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Brandenburg LS, Georgii J, Schmelzeisen R, Spies BC, Burkhardt F, Fuessinger MA, Rothweiler RM, Gross C, Schlager S, Metzger MC. Reconstruction of dental roots for implant planning purposes: a retrospective computational and radiographic assessment of single-implant cases. Int J Comput Assist Radiol Surg 2024; 19:591-599. [PMID: 37523011 PMCID: PMC10881751 DOI: 10.1007/s11548-023-02996-x] [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: 03/07/2023] [Accepted: 07/03/2023] [Indexed: 08/01/2023]
Abstract
PURPOSE The aim of the study was to assess the deviation between clinical implant axes (CIA) determined by a surgeon during preoperative planning and reconstructed tooth axes (RTA) of missing teeth which were automatically computed by a previously introduced anatomical SSM. METHODS For this purpose all available planning datasets of single-implant cases of our clinic, which were planned with coDiagnostix Version 9.9 between 2018 and 2021, were collected for retrospective investigation. Informed consent was obtained. First, the intraoral scans of implant patients were annotated and subsequently analyzed using the SSM. The RTA, computed by the SSM, was then projected into the preoperative planning dataset. The amount and direction of spatial deviation between RTA and CIA were then measured. RESULTS Thirty-five patients were implemented. The mean distance between the occlusal entry point of anterior and posterior implants and the RTA was 0.99 mm ± 0.78 mm and 1.19 mm ± 0.55, respectively. The mean angular deviation between the CIA of anterior and posterior implants and the RTA was 12.4° ± 3.85° and 5.27° ± 2.97° respectively. The deviations in anterior implant cases were systematic and could be corrected by computing a modified RTA (mRTA) with decreased deviations (0.99 mm ± 0.84 and 4.62° ± 1.95°). The safety distances of implants set along the (m)RTA to neighboring teeth were maintained in 30 of 35 cases. CONCLUSION The RTA estimated by the SSM revealed to be a viable implant axis for most of the posterior implant cases. As there are natural differences between the anatomical tooth axis and a desirable implant axis, modifications were necessary to correct the deviations which occurred in anterior implant cases. However, the presented approach is not applicable for clinical use and always requires manual optimization by the planning surgeon.
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Affiliation(s)
- Leonard Simon Brandenburg
- Department of Oral and Maxillofacial Surgery, Clinic, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany.
| | - Joachim Georgii
- Key Scientist Modeling and Simulation, Fraunhofer Institute for Digital Medicine MEVIS, Bremen, Max-von-Laue-Str. 2, 28359, Bremen, Germany
| | - Rainer Schmelzeisen
- Department of Oral and Maxillofacial Surgery, Clinic, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany
| | - Benedikt Christopher Spies
- Department of Prosthetic Dentistry, Center for Dental Medicine, Medical Center -University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany
| | - Felix Burkhardt
- Department of Prosthetic Dentistry, Center for Dental Medicine, Medical Center -University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany
| | - Marc Anton Fuessinger
- Department of Oral and Maxillofacial Surgery, Clinic, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany
| | - René Marcel Rothweiler
- Department of Oral and Maxillofacial Surgery, Clinic, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany
| | - Christian Gross
- Department of Oral and Maxillofacial Surgery, Clinic, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany
| | - Stefan Schlager
- Department of Oral and Maxillofacial Surgery, Clinic, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany
| | - Marc Christian Metzger
- Department of Oral and Maxillofacial Surgery, Clinic, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany
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Heller ZA, Hogge M, Ragan MR, Portnof JE. Applications of Cone Beam Computed Tomography Scans in Dental Medicine and Potential Medicolegal Issues. Dent Clin North Am 2024; 68:55-65. [PMID: 37951637 DOI: 10.1016/j.cden.2023.07.009] [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: 11/14/2023]
Abstract
A cone beam central tomography (CBCT) scan produces images in orthogonal and non-orthogonal with great spatial resolution. When a dental health care practitioner (DHP) orders a CBCT scan, they should consider if it is truly indicated, as CBCT scans carry up to four times the dosage of radiation compared to panoramic radiographs. Any diagnostic imaging obtained of a patient should include a formal interpretive report commenting on the findings within the imaging. Ordering of limited field of view (FOV) CBCT scans and failing to report on abnormal findings present outside of the region of interest (ROI) is a potential medicolegal issue.
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Affiliation(s)
- Zachary A Heller
- Department of Oral and Maxillofacial Surgery, Nova Southeastern University College of Dental Medicine, 3050 South University Drive, Davie, FL 33314, USA.
