facilitate prosthodontic treatment.
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Affiliation(s)
- Dean Morton
- Department of Prosthodontics, Indiana University School of Dentistry, 1121 West Michigan Street, DS-S408, Indianapolis, IN 46202-5186, USA.
| | - Kamolphob Phasuk
- Department of Prosthodontics, Indiana University School of Dentistry, 1121 West Michigan Street, DS-S408, Indianapolis, IN 46202-5186, USA
| | - Waldemar D Polido
- Department of Oral Surgery and Hospital Dentistry, Indiana University School of Dentistry, 1121 West Michigan Street, DS-S408, Indianapolis, IN 46202-5186, USA
| | - Wei-Shao Lin
- Department of Prosthodontics, Indiana University School of Dentistry, 1121 West Michigan Street, DS-S408, Indianapolis, IN 46202-5186, USA
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33
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Jones A. Accuracy of mucosa supported guided dental implant surgery. Clin Case Rep 2018; 6:2131-2139. [PMID: 30455906 PMCID: PMC6230664 DOI: 10.1002/ccr3.1809] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 08/19/2018] [Accepted: 08/21/2018] [Indexed: 12/18/2022] Open
Abstract
Implant deviation at platform and apex was comparable to that seen in similar studies, showing that Mucosa Supported Guided Dental Implant Surgery can be a safe implant placement technique. Implant diameter and length, bone density and density deviations showed moderate strong correlation with apical deviation.
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34
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Jamjoom FZ, Kim DG, McGlumphy EA, Lee DJ, Yilmaz B. Positional accuracy of a prosthetic treatment plan incorporated into a cone beam computed tomography scan using surface scan registration. J Prosthet Dent 2018; 120:367-374. [PMID: 29703673 DOI: 10.1016/j.prosdent.2017.11.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Revised: 11/01/2017] [Accepted: 11/02/2017] [Indexed: 10/17/2022]
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35
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Jacobs R, Salmon B, Codari M, Hassan B, Bornstein MM. Cone beam computed tomography in implant dentistry: recommendations for clinical use. BMC Oral Health 2018; 18:88. [PMID: 29764458 PMCID: PMC5952365 DOI: 10.1186/s12903-018-0523-5] [Citation(s) in RCA: 201] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 03/26/2018] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND In implant dentistry, three-dimensional (3D) imaging can be realised by dental cone beam computed tomography (CBCT), offering volumetric data on jaw bones and teeth with relatively low radiation doses and costs. The latter may explain why the market has been steadily growing since the first dental CBCT system appeared two decades ago. More than 85 different CBCT devices are currently available and this exponential growth has created a gap between scientific evidence and existing CBCT machines. Indeed, research for one CBCT machine cannot be automatically applied to other systems. METHODS Supported by a narrative review, recommendations for justified and optimized CBCT imaging in oral implant dentistry are provided. RESULTS The huge range in dose and diagnostic image quality requires further optimization and justification prior to clinical use. Yet, indications in implant dentistry may go beyond diagnostics. In fact, the inherent 3D datasets may further allow surgical planning and transfer to surgery via 3D printing or navigation. Nonetheless, effective radiation doses of distinct dental CBCT machines and protocols may largely vary with equivalent doses ranging between 2 to 200 panoramic radiographs, even for similar indications. Likewise, such variation is also noticed for diagnostic image quality, which reveals a massive variability amongst CBCT technologies and exposure protocols. For anatomical model making, the so-called segmentation accuracy may reach up to 200 μm, but considering wide variations in machine performance, larger inaccuracies may apply. This also holds true for linear measures, with accuracies of 200 μm being feasible, while sometimes fivefold inaccuracy levels may be reached. Diagnostic image quality may also be dramatically hampered by patient factors, such as motion and metal artefacts. Apart from radiodiagnostic possibilities, CBCT may offer a huge therapeutic potential, related to surgical guides and further prosthetic rehabilitation. Those additional opportunities may surely clarify part of the success of using CBCT for presurgical implant planning and its transfer to surgery and prosthetic solutions. CONCLUSIONS Hence, dental CBCT could be justified for presurgical diagnosis, preoperative planning and peroperative transfer for oral implant rehabilitation, whilst striving for optimisation of CBCT based machine-dependent, patient-specific and indication-oriented variables.
