Simplified radiographic-surgical template for placement of multiple, parallel implants

Overdentures Supported by Mini or Conventional Implants-effect on Patient Satisfaction and Bone Resorption Rates. A Randomized Clinical Trial

AIM: The aim of the study was to assess the difference between patient satisfaction and bone height changes of mini-implant supported overdentures in comparison with conventional implant after bone expansion technique. METHODS: This randomized clinical trial contains 36 edentulous participants with thin mandibular ridges randomly divided to receive 2 mini-implants, or 2 conventional implants after ridge splitting, both treatments were done in the inter-forminal area of the anterior mandible. Then, the patients received mandibular overdentures with ball and socket attachments. At base line, after 6 and 12 months of loading the implants, patients’ satisfaction was evaluated using visual analog scale, in addition to bone height changes using Soredex DIGORA Optime Classic software. RESULTS: There was statistically significant difference in the overall satisfaction between the mini-implants and the conventional implants group; the amount of bone height changes in the mini-implant group was statistically significant less than the conventional implant group at base line, 6 and 12 months. CONCLUSION: Treatment with two mini-implants provides high level of satisfaction and less bone height changes in a follow-up period of 12 months in comparison to conventional implants after ridge expansion.

Surgical templates for dental implant positioning; current knowledge and clinical perspectives

Dental implants have been used in a variety of different forms for many years. Since the mid-20^th century, there has been an increase in interest in the implant process for the replacement of missing teeth. Branemark was one of the initial pioneers who applied scientifically based research techniques to develop an endosseous implant that forms an immobile connection with bone. The need for a dental implant to completely address multiple physical and biological factors imposes tremendous constraints on the surgical and handling protocol. Metallic dental implants have been successfully used for decades, but they have serious shortcomings related to their bony union and the fact that their mechanical properties do not match those of bone. However, anatomic limitation and restorative demands encourage the surgeon to gain precision in planning and surgical positioning of dental implants. Ideal placement of the implant facilitates the establishment of favorable forces on the implants and the prosthetic component as well as ensures an aesthetic outcome. Therefore, it is advisable to establish a logical continuity between the planned restoration and the surgical phases, it is essential to use a transfer device that for sure increases the predictability of success. The surgical guide template is fabricated by a dental technician after the presurgical restorative appointments that primarily include determination of occlusal scheme and implant angulations. Here, authors genuinely attempted to review the evolution and clinical applicability of surgical templates used in the placement of dental implants.

Reliability of implant surgical guides based on soft-tissue models

The purpose of this study was to determine the accuracy of implant surgical guides fabricated on diagnostic casts. Guides were fabricated with radiopaque rods representing implant positions. Cone beam computerized tomograms were taken with guides in place. Accuracy was evaluated using software to simulate implant placement. Twenty-two sites (47%) were considered accurate (13 of 24 maxillary and 9 of 23 mandibular sites). Soft-tissue models do not always provide sufficient accuracy for fabricating implant surgical guides.

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.

Role of surgical stents in determining the position of implants

AIM

Demand from implant patients for quality and efficient treatment is increasing. Fortunately dental implant treatment is evolving with patients expectations.

MATERIALS AND METHODS

The study comprised of 45 patients for whom 89 implants were placed at different sites. Efficacy of the stents is evaluated in determining the position and diameter of the implants.

CONCLUSION

this study shows the extreme accuracy of this surgical stents in implant installation in terms of position and diameter.

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.

Implant surgical guide fabrication for partially edentulous patients

This article presents an innovative method for the fabrication of implant drill guides for partially edentulous patients. Using a light-polymerized composite material and drill blanks placed in the prosthodontically driven implant position, surgical guides for each implant drill are constructed on the diagnostic cast. In addition to the size-customized implant surgical guides, a ridge crest preparation guide showing the proposed crown contour is used to adjust the tissue contour, if needed, during implant surgery.

An Instrument for the Optimal Guiding of Osseointegrated Dental Implants

The purpose of this study was to design an instrument for the optimal guiding of osseointegrated implants intraoperatively to achieve parallelism or desired angulations. Seven patients (4 males and 3 females) were enrolled in the investigation. They ranged in age from 44 to 61 years. Using an instrument designed by the senior author that permitted optimal guiding of the osteotomy instruments (33 Osteofix Oy, Oulu, Finland) we placed in these patients, root form, single stage implants. The difference in angulations between the first and the remaining implants was measured using the abutment replicas on the working models. It was found that the mean deviation angle between the first and the adjacent implant replicas was 2.2° (SD = 0.4°). The largest deviation angles were 2.3° (SD = 0.5°) and 3.1° (SD = 0.8°). The study indicated that the instrument had been designed in a functional manner and that all implants in such relationships can be inserted into their desired positions, either parallel to one another or with the desired angle for the planned prostheses.

A technique for making a diagnostic and surgical template

Implant-supported restorations can restore function and esthetics provided that the implants are placed in the predetermined location and properly angulated. This article describes the fabrication of a diagnostic template incorporating a silicone radiopaque marker as a guide for achieving 3-dimensional evaluation of bone without artifacts using computed tomography. The diagnostic template may be easily transformed into a surgical template by removing the silicone marker.

Precision surgical template for implant placement: a new systematic approach

The importance of a precise surgical template for implant placement cannot be overstated. The radiographic template carries both clinical and radiographic information for the planning of fixture angulation and location. This article describes a systematic approach to the fabrication of a dual-purpose radiographic surgical template. The simple steps result in the accurate transfer of radiographic information to the surgical template with no need for complex equipment or maneuvers. key words: dental implants, implant placement, radiographic template, surgical template