| | - Maritzabel Hogge
- Department of Maxillofacial Medicine, Nova Southeastern University College of Dental Medicine, 3050 South University Drive, Davie, FL 33314, USA
| | - Michael R Ragan
- Department of Oral and Maxillofacial Surgery, Nova Southeastern University College of Dental Medicine, 3050 South University Drive, Davie, FL 33314, USA
| | - Jason E Portnof
- Department of Oral and Maxillofacial Surgery, Nova Southeastern University College of Dental Medicine, 3050 South University Drive, Davie, FL 33314, USA; Private Practice, 9980 North Central Park Boulevard, Suite 113, Boca Raton, FL 33428, USA
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Lin WS. Complications related to digital technologies in treating edentulous patients with implant-supported prostheses. Part 1: Digital data collection and surgical planning stages. J Prosthet Dent 2023; 129:674-675. [PMID: 37121623 DOI: 10.1016/j.prosdent.2023.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 01/13/2023] [Accepted: 01/13/2023] [Indexed: 05/02/2023]
Abstract
The treatment of complete or single arch edentulism remains a significant priority for dental clinicians. Patients often request immediate loading for complex complete arch treatments with shorter treatment times and fewer appointments, and digital technologies can be leveraged to provide more effective treatments. This part 1 presentation focuses on the discussion of commonly seen complications related to using digital technologies in treating edentulous patients during the data collection and surgical planning stages. Complications related to digital technologies can be prevented or corrected during these stages, preventing future complications in the clinical (surgical and prosthetic) stages.
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Affiliation(s)
- Wei-Shao Lin
- Professor, Program Director, and Chair, Advanced Education Program in Prosthodontics, Department of Prosthodontics, Indiana University School of Dentistry, Department of Prosthodontics, Indianapolis, Ind.
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Huang H, Chen D, Lippuner K, Hunziker EB. Human Bone Typing Using Quantitative Cone-Beam Computed Tomography. Int Dent J 2023; 73:259-266. [PMID: 36182605 PMCID: PMC10023581 DOI: 10.1016/j.identj.2022.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 08/20/2022] [Accepted: 08/24/2022] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Bone typing is crucial to enable the choice of a suitable implant, the surgical technique, and the evaluation of the clinical outcome. Currently, bone typing is assessed subjectively by the surgeon. OBJECTIVE The aim of this study is to establish an automatic quantification method to determine local bone types by the use of cone-beam computed tomography (CBCT) for an observer-independent approach. METHODS Six adult human cadaver skulls were used. The 4 generally used bone types in dental implantology and orthodontics were identified, and specific Hounsfield unit (HU) ranges (grey-scale values) were assigned to each bone type for identification by quantitative CBCT (qCBCT). The selected scanned planes were labelled by nonradiolucent markers for reidentification in the backup/cross-check evaluation methods. The selected planes were then physically removed as thick bone tissue sections for in vitro correlation measurements by qCBCT, quantitative micro-computed tomography (micro-CT), and quantitative histomorphometry. RESULTS Correlation analyses between the different bone tissue quantification methods to identify bone types based on numerical ranges of HU values revealed that the Pearson correlation coefficient of qCBCT with micro-CT and quantitative histomorphometry was R = 0.9 (P = .001) for all 4 bone types . CONCLUSIONS We found that qCBCT can reproducibly and objectively assess human bone types at implant sites.
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Affiliation(s)
- Hairong Huang
- Department of Osteoporosis, Inselspital Bern University Hospital, Bern, Switzerland
| | - Dong Chen
- Department of Osteoporosis, Inselspital Bern University Hospital, Bern, Switzerland; Hubei-MOST KLOS & KLOBM, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Kurt Lippuner
- Department of Osteoporosis, Inselspital Bern University Hospital, Bern, Switzerland
| | - Ernst B Hunziker
- Department of Osteoporosis, Inselspital Bern University Hospital, Bern, Switzerland; Department of Orthopaedic Surgery, Inselspital Bern University Hospital, Bern, Switzerland.
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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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Chang KW. Interdisciplinary treatment in the digital era. APOS TRENDS IN ORTHODONTICS 2022. [DOI: 10.25259/apos_126_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
In the digital era today, there are various new technologies could be applied to improve our collaboration and achieve a satisfied treatment outcome. While taking advantage of CAD/CAM technology, the traditional workflow can be simplified, altered, or reversed. Interdisciplinary treatment in the digital era is full of imagination and creativity!
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Brandenburg LS, Berger L, Schwarz SJ, Meine H, Weingart JV, Steybe D, Spies BC, Burkhardt F, Schlager S, Metzger MC. Reconstruction of dental roots for implant planning purposes: a feasibility study. Int J Comput Assist Radiol Surg 2022; 17:1957-1968. [PMID: 35902422 PMCID: PMC9468133 DOI: 10.1007/s11548-022-02716-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 07/04/2022] [Indexed: 11/27/2022]
Abstract
Purpose Modern virtual implant planning is a time-consuming procedure, requiring a careful assessment of prosthetic and anatomical factors within a three-dimensional dataset. In order to facilitate the planning process and provide additional information, this study examines a statistical shape model (SSM) to compute the course of dental roots based on a surface scan. Material and methods Plaster models of orthognathic patients were scanned and superimposed with three-dimensional data of a cone-beam computer tomography (CBCT). Based on the open-source software “R”, including the packages Morpho, mesheR, Rvcg and RvtkStatismo, an SSM was generated to estimate the tooth axes. The accuracy of the calculated tooth axes was determined using a leave-one-out cross-validation. The deviation of tooth axis prediction in terms of angle or horizontal shift is described with mean and standard deviation. The planning dataset of an implant surgery patient was additionally analyzed using the SSM. Results 71 datasets were included in this study. The mean angle between the estimated tooth-axis and the actual tooth-axis was 7.5 ± 4.3° in the upper jaw and 6.7 ± 3.8° in the lower jaw. The horizontal deviation between the tooth axis and estimated axis was 1.3 ± 0.8 mm close to the cementoenamel junction, and 0.7 ± 0.5 mm in the apical third of the root. Results for models with one missing tooth did not differ significantly. In the clinical dataset, the SSM could give a reasonable aid for implant positioning. Conclusions With the presented SSM, the approximate course of dental roots can be predicted based on a surface scan. There was no difference in predicting the tooth axis of existent or missing teeth. In clinical context, the estimation of tooth axes of missing teeth could serve as a reference for implant positioning. However, a higher number of training data must be achieved to obtain increasing accuracy. Supplementary Information The online version contains supplementary material available at 10.1007/s11548-022-02716-x.
