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Mangano FG, Yang KR, Lerner H, Admakin O, Mangano C. Artificial intelligence and mixed reality for dental implant planning: A technical note. Clin Implant Dent Relat Res 2024; 26:942-953. [PMID: 38940681 DOI: 10.1111/cid.13357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 04/25/2024] [Accepted: 06/09/2024] [Indexed: 06/29/2024]
Abstract
AIM The aim of this work is to present a new protocol for implant surgical planning which involves the combined use of artificial intelligence (AI) and mixed reality (MR). METHODS This protocol involves the acquisition of three-dimensional (3D) patient data through intraoral scanning (IOS) and cone beam computed tomography (CBCT). These data are loaded into AI software which automatically segments and aligns the patient's 3D models. These 3D models are loaded into MR software and used for planning implant surgery through holography. The files are then exported and used to design surgical guides via open-source software, which are 3D printed and used to prepare the implant sites through static computer-assisted implant surgery (s-CAIS). The case is finalized prosthetically through a fully digital protocol. The accuracy of implant positioning is verified by comparing the planned position with the actual position of the implants after surgery. RESULTS As a proof of principle, the present protocol seems to be to be reliable and efficient when used for planning simple cases of s-CAIS in partially edentulous patients. The clinician can plan the implants in an authentic 3D environment without using any radiology-guided surgery software. The precision of implant placement seems clinically acceptable, with minor deviations. CONCLUSIONS The present study suggests that AI and MR technologies can be successfully used in s-CAIS for an authentic 3D planning. Further clinical studies are needed to validate this protocol.
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Affiliation(s)
- Francesco Guido Mangano
- Department of Pediatric Preventive Dentistry and Orthodontics, Sechenov First State Medical University, Moscow, Russia
| | | | - Henriette Lerner
- Academic Teaching and Research Institution of Johann Wolfgang Goethe University, Frankfurt, Germany
| | - Oleg Admakin
- Department of Pediatric Preventive Dentistry and Orthodontics, Sechenov First State Medical University, Moscow, Russia
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Li P, Zhao C, Chen J, Xu S, Yang S, Li A. Accuracy of robotic computer-assisted implant surgery for immediate implant placement: A retrospective case series study. Clin Implant Dent Relat Res 2024. [PMID: 39302731 DOI: 10.1111/cid.13383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 08/01/2024] [Accepted: 08/10/2024] [Indexed: 09/22/2024]
Abstract
OBJECTIVES This study investigated the accuracy of robotic computer-assisted implant surgery (r-CAIS) for immediate implant placement. METHODS Twenty cases with 20 implant sites were selected based on predefined inclusion criteria. The preparation of the implant bed and implant placement followed the standardized dental implant robotic surgery protocol. Postoperative cone-beam computed tomography scans were conducted to assess possible discrepancies between actual and planned implant positions. RESULTS The r-CAIS technology for immediate implant placement exhibited a mean global coronal deviation of 0.71 ± 0.27 mm (95% CI: 0.58-0.83 mm), a mean global apical deviation of 0.69 ± 0.26 mm (95% CI: 0.56-0.81 mm), and an angular deviation of 1.27 ± 0.47° (95% CI: 1.05-1.49°). A substantial number of deviations were observed buccally at both coronal (90%) and apical (95%) levels, with a consistent tendency for buccal deviation. CONCLUSIONS The r-CAIS technology proved a promising approach for immediate implantation in the anterior region, with satisfactory clinical outcomes. However, an optimized surgical protocol for r-CAIS technology is required for particular implant sites like extraction sockets or bone defects.
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Affiliation(s)
- Ping Li
- Department of Prosthodontics, School and Hospital of Stomatology, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Medical University, Guangzhou, China
- Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou Medical University, Guangzhou, China
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Chunhui Zhao
- Department of Prosthodontics, School and Hospital of Stomatology, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Medical University, Guangzhou, China
- Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou Medical University, Guangzhou, China
| | - Jiahao Chen
- Department of Stomatology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Shulan Xu
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Shuo Yang
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
| | - An Li
- Department of Periodontology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
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Pol CWP, Cune MS, Raghoebar GM, Naves LZ, Meijer HJA. Mechanical strength of stock and custom abutments as original and aftermarket components after thermomechanical aging. Clin Exp Dent Res 2024; 10:e892. [PMID: 39052871 PMCID: PMC11271801 DOI: 10.1002/cre2.892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 04/17/2024] [Accepted: 04/23/2024] [Indexed: 07/27/2024] Open
Abstract
OBJECTIVES The study aimed to assess the impact on the mechanical strength and failure patterns of implant-abutment complexes of choosing different abutment types, designs and manufacturers, aiding in selecting the optimal restorative solution. Stock and custom abutments from original and aftermarket suppliers were subjected to thermomechanical aging. MATERIAL AND METHODS Stock and custom abutments from the implant manufacturer (original) and a aftermarket supplier (nonoriginal) were connected to identical implants with internal connection. Custom abutments were designed in a typical molar and premolar design, manufactured using the workflow from the respective suppliers. A total of 90 implants (4 mm diameter, 3.4 mm platform, 13 mm length) equally divided across 6 groups (three designs, two manufacturers) underwent thermo-mechanical aging according to three different regimes, simulating five (n = 30) or 10 years (n = 30) of clinical function, or unaged control (n = 30). Subsequently, all samples were tested to failure. RESULTS During aging, no failures occurred. The mean strength at failure was 1009N ± 171, showing significant differences between original and nonoriginal abutments overall (-230N ± 27.1, p < .001), and within each abutment type (p = .000), favoring original abutments. Aging did not significantly affect the failure load, while the type of abutment and manufacturer did, favoring original and custom-designed abutments. The most common failure was implant bending or deformation, significantly differing between original and nonoriginal abutments and screws. All failure tests resulted in clinically unsalvageable implants and abutments. CONCLUSIONS Within the limitations of this study, original abutments exhibited a higher mechanical strength compared to the nonoriginal alternative, regardless of the amount of simulated clinical use. Similarly, custom abutments showed higher mechanical strength compared to stock abutments. However, mechanical strength in all abutments tested was higher than average chewing forces reported in literature, thus components tested in this study can be expected to perform equally well in clinical situations without excessive force.