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Affiliation(s)
- Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium. .,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium. .,Department of Dental Medicine (DENTMED), Karolinska Institutet, Stockholm, Sweden.
| | - Benjamin Salmon
- EA2496, Orofacial Pathologies, Imaging and Biotherapies Lab, Dental School Paris Descartes University, Sorbonne Paris Cité, Paris, France.,Department of Odontology, AP-HP, Nord Val de Seine Hospital (Bretonneau), Paris, France
| | - Marina Codari
- Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Bassam Hassan
- Department of Oral Function and Restorative Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Research Institute MOVE, 1081 LA, Amsterdam, The Netherlands
| | - Michael M Bornstein
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium.,Applied Oral Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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36
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Ahn SY, Kim NH, Kim S, Karabucak B, Kim E. Computer-aided Design/Computer-aided Manufacturing–guided Endodontic Surgery: Guided Osteotomy and Apex Localization in a Mandibular Molar with a Thick Buccal Bone Plate. J Endod 2018; 44:665-670. [DOI: 10.1016/j.joen.2017.12.009] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 12/06/2017] [Accepted: 12/07/2017] [Indexed: 11/28/2022]
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37
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Jamjoom FZ, Kim DG, Lee DJ, McGlumphy EA, Yilmaz B. Effect of length and location of edentulous area on the accuracy of prosthetic treatment plan incorporation into cone-beam computed tomography scans. Clin Implant Dent Relat Res 2018; 20:300-307. [PMID: 29399999 DOI: 10.1111/cid.12582] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 12/22/2017] [Accepted: 12/22/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Faris Z. Jamjoom
- Advanced Graduate Program in Implant Dentistry, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine; Boston Massachusetts
- Division of Restorative Sciences and Prosthodontics; The Ohio State University College of Dentistry; Columbus Ohio
| | - Do-Gyoon Kim
- Division of Orthodontics; The Ohio State University College of Dentistry; Columbus Ohio
| | - Damian J. Lee
- Division of Restorative Sciences and Prosthodontics; The Ohio State University College of Dentistry; Columbus Ohio
| | - Edwin A. McGlumphy
- Division of Restorative Sciences and Prosthodontics; The Ohio State University College of Dentistry; Columbus Ohio
| | - Burak Yilmaz
- Division of Restorative Sciences and Prosthodontics; The Ohio State University College of Dentistry; Columbus Ohio
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Gellrich NC, Rahlf B, Zimmerer R, Pott PC, Rana M. A new concept for implant-borne dental rehabilitation; how to overcome the biological weak-spot of conventional dental implants? Head Face Med 2017; 13:17. [PMID: 28962664 PMCID: PMC5622522 DOI: 10.1186/s13005-017-0151-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 09/12/2017] [Indexed: 01/25/2023] Open
Abstract
Background Every endosseous dental implant is dependent on an adequate amount and quality of peri-implant hard and soft tissues and their fully functional interaction. The dental implant could fail in cases of insufficient bone and soft tissues or due to a violation of the soft to hard tissues to implant shoulder interface with arising of a secondary bone loss. Method To overcome this biological weak-spot, we designed a new implant that allows for multi vector endosseous anchorage around the individual underlying bone, which has to be scanned by computed tomography (CT) or Cone beam CT (CBCT) technique to allow for planning the implant. We developed a workflow to digitally engineer this customized implant made up of two planning steps. First, the implant posts are designed by prosthodontic-driven backward planning, and a wireframe-style framework is designed on the individual bony surface of the recipient site. Next, the two pieces are digitally fused and manufactured as a single piece implant using the SLM technique (selective laser melting) and titanium-alloy-powder. Results Preoperative FEM-stress-test of the individual implant is possible before it is inserted sterile in an out-patient procedure. Conclusion Unlike any other historical or current dental implant protocol, our newly developed “individual patient solutions dental” follows the principle of a fully functional and rigid osteosynthesis technology and offers a quick solution for an implant-borne dental rehabilitation in difficult conditions of soft and hard tissues.