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Affiliation(s)
- Leonard Simon Brandenburg
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Clinic, Medical Center -University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany. .,Department of Oral and Maxillofacial Surgery, Albert-Ludwigs University Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany.
| | - Lukas Berger
- Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany
| | - Steffen Jochen Schwarz
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Clinic, Medical Center -University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany
| | - Hans Meine
- Fraunhofer Institute for Digital Medicine MEVIS, Am Fallturm 1, 28359, Bremen, Germany
| | - Julia Vera Weingart
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Clinic, Medical Center -University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany
| | - David Steybe
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Clinic, Medical Center -University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany
| | - Benedikt Christopher Spies
- Department of Prosthodontics, Faculty of Medicine, Clinic, Medical Center -University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany
| | - Felix Burkhardt
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Clinic, Medical Center -University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany
| | - Stefan Schlager
- Department of Prosthodontics, Faculty of Medicine, Clinic, Medical Center -University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany
| | - Marc Christian Metzger
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Clinic, Medical Center -University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany
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Clinical Outcome of Fully Digital Workflow for Single-Implant-Supported Crowns: A Retrospective Clinical Study. Dent J (Basel) 2022; 10:dj10080139. [PMID: 36005237 PMCID: PMC9406321 DOI: 10.3390/dj10080139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/11/2022] [Accepted: 07/22/2022] [Indexed: 12/10/2022] Open
Abstract
A digital workflow by means of intraoral scanners and computer tomography has been used in dental implantology, allowing clinicians to be potentially more accurate and precise. Computer-Aided Design and Computer-Aided Manufacturing (CAD-CAM) and 3D models facilitate the process from treatment planning to the surgical procedure, up to the implant placement and final prosthesis. The aim of the present retrospective study was to evaluate a fully digital workflow for single-tooth implant rehabilitation. A total of 19 patients (22 implants) were included in the present study, with a mean follow-up time of 2 years. A fully digital workflow was performed on each patient through the planning, design and printing of a surgical guide, following a digital impression made with an intraoral scanner, computer-tomography-guided implant placement and, finally, with the delivery of a CAD-CAM crown. The two-year follow-up results were satisfactory in terms of the aesthetic yield and precision of the prosthesis. In single-implant-supported restorations, due to digital protocols and digital planning, a reduced number of clinical sessions was registered and the treatment plan results were more predictable. Future studies are needed to understand the application of fully digital protocols in cases of partially or totally edentulous patients.
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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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Nica DF, Gabor AG, Duma VF, Tudericiu VG, Tudor A, Sinescu C. Sinus Lift and Implant Insertion on 3D-Printed Polymeric Maxillary Models: Ex Vivo Training for In Vivo Surgical Procedures. J Clin Med 2021; 10:jcm10204718. [PMID: 34682841 PMCID: PMC8538196 DOI: 10.3390/jcm10204718] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 10/11/2021] [Accepted: 10/12/2021] [Indexed: 12/14/2022] Open
Abstract
Background and Objectives: The aim of this study is to demonstrate the increased efficiency achieved by dental practitioners when carrying out an ex vivo training process on 3D-printed maxillaries before performing in vivo surgery. Materials and Methods: This developed ex vivo procedure comprises the following phases: (i) scanning the area of interest for surgery; (ii) obtaining a 3D virtual model of this area using Cone Beam Computed Tomography (CBCT); (iii) obtaining a 3D-printed model (based on the virtual one), on which (iv) the dental practitioner simulates/rehearses ex vivo (most of) the surgery protocol; (v) assess with a new CBCT the 3D model after simulation. The technical steps of sinus augmentation and implant insertion could be performed on the corresponding 3D-printed hemi-maxillaries prior to the real in vivo surgery. Two study groups were considered, with forty patients divided as follows: Group 1 comprises twenty patients on which the developed simulation and rehearsal procedure was applied; Group 2 is a control one which comprises twenty patients on which similar surgery was performed without this procedure (considered in order to compare operative times without and with rehearsals). Results: Following the ex vivo training/rehearsal, an optimal surgery protocol was developed for each considered case. The results of the surgery on patients were compared with the results obtained after rehearsals on 3D-printed models. The performed quantitative assessment proved that, using the proposed training procedure, the results of the in vivo surgery are not significantly different (p = 0.089) with regard to the ex vivo simulation for both the mezio-distal position of the implant and the distance from the ridge margin to sinus window. On the contrary, the operative time of Group 1 was reduced significantly (p = 0.001), with an average of 20% with regard to in vivo procedures performed without rehearsals (on the control Group 2). Conclusions: The study demonstrated that the use of 3D-printed models can be beneficial to dental surgeon practitioners, as well as to students who must be trained before performing clinical treatments.