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Affiliation(s)
- Christiaan W. P. Pol
- Department of Integrated Dentistry, Dental School, University Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
| | - Marco S. Cune
- Department of Restorative Dentistry, Dental School, University Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
- Department of Oral and Maxillofacial SurgeryProsthodontics and Special Dental Care, St. Antonius hospital NieuwegeinNieuwegeinThe Netherlands
| | - Gerry M. Raghoebar
- Department of Oral and Maxillofacial Surgery, University Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
| | - Lucas Z. Naves
- Department of Restorative Dentistry, Dental School, University Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
| | - Henny J. A. Meijer
- Department of Restorative Dentistry, Dental School, University Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
- Department of Oral and Maxillofacial Surgery, University Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
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Ramadan RE, Bahgat MM, Abdelhamid AM, Khamis MM. Registration of maxillomandibular relationship through a fully digital workflow for complete-mouth rehabilitation with screw-retained fixed implant-supported prostheses: A clinical report. J Prosthet Dent 2024; 132:6-13. [PMID: 36609083 DOI: 10.1016/j.prosdent.2022.11.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 11/04/2022] [Accepted: 11/04/2022] [Indexed: 01/06/2023]
Abstract
Digital recording of the maxillomandibular relationship by using intraoral scanning in completely edentulous patients for computer-aided design and computer-aided manufacture implant-supported prostheses can be challenging. This clinical report describes the fabrication of complete arch, screw-retained implant-supported prostheses in a completely edentulous patient with a fully digital workflow.
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Affiliation(s)
- Rania E Ramadan
- Assistant Lecturer, Department of Prosthodontics, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
| | - Mariam M Bahgat
- Assistant Lecturer, Department of Prosthodontics, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Ahmed M Abdelhamid
- Professor, Department of Prosthodontics, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Mohamed Moataz Khamis
- Professor and Chairman, Department of Prosthodontics, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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Ko YC, Lee D, Koo KT, Seol YJ, Lee YM, Lee J. A randomized controlled trial of immediate implant placement comparing hydroxyapatite nano-coated and uncoated sandblasted/acid-etched implants using a digital surgical guide. Int J Implant Dent 2024; 10:29. [PMID: 38839621 PMCID: PMC11153479 DOI: 10.1186/s40729-024-00549-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 05/23/2024] [Indexed: 06/07/2024] Open
Abstract
PURPOSE This study evaluated the implant stability, volumetric changes, and patient-reported outcome measures (PROMs) of hydroxyapatite (HA) nano-coated sandblasted/acid-etched (SLA) implants compared to uncoated SLA implants. METHODS Forty patients were recruited and randomly allocated to HA nano-coated SLA group (test, n = 20) and uncoated SLA group (control, n = 20) using single-blinded/block randomization. Implants were immediately placed in maxillary posterior region using a digital surgical guide. Insertion torque and implant stability quotient (ISQ) were measured at implant surgery and 1, 2, 3, and 4 months postoperatively. Intraoral scans, PROMs and soft tissue inflammation data were collected, and multivariable linear regression analysis of ISQ was performed. RESULTS In total, 48 implants (test; n = 24, control; n = 24) in 37 patients (test; n = 19, control; n = 18) were analyzed. Despite no significant between-group difference at surgery, the test group showed higher ISQ values than the control group at 2 (76.53 ± 4.17 vs. 71.32 ± 4.79, p < 0.01), 3 (77.45 ± 4.41 vs. 73.85 ± 4.69, p < 0.05), and 4 months (79.08 ± 2.96 vs. 73.43 ± 3.52, p < 0.0001) postoperatively. There were no significant differences in linear and volumetric changes, PROMs, and soft tissue inflammation analysis between two groups. The ISQ at implant surgery was influenced by age and diabetes mellitus (DM) at the implant level and DM and predicted total bone-to-implant contact area at the patient level. CONCLUSION HA nano-coated SLA implants promoted favorable immediate implants stability during early osseointegration phase compared to uncoated SLA implants, but displayed similar dimensional changes, PROMs, and soft tissue inflammation outcomes. TRIAL REGISTRATION Clinical Research Information Service (CRIS), KCT0006364. Registered 21 July 2021, https://cris.nih.go.kr/cris/search/detailSearch.do?seq=24221&search_page=L .
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Affiliation(s)
- Young-Chang Ko
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Dongseob Lee
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
- National Dental Care Center for Persons with Special Needs, Seoul National University Dental Hospital, Seoul, Republic of Korea
| | - Ki-Tae Koo
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Yang-Jo Seol
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Yong-Moo Lee
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
| | - Jungwon Lee
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
- One-Stop Specialty Center, Seoul National University Dental Hospital, Seoul, Republic of Korea.
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Younis H, Lv C, Xu B, Zhou H, Du L, Liao L, Zhao N, Long W, Elayah SA, Chang X, He L. Accuracy of dynamic navigation compared to static surgical guides and the freehand approach in implant placement: a prospective clinical study. Head Face Med 2024; 20:30. [PMID: 38745297 PMCID: PMC11092008 DOI: 10.1186/s13005-024-00433-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 04/29/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Computer-guided implant surgery has improved the quality of implant treatment by facilitating the placement of implants in a more accurate manner. This study aimed to assess the accuracy of implant placement in a clinical setting using three techniques: dynamic navigation, static surgical guides, and freehand placement. We also investigated potential factors influencing accuracy to provide a comprehensive evaluation of each technique's advantages and disadvantages. MATERIALS AND METHODS Ninety-four implants in 65 patients were included in this prospective study. Patients were randomly assigned to one of three groups: dynamic navigation, static surgical guides, or freehand placement. Implants were placed using a prosthetically oriented digital implant planning approach, and postoperative CBCT scans were superimposed on preoperative plans to measure accuracy. Seven deviation values were calculated, including angular, platform, and apical deviations. Demographic and consistency analyses were performed, along with one-way ANOVA and post-hoc tests for deviation values. RESULTS The mean global platform, global apical, and angular deviations were 0.99 mm (SD 0.52), 1.14 mm (SD 0.56), and 3.66° (SD 1.64°) for the dynamic navigation group; 0.92 mm (SD 0.36), 1.06 mm (SD 0.47), and 2.52° (SD 1.18°) for the surgical guide group; and 1.36 mm (SD 0.62), 1.73 mm (SD 0.66), and 5.82° (SD 2.79°) for the freehand group. Both the dynamic navigation and surgical guide groups exhibited statistically significant differences in all values except depth deviations compared to the freehand group (p < 0.05), whereas only the angular deviation showed a significant difference between the dynamic navigation and surgical guide groups (p = 0.002). CONCLUSION Our findings highlight the superior accuracy and consistency of dynamic navigation and static surgical guides compared to freehand placement in implant surgery. Dynamic navigation offers precision and flexibility. However, it comes with cost and convenience considerations. Future research should focus on improving its practicality. TRIAL REGISTRATION This study was retrospectively registered at the Thai Clinical Trials Register-Medical Research Foundation of Thailand (MRF) with the TCTR identification number TCTR20230804001 on 04/08/2023. It was also conducted in accordance with the Declaration of Helsinki and approved by the institutional ethics committee at the Xian Jiaotong University Hospital of Stomatology, Xian, China (xjkqII[2021] No: 043). Written informed consent was obtained from all participants.
