A technique for making a diagnostic and surgical template

Methods Used to Assess the 3D Accuracy of Dental Implant Positions in Computer-Guided Implant Placement: A Review

The purpose of this review is to examine various assessment methods in order to compare the accuracy between the virtually planned and clinically achieved implant positions. In this review, comparison methods using pre- and post-operative computed topography (CT) data and digital impressions for definitive prosthesis will be described. The method for the displacement and strain for quantification of the error will also be explored. The difference between the planned and the actual implant placement position in guided implant surgery is expressed as an error. Assessing the accuracy of implant-guided surgery can play an important role as positive feedback in order to reduce errors. All of the assessment methods have their own inevitable errors and require careful interpretation in evaluation.

Flexible thermoplastic resin to add retention to tooth-supported stereolithographic surgical guides

Surgical guides produced by stereolithography use hard resin. The hard resin prevents seating beyond the height of contour, hence these guides are not intrinsically retentive. By covering the guide with a flexible thermoplastic material that extends into the undercuts, the resulting guide now has a retentive feature. This allows it to maintain its position during surgery yet it can easily be removed and repositioned.

An adjustable, cast based, fully restrictive surgical guide

The 3D Click Guide is a fully restrictive cast-based surgical guide for the placement of dental implants. This in-office system consists of prefabricated parts that are assembled onto a carrier. The 3-dimensional data are derived from a dental cast in combination with a periapical radiograph or cone-beam computed tomography data.

Designing a custom made gauge device for application in the access hole correction in the dental implant surgical guide

Anatomic limitation and restorative demands encourage the surgeon to gain precision in planning and surgical positioning of dental implants. Ideal placement facilitates the establishment of favorable forces on the implants and the prosthetic component as well as ensures an esthetic outcome. The predictability of success can be increased, if the implants are placed properly. During oral implant placement, the drill must be guided by the surgeon according to the final form of the restoration. A surgical template would be helpful in more accurate placement of the dental implants. Surgical guides fabricated in laboratory are still being used. But these guides often need correction after computed tomography (CT) scan evaluation. For their correction and reducing the possibility of error, a scaled milling machine is usually required. But this scaled milling machine is not available omnipresent. In this article a simple device is described that can be attached to any milling machine and surveyor. The presented device can correct the diagnostic template easily and predicts dental implants placement with more favorable esthetic and occlusal outcome.

Types of Implant Surgical Guides in Dentistry: A Review

Various techniques have been proposed for the fabrication of surgical guide templates in implant dentistry. The objective of this paper is to review the associated literature and recent advancements in this field, based on design concept. An electronic and hand search of the literature revealed 3 categories, namely, nonlimiting, partially limiting, and completely limiting design. Most clinicians still adopt the partially limiting design due to its cost-effectiveness and credibility. Moreover, clinicians use cross-sectional imaging during the preimplant assessment of surgical sites.

Fabrication of a cast-based implant surgical guide using guide sleeves

A unique method for fabricating cast-based surgical guides is presented. A proposed position and mesiodistal angulation of the implant are verified with periapical radiography and registered with a commercially available guide sleeve. The sleeve is attached to a surgical guide made of light-polymerized acrylic resin. The surgical guide can be used in a broad range of situations and allows for accurate implant placement in a prosthetically driven position with surgical access and visibility, simplicity, and cost efficiency.

Use of diagnostic and surgical stent: a simplified approach for implant placement

Dental implantology has emerged as a practical alternative to traditional prosthodontics. Since the beginning, placement of implant in the bone to achieve a prosthetic solution that fulfils biologic, aesthetic and biomechanical requirements has been a challenge. In the past, implant site and inclination were dictated by residual bone quality. The desire for predictable prosthesis led to the development of prosthetically guided implantology. This concept establishes the correct implant position during the diagnostic stage according to planned definitive restoration. In prosthetically guided implantology where ideal placement of implant is determined by the definitive restoration, use of radiographic and surgical stent in conjunction with dental CT scan can play an important role. A stent is an appliance used for radiographic evaluation during treatment planning for implant placement and during surgical procedures to locate optimal implant placement site. The stent with dental CT scan enables the dental team to identify specific sites of prospective implant surgery and hence determines the optimal position and angulation of implant relative to occlusal load. Aided by stent the surgeon can avoid undesirable implant site preparation and minimize unnecessary osteotomy, resulting in favorable design of prosthesis, reduced surgical trauma, reduced surgical time and increased patient comfort. This case report is an insight into the method of fabrication of simple and cost effective stent for implant placement and its advantages over the other techniques of stent fabrication.

Cast-based guided implant placement: a novel technique

One of the most challenging aspects of implant placement is the correct spatial positioning of the dental implant in the bone. Surgical guides of various configurations have been proposed to aid implant placement. If a fully limiting surgical guide is used, the encoded information should be reliable, as deviations are not possible during surgery. This article describes a combination of analog techniques, including bone sounding and periapical radiographs used to study the available bone volume. A simplified casting protocol is proposed, and the implant platform position of the implant analog is transferred to a surgical guide composed of a stiff vinyl polysiloxane material. This surgical guide is used in a conventional flapless guided implant surgery protocol. This combination of techniques allows precise placement of a dental implant, abutment, and provisional restoration in a minimally invasive manner.

A surgical guide for dental implant placement in edentulous posterior regions

Proper implant placement is crucial for successful implant-supported restorations. This article describes a simple technique for fabricating a vacuum-formed surgical guide to assist in dental implant placement in edentulous posterior regions.

Accuracy of image-guided implantology

OBJECTIVES

The accuracy of two commercially available systems for image-guided dental implant insertion based on infrared tracking cameras was compared with manual implantation.

MATERIAL AND METHODS

Phantoms of partially edentulous mandibles were used. In a master phantom, pilot boreholes for dental implants were placed. These boreholes were reproduced in slave phantoms using either of the two image-guided systems and manual implantation. The resulting positions were determined using a coordinate measurement machine and compared with the master model.

RESULTS

In comparison with manual implantation, the difference of borehole positions to the master phantom was significantly lower using either of the systems for image-guided implant insertion.

CONCLUSION

Image-guided insertion of dental implants is significantly more accurate than manual insertion. However, the accuracy that can be achieved with manual implantation is sufficient for most clinical situations.