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Affiliation(s)
- Diana Florina Nica
- School of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy of Timisoara, 2A Eftimie Murgu Place, 300070 Timisoara, Romania;
| | - Alin Gabriel Gabor
- Research Center in Dental Medicine Using Conventional and Alternative Technologies, School of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy of Timisoara, 9 Revolutiei 1989 Ave., 300070 Timisoara, Romania; (A.G.G.); (A.T.); (C.S.)
| | - Virgil-Florin Duma
- 3OM Optomechatronics Group, Faculty of Engineering, “Aurel Vlaicu” University of Arad, 2 Elena Dragoi, 310177 Arad, Romania
- Doctoral School, Polytechnic University of Timisoara, 1 Mihai Viteazu Ave., 300222 Timisoara, Romania
- Correspondence: ; Tel.: +40-751-511451
| | | | - Anca Tudor
- Research Center in Dental Medicine Using Conventional and Alternative Technologies, School of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy of Timisoara, 9 Revolutiei 1989 Ave., 300070 Timisoara, Romania; (A.G.G.); (A.T.); (C.S.)
| | - Cosmin Sinescu
- Research Center in Dental Medicine Using Conventional and Alternative Technologies, School of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy of Timisoara, 9 Revolutiei 1989 Ave., 300070 Timisoara, Romania; (A.G.G.); (A.T.); (C.S.)
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Schwindling FS, Juerchott A, Boehm S, Rues S, Kronsteiner D, Heiland S, Bendszus M, Rammelsberg P, Hilgenfeld T. Three-dimensional accuracy of partially guided implant surgery based on dental magnetic resonance imaging. Clin Oral Implants Res 2021; 32:1218-1227. [PMID: 34352147 DOI: 10.1111/clr.13819] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 06/08/2021] [Accepted: 07/07/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To measure in vivo 3D accuracy of backward-planned partially guided implant surgery (PGIS) based on dental magnetic resonance imaging (dMRI). MATERIAL AND METHODS Thirty-four patients underwent dMRI examinations. Tooth-supported templates were backward planned using standard dental software, 3D-printed, and placed intraorally during a cone beam computed tomography (CBCT) scan. Treatment plans were verified for surgical viability in CBCT, and implants were placed with guiding of the pilot drill. High-precision impressions were taken after healing. The 3D accuracy of 41 implants was evaluated by comparing the virtually planned and definitive implant positions with respect to implant entry point, apex, and axis. Deviations from the dMRI-based implant plans were compared with the maximum deviations calculated for a typical single implant. RESULTS Twenty-eight implants were placed as planned in dMRI. Evaluation of 3D accuracy revealed mean deviations (99% confidence intervals) of 1.7 ± 0.9mm (1.2-2.1mm) / 2.3 ± 1.1mm (1.8-2.9 mm) / 7.1 ± 4.8° (4.6-9.6°) for entry point / apex / axis. The maximum deviations calculated for the typical single implant surpassed the upper bounds of the 99% CIs for the apex and axis, but not for the entry point. In the 13 other implants, dMRI-based implant plans were optimized after CBCT. Here, deviations between the initial dMRI plan and definitive implant position were only in part higher than in the unaltered group (1.9 ± 1.7 mm [0.5-3.4 mm] / 2.5 ± 1.5 mm [1.2-3.8 mm] / 6.8 ± 3.8° [3.6-10.1°] for entry point / apex / axis). CONCLUSIONS The 3D accuracy of dMRI-based PGIS was lower than that previously reported for CBCT-based PGIS. Nonetheless, the values seem promising to facilitate backward planning without ionizing radiation.
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Affiliation(s)
| | - Alexander Juerchott
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Sophia Boehm
- Department of Prosthetic Dentistry, Heidelberg University Hospital, Heidelberg, Germany
| | - Stefan Rues
- Department of Prosthetic Dentistry, Heidelberg University Hospital, Heidelberg, Germany
| | - Dorothea Kronsteiner
- Institute of Medical Biometry and Informatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Sabine Heiland
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Martin Bendszus
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Peter Rammelsberg
- Department of Prosthetic Dentistry, Heidelberg University Hospital, Heidelberg, Germany
| | - Tim Hilgenfeld
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
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Abstract
This article focuses on radiographic imaging with regard to planning, treating, and maintaining partially and completely edentulous prosthodontic patients with dental implants. Cone-beam computed tomography (CBCT) is the preferred imaging method for pretreatment dental implant treatment planning. Radiographic guides containing radiopaque materials and/or fiducial markers transfer both the proposed prosthesis design and desired implant location for appropriate radiographic evaluation. The three-dimensional CBCT analysis provides information on the adjacent relevant anatomy, bone volume of the edentulous sites, and restorative space assessment.