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Affiliation(s)
- Hamza Younis
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
- Department of Oral Implantology, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
- Department of Oral and Maxillofacial Surgery, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
- State Key Laboratory of Oral Diseases & National Center for Stomatology &, National Clinical Research Center for Oral Diseases and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Chengpeng Lv
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
- Department of Oral Implantology, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Boya Xu
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
- Department of Oral Implantology, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Huixia Zhou
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
- Department of Oral Implantology, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Liangzhi Du
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
- Department of Oral Implantology, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Lifan Liao
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
- Department of Oral Implantology, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Ningbo Zhao
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
- Department of Oral Implantology, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Wen Long
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
- Department of Oral Implantology, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Sadam Ahmed Elayah
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
- Department of Oral and Maxillofacial Surgery, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
- State Key Laboratory of Oral Diseases & National Center for Stomatology &, National Clinical Research Center for Oral Diseases and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Xiaofeng Chang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China.
- Department of Oral Implantology, College of Stomatology, Xi'an Jiaotong University, Xi'an, China.
| | - Longlong He
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China.
- Department of Oral Implantology, College of Stomatology, Xi'an Jiaotong University, Xi'an, China.
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Mozer PS, Guentsch A. An in vitro analysis of the accuracy of static and robot-assisted implant surgery. Clin Oral Implants Res 2024; 35:487-497. [PMID: 38189471 DOI: 10.1111/clr.14233] [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: 07/31/2023] [Revised: 11/26/2023] [Accepted: 12/19/2023] [Indexed: 01/09/2024]
Abstract
OBJECTIVES Robot-assisted implant surgery (RAIS) is purported to improve the accuracy of implant placement. The objective of this study was to compare RAIS with static computer-assisted implant surgery (sCAIS) in a controlled environment. MATERIALS AND METHODS A total of n = 102 implants were placed in the same modified typodont (n = 17 repeated simulated implant surgeries with each n = 3 implants per group) using robot-assisted or static computer-assisted implant surgery. The final implant positions were digitized utilizing cone-beam tomography and compared with the planned position. The angular deviation was the primary outcome parameter. 3D deviations at the implant platform level and the apex were secondary outcome parameters. Accuracy in terms of trueness and precision were assessed. Means, standard deviation, and 95%-confidence intervals were analyzed statistically. RESULTS The overall angular deviation was 2.66 ± 1.83° for the robotic system and 0.68 ± 0.38° for guided surgery using static guides (p < .001), the 3D-deviation of the implant platform at crest level was for sCAIS 0.79 ± 0.28 mm and RAIS 1.51 ± 0.53 mm (p < .001) and at the apex for sCAIS 0.82 ± 0.26 mm and for RAIS 1.97 ± 0.79 mm (p < .001), respectively. CONCLUSIONS Robotically guided implant surgery was less accurate in terms of trueness (planned vs. actual position) and precision (deviations among implants) than traditional static computer-assisted implant surgery in this in vitro study.
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Affiliation(s)
- Paul S Mozer
- Private Practice, 100 West Market Street, Red Hook, New York, USA
| | - Arndt Guentsch
- Department of Surgical and Diagnostic Sciences, Marquette University School of Dentistry, Milwaukee, Wisconsin, USA
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Sharma S, Tan E, Tran B, Siow HY, Tafesse E, Thong YHJ, Tan RJM, Son J, Todaro L, Teo J, Abduo J. Effect of pilot-guided implant placement concept on the accuracy of osteotomy preparation and implant placement. J Oral Sci 2024; 66:20-25. [PMID: 38030287 DOI: 10.2334/josnusd.23-0157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
PURPOSE To evaluate the accuracy of osteotomy preparation and implant placement for 3 pilot-guided (PG) concepts, namely, a surgical template with a metal sleeve (MS), a surgical template with an in-built nonmetal sleeve (NMS), and a surgical template with an in-built nonmetal sleeve for round bur indentation (RB). METHODS Surgical models with missing maxillary molars were studied. The MS templates were designed to accept metal sleeves, while the NMS and RB templates were designed with in-built nonmetal sleeves. Ten templates were tested per group (n = 10). After each step (pilot drilling, 2nd drilling, 3rd drilling, profiling, and implant placement), the surgical model was scanned and compared against the planning model to determine maximum horizontal deviation (MHD) and maximum angle deviation (MAD). RESULTS The MS and NMS templates exhibited a similar increase in MHD with successive drilling steps. The MAD for the pilot drilling step was significantly lower for MS than for the other groups. However, the differences among groups for MHD and MAD diminished in later steps. All templates had an MHD of 1.0 mm or less and an MAD less than 8°. CONCLUSION The investigated PG implant placement concepts resulted in similar deviations in the placed implants.