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Affiliation(s)
- Nils-Claudius Gellrich
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Björn Rahlf
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
| | - Rüdiger Zimmerer
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Philipp-Cornelius Pott
- Department of Prosthetic Dentistry and Biomedical Materials Research, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Majeed Rana
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
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Creation of a 3-dimensional virtual dental patient for computer-guided surgery and CAD-CAM interim complete removable and fixed dental prostheses: A clinical report. J Prosthet Dent 2017; 117:197-204. [DOI: 10.1016/j.prosdent.2016.06.012] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 06/21/2016] [Accepted: 06/21/2016] [Indexed: 11/23/2022]
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Charette JR, Goldberg J, Harris BT, Morton D, Llop DR, Lin WS. Cone beam computed tomography imaging as a primary diagnostic tool for computer-guided surgery and CAD-CAM interim removable and fixed dental prostheses. J Prosthet Dent 2016; 116:157-65. [DOI: 10.1016/j.prosdent.2016.02.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 02/11/2016] [Accepted: 02/15/2016] [Indexed: 10/22/2022]
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From Guided Surgery to Final Prosthesis with a Fully Digital Procedure: A Prospective Clinical Study on 15 Partially Edentulous Patients. Int J Dent 2016; 2016:7358423. [PMID: 27493665 PMCID: PMC4963589 DOI: 10.1155/2016/7358423] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2016] [Accepted: 06/19/2016] [Indexed: 01/20/2023] Open
Abstract
Scope. To demonstrate guided implant placement and the application of fixed, implant-supported prosthetic restorations with a fully digital workflow. Methods. Over a 2-year period, all patients with partial edentulism of the posterior maxilla, in need of fixed implant-supported prostheses, were considered for inclusion in this study. The protocol required intraoral scanning and cone beam computed tomography (CBCT), the superimposition of dental-gingival information on bone anatomy, surgical planning, 3D-printed teeth-supported surgical templates, and modelling and milling of polymethylmethacrylate (PMMA) temporaries for immediate loading. After 3 months, final optical impression was taken and milled zirconia frameworks and 3D-printed models were fabricated. The frameworks were veneered with ceramic and delivered to the patients. Results. Fifteen patients were selected for this study. The surgical templates were stable. Thirty implants were placed (BTK Safe®, BTK, Vicenza, Italy) and immediately loaded with PMMA temporaries. After 3 months, the temporaries were replaced by the final restorations in zirconia-ceramic, fabricated with a fully digital process. At 6 months, none of the patients reported any biological or functional problems with the implant-supported prostheses. Conclusions. The present procedure for fully digital planning of implants and short-span fixed implant-supported restorations has been shown to be reliable. Further studies are needed to validate these results.
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Arunyanak SP, Harris BT, Grant GT, Morton D, Lin WS. Digital approach to planning computer-guided surgery and immediate provisionalization in a partially edentulous patient. J Prosthet Dent 2016; 116:8-14. [DOI: 10.1016/j.prosdent.2015.11.023] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2015] [Revised: 11/17/2015] [Accepted: 11/19/2015] [Indexed: 11/16/2022]
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Lewis RC, Harris BT, Sarno R, Morton D, Llop DR, Lin WS. Maxillary and mandibular immediately loaded implant-supported interim complete fixed dental prostheses on immediately placed dental implants with a digital approach: A clinical report. J Prosthet Dent 2015; 114:315-22. [DOI: 10.1016/j.prosdent.2015.03.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 03/26/2015] [Accepted: 03/26/2015] [Indexed: 10/23/2022]
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Abstract
Maxillary sinus expansion and atrophy can be difficult to overcome for patients who require functional dental prostheses. One solution for this problem is sinus augmentation and implant placement. Patients are evaluated and diagnosis is ascertained, leading to development of a treatment plan and surgical strategy. The surgeon decides on a surgical technique and grafting material, based on ultimate success, stability, and function as they relate to the goals. Complications can occur during an operation or during the postoperative healing phase. Dealing with these complications can be challenging; however, solving these problems positively affects the overall outcome and success.
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Affiliation(s)
- Vincent Carrao
- The Mount Sinai Hospital, Mount Sinai Icahn School of Medicine, 1 Gustave L. Levy Place, New York, NY 10029, USA.
| | - Isabelle DeMatteis
- The Mount Sinai Hospital, Mount Sinai Icahn School of Medicine, 1 Gustave L. Levy Place, New York, NY 10029, USA
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