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Affiliation(s)
- Eva Anadioti
- Department of Preventive and Restorative Sciences, University of Pennsylvania School of Dental Medicine, 240 South 40th Street, Philadelphia, PA 19104, USA.
| | - Heidi Kohltfarber
- Division of Diagnostic Sciences, University of North Carolina School of Dentistry, 385 S Columbia St, Chapel Hill, NC 27599, USA
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Mai HN, Lee DH. Radiopaque Tissue Surface-Based Digital Registration Technique for Completely Edentulous Ridge. J ORAL IMPLANTOL 2021; 47:73-77. [PMID: 32662829 DOI: 10.1563/aaid-joi-d-20-00014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Hang-Nga Mai
- Institute for Translational Research in Dentistry, Kyungpook National University, Daegu, Republic of Korea
| | - Du-Hyeong Lee
- Institute for Translational Research in Dentistry, Kyungpook National University, Daegu, Republic of Korea.,Department of Prosthodontics, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
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14
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Bernaerts A, Barbier L, Abeloos J, De Backer T, Bosmans F, Vanhoenacker FM, Casselman J. Cone Beam Computed Tomography Imaging in Dental Implants: A Primer for Clinical Radiologists. Semin Musculoskelet Radiol 2020; 24:499-509. [PMID: 33036038 DOI: 10.1055/s-0040-1701496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
With the introduction of cone beam computed tomography (CBCT) into dentistry in the 1990s, radiologists have become more frequently involved in dental implant planning. This article describes the information that should be included in a radiology report to achieve a successful implantation. The justification to use CBCT during the preoperative planning phase is based on the need to evaluate patient-specific anatomy in detail (general condition of the jaw, bone quantity, and bone quality), the application of more advanced surgical techniques (maxillary sinus augmentation procedure, zygomatic implants), and the integrated presurgical planning and virtual patient approach. Postoperatively, CBCT is used when implant retrieval is anticipated and two-dimensional radiographs have not provided sufficient information, for evaluation of graft healing, or to assess complications, mostly related to neurovascular trauma.
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Affiliation(s)
- Anja Bernaerts
- Department of Radiology, GZA Hospitals, Antwerp, Belgium
| | - Lieven Barbier
- Training Center for Dental Students of the KU Leuven, AZ Sint-Jan Brugge-Oostende AV, Bruges, Belgium
| | - Johan Abeloos
- Department of Maxillo-Facial Surgery, AZ Sint-Jan Brugge-Oostende AV, Bruges, Belgium
| | - Tom De Backer
- Department of Maxillo-Facial Surgery, AZ Sint-Jan Brugge-Oostende AV, Bruges, Belgium
| | - Frederik Bosmans
- Department of Radiology, Antwerp University Hospital, Edegem, Belgium.,Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Filip M Vanhoenacker
- Department of Radiology, Antwerp University Hospital, Edegem, Belgium.,Department of Radiology, AZ Sint-Maarten, Mechelen, Belgium.,Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Jan Casselman
- Department of Radiology, GZA Hospitals, Antwerp, Belgium.,Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Department of Radiology, AZ Sint-Jan Brugge-Oostende AV, Bruges, Belgium
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15
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Impact of Matching Point Selections on Image Registration Accuracy between Optical Scan and Computed Tomography. BIOMED RESEARCH INTERNATIONAL 2020; 2020:3285431. [PMID: 32802841 PMCID: PMC7426779 DOI: 10.1155/2020/3285431] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 07/21/2020] [Indexed: 01/08/2023]
Abstract
The point-based surface registration method involves the manual selection process of paired matching points on the data of computed tomography and optical scan. The purpose of this study was to investigate the impact of selection error and distribution of fiducial points on the accuracy of image matching between 3-dimensional (3D) images in dental planning software programs. Computed tomography and optical scan images of a partial edentulous dental arch were obtained. Image registration of the optical scan image to computed tomography was performed using the point-based surface registration method in planning software programs under different conditions of 3 fiducial points: point selection error (0, 1, or 2 mm), point distribution (unilateral, bilateral), and planning software (Implant Studio, Blue Bio Plan) (n = 5 per condition, N = 60). The accuracy of image registration at each condition was evaluated by measuring linear discrepancies between matched images at X, Y, and Z axes. Kruskal-Wallis test, Mann-Whitney U test with Bonferroni correction, and 3-way analysis of variance were used to statistically analyse the measurement data (α = 0.05). No statistically significant difference was exhibited between the 0 and 1 mm point mismatch conditions in either unilateral or bilateral point distributions. The discrepancy values in the 2 mm mismatch condition were significantly different from the other mismatch conditions, especially in the unilateral point distribution (P < 0.05). Strong interactions among point selection error, distribution, and software programs on the image registration were found (P < 0.001). Minor matching point selection error did not influence the accuracy of point-based automatic image registration in the software programs. When the fiducial points are distributed unilaterally with large point selection error, the image matching accuracy could be decreased.
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16
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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: 52] [Impact Index Per Article: 13.0] [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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17
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Vandenberghe B. The crucial role of imaging in digital dentistry. Dent Mater 2020; 36:581-591. [PMID: 32299666 DOI: 10.1016/j.dental.2020.03.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 03/09/2020] [Indexed: 10/24/2022]
Abstract
One of the recent trends in dentistry - and this in every field from the restorative to the orthodontic one- is the introduction of simplified completely digital workflows. Digital dentistry is supposed to allow dentists to work more efficiently, and this at higher precision, and with the possibility of all-in-one sessions using in-house computerized techniques. In this workflow, one of the major tools for simulating and transferring dental treatments is imaging. Both 3D low dose radiographic as well as optical imaging are playing crucial roles and have been overwhelming the market. Novel design platforms, compact and extremely fast milling and printing units are now also plentiful and rapidly being adopted in practice. Nevertheless, many of the steps in this digital dentistry process, no matter how simplified, present risks that can contribute to reduced precision and clinical difficulties. It is therefore the purpose of the article to briefly describe the role of imaging in this digital workflow, and where the pitfalls can be found that may lead to errors and imprecision.