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Affiliation(s)
- Shruti Sharma
- Restorative Section, Melbourne Dental School, Melbourne University
| | - Emilie Tan
- Restorative Section, Melbourne Dental School, Melbourne University
| | - Britney Tran
- Restorative Section, Melbourne Dental School, Melbourne University
| | - Hui Y Siow
- Restorative Section, Melbourne Dental School, Melbourne University
| | | | - Yoong H J Thong
- Restorative Section, Melbourne Dental School, Melbourne University
| | - Row J M Tan
- Restorative Section, Melbourne Dental School, Melbourne University
| | - Jungwoo Son
- Restorative Section, Melbourne Dental School, Melbourne University
| | - Lisa Todaro
- Restorative Section, Melbourne Dental School, Melbourne University
| | - Josephine Teo
- Restorative Section, Melbourne Dental School, Melbourne University
| | - Jaafar Abduo
- Restorative Section, Melbourne Dental School, Melbourne University
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Rutkunas V, Gendviliene I, Auskalnis L, Mangano F, Zlatev S, Ivanova V, Mijiritsky E, Borusevicius R. Influence of Kennedy class and number of implants on the accuracy of dynamic implant navigation: An in vitro study using an X-ray free evaluation methodology. J Dent 2023; 139:104679. [PMID: 37683800 DOI: 10.1016/j.jdent.2023.104679] [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: 09/15/2022] [Revised: 05/21/2023] [Accepted: 08/11/2023] [Indexed: 09/10/2023] Open
Abstract
OBJECTIVES The aim of this in vitro study was to evaluate the accuracy of fully guided dynamic implant navigation surgery in Kennedy I, II, and III class dental arch defects with two different implant designs, using an X-ray free evaluation method. METHODS Polyurethane resin maxillary models simulated posterior edentulous defects. Four cone beam computed tomography (CBCT) scans and four intraoral (IOS) scans were obtained for each model and a digital wax-up with the correct implant positions was made. The accuracy of implant positions was evaluated using an IOS-based X-ray-free method (3Shape). Four deviation characteristics were evaluated: insertion point, depth deviation, horizontal and angle deviation. RESULTS The insertion point deviation measures ranged from 0.19 mm to 1.71 mm. Depth (s) and (u) deviations ranged from -1.47 mm to 0.74 mm and from 0.02 mm to 1.47 mm, respectively. Horizontal deviation ranged from 0.09 mm to 1.37 mm. CONCLUSIONS There is a tendency of a decreasing insertion point deviation for an increasing number and distribution area of the teeth (increasing Kennedy class number). Kennedy class II and distal implant position had the most influence for the higher deviations. CLINICAL SIGNIFICANCE Dynamic implant guidance provides accurate spacing, angulation, depth and position of the implants. It is important to understand how the number of missing teeth and implant design could influence the accuracy of dynamic implant navigation. Thus, it is important to evaluate factors influencing the accuracy of dynamic systems by using a X-ray-free post-operative method and to overcome the limitations of providing multiple CBCT scans.
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Affiliation(s)
- Vygandas Rutkunas
- Institute of Odontology, Faculty of Medicine, Vilnius University, Vilnius 03101, Lithuania
| | - Ieva Gendviliene
- Institute of Odontology, Faculty of Medicine, Vilnius University, Vilnius 03101, Lithuania
| | - Liudas Auskalnis
- Institute of Odontology, Faculty of Medicine, Vilnius University, Vilnius 03101, Lithuania
| | - Francesco Mangano
- Honorary Professor in Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Stefan Zlatev
- CAD/CAM Center of Dental Medicine at the Research Institute, Medical University-Plovdiv, Plovdiv 4000, Bulgaria
| | - Vasilena Ivanova
- Oral Surgery Department, Faculty of Dental Medicine, Medical University of Plovdiv, Plovdiv 4000, Bulgaria
| | - Eitan Mijiritsky
- Head and Neck Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Department of Otolaryngology, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 699350, Israel
| | - Rokas Borusevicius
- Institute of Odontology, Faculty of Medicine, Vilnius University, Vilnius 03101, Lithuania.
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Vinnakota DN, Kamatham R, Nagaraj E, Reddy PS. Is dynamic computer-assisted surgery more accurate than the static method for dental implant placement? A systematic review and meta-analysis. J Prosthet Dent 2023:S0022-3913(23)00493-6. [PMID: 37690856 DOI: 10.1016/j.prosdent.2023.07.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 07/22/2023] [Accepted: 07/26/2023] [Indexed: 09/12/2023]
Abstract
STATEMENT OF PROBLEM Dynamic computer-assisted surgery for dental implant placement has become popular, but systematic comparisons of the accuracy of computer-assisted surgery with static surgery are lacking. PURPOSE The purpose of this systematic review and meta-analysis was to determine evidence on the difference in the accuracy of dynamic computer-assisted surgery compared with the static method for dental implant placement. MATERIAL AND METHODS A systematic search was conducted in 3 electronic databases: PubMed, Ovid, and Cochrane. Studies conducted on dental implants that compared the accuracy of positioning implants with a dynamic system with that of a static system were included. Randomized clinical trials, prospective and retrospective cohort studies, and in vitro studies were included in the review. Review articles, case reports, letters, opinion articles, commentaries, and nonpeer-reviewed literature were excluded. RESULTS Of the 26 full-text articles, 14 fulfilled the inclusion criteria. Of these, 2 were randomized clinical trials, 2 were prospective studies, and 1 was a retrospective cohort study. The remaining 9 were in vitro studies. A total of 1633 implants were placed with the static and 902 with the dynamic method. A significant mean difference (-0.51 degrees [95% CI: -0.90, -0.13]) between dynamic and static systems was only observed in the angular deviation of in vitro studies (P=.009). Meta-analysis was performed using Review Manager statistical software and forest plots were generated. CONCLUSIONS A difference was found in the angular deviation of implants placed with the dynamic approach compared with the static system. The dynamic system was better, but this difference was not demonstrable in clinical studies. No significant difference was found in the apical and coronal deviations of the dynamic and static systems.