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Affiliation(s)
- Bart Vandenberghe
- Advimago, Center for Advanced Oral Imaging, Emile Clausstraat 42, 1050 Brussels, Belgium.
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18
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Yuan C, Wei L, Li X, Wang P. A technique for registering digital dental casts onto cone beam computed tomography scans with excessive metallic artifacts. J Prosthet Dent 2020; 125:29-33. [PMID: 32085869 DOI: 10.1016/j.prosdent.2019.12.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 12/17/2019] [Accepted: 12/18/2019] [Indexed: 11/15/2022]
Abstract
This article describes a method of integrating digital dental casts into cone beam computed tomography (CBCT) scans in virtual implant planning in situations with an excessive number of metal artifacts. This technique requires the use of a prefabricated registration tray to provide a common landmark; is noninvasive, minimally time-consuming, and cost-effective; and requires only a single registration and minimal exposure to radiation.
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Affiliation(s)
- Changyong Yuan
- Associate Professor, Department of Oral Implantology, Affiliated Stomatological Hospital of Xuzhou Medical University, Xuzhou, PR China
| | - Luming Wei
- Graduate student, School of Stomatology, Xuzhou Medical University, Xuzhou, PR China
| | - Xingjia Li
- Graduate student, School of Stomatology, Xuzhou Medical University, Xuzhou, PR China
| | - Penglai Wang
- Professor, Department of Oral Implantology, Affiliated Stomatological Hospital of Xuzhou Medical University, Xuzhou, PR China.
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19
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Forna N, Agop-Forna D. Esthetic aspects in implant-prosthetic rehabilitation. Med Pharm Rep 2019; 92:S6-S13. [PMID: 31989103 PMCID: PMC6978930 DOI: 10.15386/mpr-1515] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Accepted: 09/02/2019] [Indexed: 12/12/2022] Open
Abstract
The esthetic component is critical for the successful outcome and patients’ satisfaction regarding the implant-prosthetic therapy. The esthetic outcome success depends mostly on the optimization of the algorithms specific to the pro-implant and implant stage as well as to the designing and technological execution of the future prosthetic restoration. A proper planning of optimal facial esthetics must involve a multidisciplinary approach with inclusion of periodontists, orthodontists, oral surgeons and implantology specialists. The dental practitioner must consider various factors that influence the esthetic outcome (tooth position, root position of the adjacent teeth, biotype of the periodontium, tooth shape, smile line, implant site anatomy, implant positioning). Also, some factors (anatomical limits of the implant site, periodontal status, occlusal parameters), which can alter the final esthetic result, must be assessed prior to planning the esthetic parameters of the future prosthetic restoration. The esthetic outcome can be improved by using new digital technologies based on software applications for assessment of clinical and biological indices of the prosthetic field, virtual planning of implants positioning and design projection of future prosthetic restoration.
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Affiliation(s)
- Norina Forna
- Department Implantology, Removable Restorations, Dental Medical Faculty, Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania
| | - Doriana Agop-Forna
- Department of Oral Surgery, Dental Medical Faculty, Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania
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20
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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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21
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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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22
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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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23
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Digital implant planning and guided implant surgery – workflow and reliability. Br Dent J 2019; 226:101-108. [DOI: 10.1038/sj.bdj.2019.44] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2018] [Indexed: 12/13/2022]
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24
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El Sahili N, David-Tchouda S, Thoret S, Nasseh I, Berberi A, Fortin T. Effect of Milliamperage Reduction on Pre-surgical Implant Planning Using Cone Beam Computed Tomography by Surgeons of Varying Experience. J Maxillofac Oral Surg 2018; 17:520-530. [PMID: 30344396 PMCID: PMC6181865 DOI: 10.1007/s12663-017-1075-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 12/14/2017] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND Differences in CBCT units and the lack of standardization result in exposure to radiation doses beyond what is required for diagnostic purposes, especially when planning the surgical placement of dental implants. AIM To assess the influence of low- and high-dose milliamperage settings on CBCT images for objective and subjective implant planning among senior specialists (5 years of experience) and juniors (fresh graduates). MATERIALS AND METHODS Two dry skulls (4 hemi-maxillary segments of the maxilla and 4 hemi-maxillary segments of the mandible) were scanned under low (2 mA) and high (6.3 mA) dosage settings using the Carestream CS 9300 machine. Cross-sectional slices of both image qualities were evaluated by the 5 seniors and the 5 juniors for subjective image utility for implant planning and for objective linear bone measurements. RESULTS There were no significant differences in bone measurements taken on high- or low-dose images by all seniors and by the majority of juniors (p > 0.05). In qualitative image assessments, there was independence between assessment and image quality for almost all observers. For planning posterior mandibular implant placement, increased dosage improved concordance and kappa values between low- and high-dose images for senior observers (from K = 0.287 at low dose to K = 0.718 at high does) but not for juniors (K = 0.661 and K = 0.509 for low and high dose, respectively). CONCLUSION Reduction in milliamperage did not affect diagnostic image quality for objective bone measurements and produced sufficient concordance for qualitative assessment. Judicious optimization of milliamperage settings based on individual diagnostic requirements can result in significant dose reduction without compromising diagnostic decision-making.
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Affiliation(s)
- N. El Sahili
- School of Dentistry, Lebanese University, Beirut, Lebanon
| | - S. David-Tchouda
- Medico-economic Evaluation Unit, University Hospital of Grenoble, France/ThEMAS TIMC, UMR CNRS 5525, Grenoble Joseph Fourier University, Grenoble, France
| | - S. Thoret
- Investigation Clinical Center of Grenoble, INSERM, Grenoble, France
| | - I. Nasseh
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Lebanese University, Beirut, Lebanon
| | - A. Berberi
- Department of Oral and MaxilloFaciale Surgery, School of Dentistry, Lebanese University, Beirut, Lebanon
| | - T. Fortin
- Department of Oral Surgery, Dental University of Lyon, University Claude Bernard, Lyon 1, France. UJF-Grenoble 1/CNRS/TIMC-IMAG UMR 5525, 38041 Grenoble, France
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25
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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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26
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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: 193] [Impact Index Per Article: 32.2] [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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27
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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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28
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Dawson JH, Hyde B, Hurst M, Harris BT, Lin WS. Polyetherketoneketone (PEKK), a framework material for complete fixed and removable dental prostheses: A clinical report. J Prosthet Dent 2017; 119:867-872. [PMID: 29195815 DOI: 10.1016/j.prosdent.2017.09.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 09/15/2017] [Accepted: 09/15/2017] [Indexed: 10/18/2022]
Abstract
This clinical report demonstrates the use of polyetherketoneketone (PEKK) as a framework material with individually luted heat-pressed lithium disilicate glass-ceramic crowns for an implant-supported complete fixed dental prosthesis (ICFDP) and a conventional complete removable dental prosthesis (CRDP). This prosthesis design provides a non-computer-aided design and computer-aided manufacturing (CAD-CAM) option for the fabrication of ICFDPs and CRDPs with individualized ceramic crowns for optimal esthetics. The performance of PEKK as a framework material needs to be assessed in clinical trials.
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Affiliation(s)
- Jonathan H Dawson
- Private practice, Greensboro, NC. Former resident, Advanced Education in Prosthodontics, Department of Oral Health and Rehabilitation, School of Dentistry, University of Louisville, Louisville, Ky
| | | | | | - Bryan T Harris
- Associate Professor and Director, Advanced Education in Prosthodontics, Department of Oral Health and Rehabilitation, School of Dentistry, University of Louisville, Louisville, Ky
| | - Wei-Shao Lin
- Associate Professor and Director, Division of Prosthodontics, Department of Oral Health and Rehabilitation, University of Louisville School of Dentistry, Louisville, Ky.
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29
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Wang CW, Bhaskar V, Dickerman B, Kaigler D. Computer-Guided Immediate Implant Placement and Pre-Digitally-Designed Immediate Provisionalization. Clin Adv Periodontics 2017. [DOI: 10.1902/cap.2017.170034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Chin-Wei Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
| | | | | | - Darnell Kaigler
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
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Tian T, Zhang T, Ma Q, Zhang Q, Cai X. Reconstruction of Mandible: A Fully Digital Workflow From Visualized Iliac Bone Grafting to Implant Restoration. J Oral Maxillofac Surg 2017; 75:1403.e1-1403.e10. [PMID: 28359016 DOI: 10.1016/j.joms.2017.02.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Revised: 02/25/2017] [Accepted: 02/26/2017] [Indexed: 02/05/2023]
Abstract
PURPOSE Although digital aids can help surgeons compensate for the shortcomings of traditional mandibular reconstruction techniques to perform surgery more precisely and effectively, the use of these digital techniques has often been fragmented, divided, and incomplete. This article describes the workflow of a fully digital mandibular reconstruction to explore the proper indications and discusses innovations based on the accuracy and effectiveness of digital techniques. MATERIALS AND METHODS A restoration-oriented mandibular reconstruction was performed by applying different digital techniques. Preoperative virtual surgery and rapid prototyping were used to aid the vascularized iliac bone graft surgery, which offered a solid basis for the ensuing treatment. Subsequently, implant rehabilitation was accomplished with the assistance of computer-assisted design and manufacture, laser treatment, and selective laser melting techniques. RESULT The workflow of the fully digital mandibular reconstruction successfully achieved a restoration-oriented treatment. These predictable, accurate, and effective digital techniques improved the consistency of pretreatment design and follow-up treatment. The treatment sequence achieved high predictability and reproducibility owing to the use of digital techniques. CONCLUSION This study shows that a digital workflow can be predictable, accurate, and effective, which suggests that it could be a valid digital protocol for developing a treatment sequence for patients with jaw defects caused by trauma, congenital anomalies, or mandibular tumor resection.
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Affiliation(s)
- Taoran Tian
- Resident, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan Province, China
| | - Tao Zhang
- Resident, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan Province, China
| | - Quanquan Ma
- Resident, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan Province, China
| | - Qi Zhang
- Resident, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan Province, China
| | - Xiaoxiao Cai
- Professor, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan Province, China.