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Affiliation(s)
- Dileep Nag Vinnakota
- Professor, Department of Prosthodontics, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India.
| | - Rekhalakshmi Kamatham
- Associate Professor, Department of Paediatrics and Preventive Dentistry, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
| | - Edamadaka Nagaraj
- Professor, Department of Prosthodontics, PMNM Dental College and Hospital, Bagalkot, Karnataka, India
| | - Papala Sesha Reddy
- Professor, Department of Prosthodontics, Government Dental College and Hospital, RIMS, Kadapa, Andhra Pradesh, India
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Lin WS. Complications related to digital technologies in treating edentulous patients with dental implants-Part II. Computer-guided surgery and prosthetic stages. J Prosthet Dent 2023; 129:817-818. [PMID: 37270261 DOI: 10.1016/j.prosdent.2023.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 03/11/2023] [Accepted: 03/13/2023] [Indexed: 06/05/2023]
Abstract
This is the second part of a JPD Digital presentation focusing on commonly seen complications and solutions related to using digital technologies in treating edentulous patients during the surgical and prosthetic stages. The proper usage of the computer-aided design and computer-aided manufacturing surgical templates and immediate loading prosthesis during computer-guided surgery and accurate translation of digital planning into clinical execution are discussed. In addition, design concepts of implant-supported complete fixed dental prostheses are presented to minimize subsequent issues in their long-term clinical service. In concert with these topics, this presentation will allow clinicians to deepen their understanding of the advantages and limitations of utilizing digital technologies in implant dentistry.
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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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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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Bathija A, Papaspyridakos P, Finkelman M, Kim Y, Kang K, De Souza AB. Accuracy of static computer-aided implant surgery (S-CAIS) using CAD-CAM surgical templates fabricated from different additive manufacturing technologies. J Prosthet Dent 2023:S0022-3913(23)00191-9. [PMID: 37121851 DOI: 10.1016/j.prosdent.2023.03.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 03/26/2023] [Accepted: 03/28/2023] [Indexed: 05/02/2023]
Abstract
STATEMENT OF PROBLEM Different 3D printers are available for guided implant surgery, but studies that evaluate their source of errors and their cost-effectiveness are lacking. PURPOSE The purpose of this in vitro study was to compare the accuracy of different 3-dimensional (3D) printed surgical templates made using different additive manufacturing technologies and to evaluate the effect of implant location on the accuracy of fully guided implant placement. MATERIAL AND METHODS Fifty partially edentulous maxillary typodonts with edentulous sites in the right second premolar (SP), right lateral incisor (LI), left central incisor (CI), and left first molar (FM) locations were scanned and printed from the standard tessellation language (STL) datasets. The study compared 5 groups for the fabrication of implant surgical templates: Varseo S-Bego (Bego), Polyjet-Stratasys (Poly), Low Force Stereolithography-FormLabs (LFS), P30+-Straumann (P30), and M2-Carbon (M2). After fully guided implant placement, the typodont was scanned, and the 3D implant positions were compared with the master model by superimposing the STL files. Descriptive statistics were calculated for groups and subgroups, and comparisons among the groups and subgroups were conducted via 2-way mixed analysis of variance, Tukey honest significant difference, and post hoc Bonferroni tests (α=.05). RESULTS The results were site specific and not consistent within each group. For angle deviation, the within-group analysis for P30 demonstrated significantly lower values for implants positioned at site SP (1.4 ±0.8 degrees) than for sites LI (2.3 ±0.7 degrees; P=.001) and CI (2.3 ±0.8 degrees; P=.007). For 3D offset at base for implant CI, LFS was significantly higher than Bego (P=.002), Poly (P=.035), or M2 (P=.001); P30 was also significantly higher than Bego (P=.014) and M2 (P=.006). LFS had a significantly higher 3D offset at the tip than Bego (P=.001) and M2 (P=.022) for implant CI. CONCLUSIONS The choice of 3D printer seemed to influence fully guided implant surgery in terms of the final implant position compared with initial implant planning. However, although statistically significant differences were present across groups, all additive manufacturing technologies were within clinically acceptable values.
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Affiliation(s)
- Anshu Bathija
- Assistant Professor, Department of Prosthodontics, University of New England, Portland, Maine
| | - Panos Papaspyridakos
- Associate Professor, Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass Adjunct Associate Professor, University of Rochester Eastman Institute for Oral Health, Rochester, NY
| | - Matthew Finkelman
- Associate Professor, Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston, Mass
| | - Yongjeong Kim
- Associate Professor, Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass
| | - Kiho Kang
- Professor, Loma Linda University School of Dentistry, Loma Linda, CA
| | - Andre B De Souza
- Adjunct Professor, Department of Periodontology, Nova Southeastern University College of Dental Medicine, Davie, Fla.
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Guentsch A, Bjork J, Saxe R, Han S, Dentino AR. An in-vitro analysis of the accuracy of different guided surgery systems - They are not all the same. Clin Oral Implants Res 2023; 34:531-541. [PMID: 36892499 DOI: 10.1111/clr.14061] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/31/2023] [Accepted: 02/24/2023] [Indexed: 03/10/2023]
Abstract
OBJECTIVES Different static computer-assisted implant surgery (sCAIS) systems are available that are based on different design concepts. The objective was to assess seven different systems in a controlled environment. MATERIALS AND METHODS Each n = 20 implants were placed in identical mandible replicas (total n = 140). The systems utilized either drill-handles (group S and B), drill-body guidance (group Z and C), had the key attached to the drill (group D and V), or combined different design concepts (group N). The achieved final implant position was digitized utilizing cone-beam tomography and compared with the planned position. The angular deviation was defined as the primary outcome parameter. The means, standard deviation, and 95%-confidence intervals were analyzed statistically with 1-way ANOVA. A linear regression model was applied with the angle deviation as predictor and the sleeve height as response. RESULTS The overall angular deviation was 1.94 ± 1.51°, the 3D-deviation at the crest 0.54 ± 0.28 mm, and at the implant tip 0.67 ± 0.40 mm, respectively. Significant differences were found between the tested sCAIS systems. The angular deviation ranged between 0.88 ± 0.41° (S) and 3.97 ± 2.01° (C) (p < .01). Sleeve heights ≤4 mm are correlated with higher angle deviations, sleeve heights ≥5 mm with lower deviations from the planned implant position. CONCLUSIONS Significant differences were found among the seven tested sCAIS systems. Systems that use drill-handles achieved the highest accuracy, followed by the systems that attach the key to the drill. The sleeve height appears to impact the accuracy.