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Kamble AP, Pawar RR, Mattigatti S, Mangala TM, Makandar S. Cone-beam computed tomography as advanced diagnostic aid in endodontic treatment of molars with multiple canals: Two case reports. J Conserv Dent 2017; 20:273-277. [PMID: 29259367 PMCID: PMC5721512 DOI: 10.4103/0972-0707.219194] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The purpose of these case reports is to emphasize the importance of knowledge regarding the root canal morphology and current diagnostic aids one should have as both of these important factors going to affect the prognosis of the endodontic treatment. These two case reports describe the maxillary and mandibular first molars with multiple canals. After clinical and radiographic diagnosis, additional help of cone-beam computed tomography (CBCT) of mandibular molar has been taken to evaluate the morphology and canal pattern; while maxillary molar was evaluated using CBCT scan to evaluate the canal configuration and obturation. In CBCT evaluation, the mandibular molar was diagnosed with six separated canals with three mesial and three distal canals and with radix paramolaris and radix entomolaris. The maxillary molar had five canals with three mesiobuccal (MB) canals. Both molars were instrumented with conventional hand and rotary file systems and obturated by conventional lateral compaction method. The axial images from CBCT show Vertucci Type VIII canal pattern in both roots of first mandibular molars and in MB root of maxillary first molar Sert and Bayirli Type XVIII canal configuration and no accessory canal in distobuccal and palatal root. With the recent innovations in diagnostic and operating aids, we can come across many variations in the root canal morphology of both mandibular and maxillary teeth, especially multi-rooted one (i.e., molars), and the knowledge of which leads to successful endodontic treatment with an excellent prognosis.
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Affiliation(s)
- Amit Pralhad Kamble
- Department of Conservative Dentistry and Endodontics, School of Dental Sciences, Krishna Institute of Medical Sciences Deemed University, Karad, Maharashtra, India
| | - Rohini Rangarao Pawar
- Department of Conservative Dentistry and Endodontics, School of Dental Sciences, Krishna Institute of Medical Sciences Deemed University, Karad, Maharashtra, India
| | - Sudha Mattigatti
- Department of Conservative Dentistry and Endodontics, School of Dental Sciences, Krishna Institute of Medical Sciences Deemed University, Karad, Maharashtra, India
| | - T M Mangala
- Department of Conservative Dentistry and Endodontics, School of Dental Sciences, Krishna Institute of Medical Sciences Deemed University, Karad, Maharashtra, India
| | - Saleem Makandar
- Department of Conservative Dentistry and Endodontics, School of Dental Sciences, Krishna Institute of Medical Sciences Deemed University, Karad, Maharashtra, India
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Kwun TL, Razzoog M. Technique for transferring the path of insertion of a removable partial denture to a CAD-CAM-generated implant surgical template. J Prosthet Dent 2016; 117:475-477. [PMID: 27881308 DOI: 10.1016/j.prosdent.2016.08.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 08/11/2016] [Accepted: 08/11/2016] [Indexed: 11/18/2022]
Abstract
A technique is described that uses a surveyor, gutta percha points, and a computer-aided design and computer-aided manufacturing (CAD-CAM)-guided implant surgery system to predetermine and transfer the ideal angulation of the implant to be placed.
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Affiliation(s)
- Thomas L Kwun
- Resident, Department of Prosthodontics, University of Michigan-Ann Arbor, School of Dentistry, Ann Arbor, Mich.
| | - Michael Razzoog
- Professor, Department of Prosthodontics, University of Michigan-Ann Arbor, School of Dentistry, Ann Arbor, Mich
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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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Malta Barbosa J, Bártolo Caramês G, Granda Gill G, Caramês J. Adaptation of an interim partial removable dental prosthesis as a radiographic template for implant placement. J Prosthet Dent 2016; 116:147-8. [DOI: 10.1016/j.prosdent.2016.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Revised: 01/15/2016] [Accepted: 01/15/2016] [Indexed: 10/22/2022]
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Seitz SD, Zimmermann RL, Hendricson WD. Expansion of a Predoctoral Surgical Implant Selective for Dental Students. J Dent Educ 2016. [DOI: 10.1002/j.0022-0337.2016.80.3.tb06088.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Stefanie D. Seitz
- School of Dentistry; University of Texas Health Science Center; San Antonio
| | | | - William D. Hendricson
- Educational and Faculty Development; School of Dentistry; University of Texas Health Science Center; San Antonio
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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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Radiopaque dental impression method for radiographic interpretation, digital alignment, and surgical guide fabrication for dental implant placement. J Prosthet Dent 2015; 113:343-6. [PMID: 25702970 DOI: 10.1016/j.prosdent.2014.02.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Revised: 02/09/2014] [Accepted: 02/10/2014] [Indexed: 11/23/2022]
Abstract
Adequate visualization of existing/proposed tooth position, denture base contours, and prosthetic space is critical to treatment planning of dental implants. Multiple techniques exist for fabricating radiographic guides; many involve duplicating the patient's existing prosthesis or fabricating a new diagnostic template. This article describes a technique that provides anatomic and restorative information by using an existing prosthesis and a radiographic impression method without the need to fabricate a duplicate or new template.
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