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Affiliation(s)
- Arndt Guentsch
- Department of Surgical Sciences, Marquette University School of Dentistry, Milwaukee, Wisconsin, USA
| | - Jennifer Bjork
- Department of General Dental Sciences, Marquette University School of Dentistry, Milwaukee, Wisconsin, USA
| | - Reagan Saxe
- Department of General Dental Sciences, Marquette University School of Dentistry, Milwaukee, Wisconsin, USA
| | - Shengtong Han
- Marquette University School of Dentistry, Milwaukee, Wisconsin, USA
| | - Andrew R Dentino
- Department of Surgical Sciences, Marquette University School of Dentistry, Milwaukee, Wisconsin, USA
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Pomares-Puig C, Sánchez-Garcés MA, Jorba-García A. Dynamic and static computer-assisted implant surgery for completely edentulous patients. A proof of a concept. J Dent 2023; 130:104443. [PMID: 36720424 DOI: 10.1016/j.jdent.2023.104443] [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: 11/28/2022] [Revised: 01/24/2023] [Accepted: 01/26/2023] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVES To assess the accuracy and patient reported outcome measures (PROMs) of the computer-guided "double factor" technique for treating fully edentulous patients. METHODS A proof of concept prospective study was designed. Ten consecutive patients requiring full arch dental implant supported rehabilitation in a private practice were enrolled between October 2021 and March 2022. All patients were treated by means of an All-on-four®, and implants were planned and placed according to the "double factor" technique. This technique merges the static and dynamic computer-guided surgical approach in the same surgery. The primary outcome was the accuracy of implant placement, measured by overlapping post- and pre-operative cone-beam computerized tomography with the implant planning. Additionally, PROMs and patient quality of life after surgery were evaluated using different questionnaires. Descriptive and bivariate data analyses were performed. Statistical significance was considered for p < 0.05. RESULTS A total of 48 implants were placed using the "double factor" technique, and 12 full-arch immediate loading prostheses were delivered. The mean angular deviation was 3.74° (standard deviation [SD]: 2). The total linear deviation at the apex and platform of the implant was 1.25 mm (SD: 0.55) and 1.42 mm (SD: 0.64), respectively. No statistically significant differences were found between tilted and axial implants, the upper and lower jaw, or the right and left side. High self-reported satisfaction was registered, and the Oral Health Impact Profile-14 (OHIP-14) score improved postoperatively (p = 0.002). CONCLUSIONS The "double factor" technique is a valid and accurate treatment approach for fully edentulous patients. CLINICAL SIGNIFICANCE The double factor technique merges the advantages of both the dynamic and static computer assisted surgery approaches, affording accurate and predictable results when treating fully edentulous patients in a minimally invasive manner.
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Affiliation(s)
| | - M Angeles Sánchez-Garcés
- Faculty of Medicine and Health Sciences, University of Barcelona, Researcher at the IDIBELL (Bellvitge Biomedical Research Institute), Barcelona, Spain.
| | - Adrià Jorba-García
- Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
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Jorba-García A, Bara-Casaus JJ, Camps-Font O, Sánchez-Garcés MÁ, Figueiredo R, Valmaseda-Castellón E. Accuracy of dental implant placement with or without the use of a dynamic navigation assisted system: A randomized clinical trial. Clin Oral Implants Res 2023; 34:438-449. [PMID: 36794798 DOI: 10.1111/clr.14050] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 01/29/2023] [Accepted: 01/30/2023] [Indexed: 02/17/2023]
Abstract
OBJECTIVES To assess dental implant placement accuracy with a dynamic computer-assisted implant surgery (dCAIS) system and a freehand approach. Secondarily, to compare the patients' perception and quality of life (QoL) with the two approaches. METHODS A double-arm randomized clinical trial was conducted. Consecutive partially edentulous patients were randomly allocated to the dCAIS or standard freehand approach groups. Implant placement accuracy was evaluated by overlapping the preoperative and postoperative Cone Beam Computer Tomographs (CBCT) and recording linear deviations at the implant apex and platform (in mm) and angular deviations (in degrees). Questionnaires recorded self-reported satisfaction, pain and QoL during surgery and postoperatively. RESULTS Thirty patients (22 implants) were enrolled in each group. One patient was lost to follow-up. A significant difference (p < .001) in mean angular deviation was found between the dCAIS (4.02°; 95% CI: 2.85 to 5.19) and the FH (7.97°; 95% CI: 5.36 to 10.58) groups. Linear deviations were significantly lower in the dCAIS group, except for the apex vertical deviation, where no differences were found. Although dCAIS took 14 min longer (95% CI: 6.43 to 21.24; p < .001), patients in both groups considered the surgical time acceptable. Postoperative pain and analgesic consumption during the first postoperative week were similar between groups and self-reported satisfaction was very high. CONCLUSION dCAIS systems significantly increase the accuracy of implant placement in partially edentulous patients in comparison with the conventional freehand approach. However, they increase the surgical time significantly and do not seem to improve patient satisfaction or reduce postoperative pain.
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Affiliation(s)
- Adrià Jorba-García
- Master of Oral Surgery and Implantology, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | | | - Octavi Camps-Font
- Oral Surgery, Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain.,IDIBELL Institute (Bellvitge Biomedical Research Institute), Barcelona, Spain
| | - Maria Ángeles Sánchez-Garcés
- Oral Surgery, Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain.,IDIBELL Institute (Bellvitge Biomedical Research Institute), Barcelona, Spain
| | - Rui Figueiredo
- Oral Surgery, Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain.,IDIBELL Institute (Bellvitge Biomedical Research Institute), Barcelona, Spain
| | - Eduard Valmaseda-Castellón
- Oral Surgery, Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain.,IDIBELL Institute (Bellvitge Biomedical Research Institute), Barcelona, Spain
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Nicchio N, Gonçalves V, Mendonça G, Sales E Pessoa R, Frizzera F, Zandim-Barcelos DL. Accuracy of partially and fully guided surgical techniques for immediate implant placement: An in vitro assessment. J Prosthet Dent 2023; 129:363.e1-363.e7. [PMID: 36577570 DOI: 10.1016/j.prosdent.2022.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 11/22/2022] [Accepted: 11/22/2022] [Indexed: 12/27/2022]
Abstract
STATEMENT OF PROBLEM Optimal implant positioning is essential to achieving predictable results. Computer-guided surgery has been reported to be an accurate technique for implant placement in healed sites, but the accuracy of guided techniques for immediate implant placement into fresh sockets is still unclear. PURPOSE The purpose of this experimental randomized split-mouth study in pig jaws was to determine the accuracy of partially and fully guided surgical techniques for immediate implant placement into fresh sockets and to compare 2 different methods of implant position deviations analysis. MATERIAL AND METHODS Twenty implants were installed in 10 pig jaws using 2 different techniques: partially guided (n=10) and fully guided (n=10). Cone beam computed tomography and digital scanning were performed before and after the surgical procedure to plan the virtual implant position and fabricate the surgical guide, as well as to determine implant position deviations. Two methods were used to evaluate implant deviations: tomographic and digital scanning. The Shapiro-Wilk test of normality was used. Deviation comparisons were carried out by using paired t tests (α=.05), and intraclass correlation coefficient (ICC) was computed to assess the agreement between the 2 methods of implant deviation analysis. RESULTS In the tomographic analysis, the partially guided technique resulted in significantly higher global apical and lateral coronal deviations (2.25 ±0.59 mm; 0.96 ±0.55 mm) than fully guided (1.52 ±0.89 mm; 0.75 ±0.52 mm) (P<.01 and P<.05, respectively). The analysis performed using digital scanning showed significantly higher angular, global apical, and lateral apical deviations in the partially guided (6 ±3.28 degrees; 2.49 ±1.03 mm; 2.16 ±1.07 mm) technique than in the fully guided (3.32 ±1.84 degrees; 1.5 ±0.58 mm; 0.98 ±0.67 mm) (P<.05). An ICC of 0.522 between the 2 methods of implant deviation analysis was obtained. CONCLUSIONS The partially guided technique was less accurate than the fully guided technique for immediate implant placement into fresh sockets. A moderate concordance was observed between cone beam computed tomography and digital scanning analyses, suggesting that more studies are required to validate and to define the most reliable method of measuring implant deviation.
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Affiliation(s)
- Nicolas Nicchio
- PhD student, Department of Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry at Araraquara, Araraquara, São Paulo, Brazil
| | - Victor Gonçalves
- PhD student, Department of Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry at Araraquara, Araraquara, São Paulo, Brazil
| | - Gustavo Mendonça
- Professor, Department of Biologic and Materials Sciences and Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, Mich
| | - Roberto Sales E Pessoa
- Professor, Department of Periodontology, Unitri School of Dentistry (UFTM), Uberlândia, Minas Gerais, Brazil
| | - Fausto Frizzera
- Professor, Department of Periodontology and Implantology, FAESA University Center (FAESA), Espírito Santo, Brazil
| | - Daniela Leal Zandim-Barcelos
- Professor, Department of Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry at Araraquara, Araraquara, São Paulo, Brazil.
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Retentive design of a small surgical guide for implant surgery: An in-vitro study. J Dent 2023; 128:104384. [PMID: 36470471 DOI: 10.1016/j.jdent.2022.104384] [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: 03/21/2022] [Revised: 10/17/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES Instability of the surgical guide is an overlooked factor that can result in a difference between the planned and the actual positions of an implant. Our aim was to compare the stability of the retentive surgical guide (RSG) with a conventional surgical guide (CSG) in an in-vitro experiment. METHODS A platform to evaluate the stability of the surgical guide was designed using 3D-modelling software (Meshmixer 3.5, Autodesk). Imaging data from 15 patients with a single missing tooth were used to plan the virtual implant. Two surgical guides were designed (Blue Sky Plan 4.8, Blue Sky Bio) and 3D printed (Form2, Dental SG resin, Formlabs) for each case: the CSG with the default, predetermined software settings, and the RSG, designed on a dental model with a 0.1-mm undercut and altered production parameters (reduced guide-to-teeth offset of 0.07 mm, reduced guide thickness of 2.3 mm and a retentive clasp in a marginal area). The dental models were reproducibly secured on the testing platform using a digital force gauge, and the surgical guides were positioned. An increasing force of 0.1 N, 1 N, 2.5 N, and 5 N was sequentially applied from the buccal and the oral directions to the surgical guide via a drill handle. For each force, either the magnitude of the guide's displacement was captured with an intra-oral scanner (CEREC Omnicam AC, Dentsply Sirona; software version: SW 4.5.2) or the dislodgement of the guide was recorded. Scans were imported for analysis (GOM Inspect 2018, GOM GmbH), and library files of the surgical guides and implants were superimposed as a joined complex. The deviation of the implant's position was calculated from the displacement of the guide's position RESULTS: Three-way repeated measures using ANOVA revealed a more significant guide displacement and virtually projected implant deviation in the CSG group than the RSG group and with increasing force in all the deviation parameters. Both groups showed greater resistance to the displacement with the force applied from the oral direction than the buccal direction. The application of the force in the buccal direction resulted in guide dislodgements of 13% and 0% for the CSG and RSG, respectively. In the oral direction, the dislodgement rates were 33% and 7% for the CSG and RSG, respectively. CONCLUSIONS Within the limitations of this study, the retentive design increased the stability of the surgical guide and, consequently, the accuracy of the virtually projected implants in comparison to the conventional surgical guide designed using the default settings. Clinical trials are needed to confirm its advantages in clinical use. CLINICAL SIGNIFICANCE With a simple modification to the design, the surgical guide retention provided greater stability, with smaller deviations under loading; this resulted in improved implant precision parameters without requiring additional materials or software. Further studies are needed to assess the clinical feasibility of this surgical guide with improved retention and function.
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Gintaute A, Zitzmann NU, Brägger U, Weber K, Joda T. Patient-reported outcome measures compared to professional dental assessments of monolithic ZrO 2 implant fixed dental prostheses in complete digital workflows: A double-blind crossover randomized controlled trial. J Prosthodont 2023; 32:18-25. [PMID: 35938349 PMCID: PMC10087166 DOI: 10.1111/jopr.13589] [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: 06/07/2022] [Accepted: 08/02/2022] [Indexed: 01/25/2023] Open
Abstract
PURPOSE This double-blind randomized controlled trial analyzed patient-reported outcome measures in terms of subjective patient satisfaction compared to objective dental evaluation of prosthetic treatment with 3-unit monolithic zirconium dioxide implant fixed dental prostheses (iFDPs) in 3 digital workflows. MATERIAL AND METHODS Twenty patients were restored with 3 iFDPs each on Straumann TL-implants with 2 completely digital workflows using different intraoral optical scanning systems with model-free fabrication of the restoration (Trios 3/3Shape [Test-1]; Virtuo Vivo/Straumann [Test-2]), and mixed analog-digital workflow with conventional impressions and digitized gypsum casts (Impregum/3M Espe [Control]). The order of impression-taking and the prosthetic try-in were randomly allocated. Sixty iFDPs were compared for patient satisfaction and dental evaluation using ANOVA. RESULTS For iFDP evaluation, patients generally provided more favorable ratings than dental experts, regardless of the workflow. ANOVA revealed no significant difference for overall satisfaction when comparing Test-1, Test-2, or Control, either for patients (f-ratio: 0.13; p = 0.876) or dentist (f-ratio: 1.55: p = 0.221). Secondary, patients clearly favored the digital impression workflows over the conventional approach (f-ratio: 14.57; p < 0.001). Overall, the 3Shape workflow (Test-1) received the highest scores for all analyses. CONCLUSIONS The different digital workflows demonstrated minor influence on the subjective and objective evaluation of the monolithic zirconium dioxide iFDPs in nonesthetic regions; however, the dentist may significantly increase patient satisfaction by choosing intraoral scanning instead of conventional impressions. The dentist has to consider individual patients' needs to fulfill their expectations for a personalized solution.
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Affiliation(s)
- Aiste Gintaute
- Department of Reconstructive Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland
| | - Nicola U Zitzmann
- Department of Reconstructive Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland
| | - Urs Brägger
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Karin Weber
- Department of Reconstructive Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland
| | - Tim Joda
- Department of Reconstructive Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland.,Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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Guided Biopsy of a Radiopaque Lesion Simultaneous with Dental Implants’ Placement: A Multidisciplinary Approach. SURGERIES 2022. [DOI: 10.3390/surgeries3040032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background: New technologies and techniques allow us to offer better solutions for patients’ needs. Specifically, guided surgery is usually flapless, and the resulting prosthetic rehabilitation often includes immediate loading. Thus, bleeding risk is controlled, and more comfortable prosthetic procedures are performed. Guided surgery decreases surgical risks and is less invasive. The aim of this article is to present a case of guided osteotomy for bone biopsy and implant placement. Methods: CBCT was performed for the patient’s bone examination, an optical scanner was used for intra-oral images, and surgical certified software was applied for the osteotomy planning and the surgeon’s guide realization. Case report: The patient’s question is about left maxilla prosthetic rehabilitation. During the oral cavity and X-ray examination, a radiopacity with a feathered edge was found; in order to detect the finding, a CBCT was performed, and the surgery was planned. A bone biopsy was performed simultaneously with the implant’s placement through a drill guide. The specimen sent for histological exam showed osteosclerosis. Conclusions: It is the opinion of the authors that by involving and combining close collaboration and communication, several professional specializations (clinicians and radiologists) can improve the treatments for better patient care.
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Abduo J, Lau D. Duration, deviation and operator's perception of static computer assisted implant placements by inexperienced clinicians. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2022; 26:477-487. [PMID: 34797018 DOI: 10.1111/eje.12724] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 09/19/2021] [Accepted: 09/27/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION This study measured the duration, deviation and operator's perception of implant placement by fully guided (FG), pilot-guided (PG) and freehand (FH) protocols by postgraduate students with minimal implant experience. MATERIALS AND METHODS Twenty postgraduate students participated in the study. Half of them placed single anterior (S-Ant) and single posterior (S-Post) implants, and the other half placed anterior (B-Ant) and posterior (B-Post) implants in a wide edentulous area. The PG placement involved surgical guides that only controlled pilot drilling, whilst the FG placement controlled all the drilling steps and implant placement. The duration of implant placement and the operator's perception (ease of drilling, ease of implant placement and operator's preference) were measured. The deviations of placed implants were quantified by measuring the trueness and angulation deviations in relation to the planned implants. RESULTS The PG placement was the quickest for inserting implants, followed by FG and FH placements, respectively (p < .05). The location of the implant had influenced the duration of implant placement only for the PG placement. In relation to ease of drilling, ease of implant placement and operator's preference, there was no significant difference amongst the different placement protocols or implant locations. The FG placement was associated with least deviations, followed by PG and FH placements, respectively (p < .05). CONCLUSIONS In the hands of postgraduate students with minimal implant experience, FG and PG placements reduced the implant placement duration in comparison with FH placement. The FG placement was consistently more accurate followed by PG placement.
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Affiliation(s)
- Jaafar Abduo
- Melbourne Dental School, Melbourne University, Melbourne, Victoria, Australia
| | - Douglas Lau
- Private Practice, Melbourne Dental School, Melbourne University, Melbourne, Victoria, Australia
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22
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Wei SM, Li Y, Deng K, Lai HC, Tonetti MS, Shi JY. Does machine-vision-assisted dynamic navigation improve the accuracy of digitally planned prosthetically guided immediate implant placement? A randomized controlled trial. Clin Oral Implants Res 2022; 33:804-815. [PMID: 35652362 DOI: 10.1111/clr.13961] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/19/2022] [Accepted: 05/29/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES This randomized controlled clinical trial was designed to compare the accuracy of machine-vision (MV)-based dynamic navigation (DN)-assisted immediate implant placement with the conventional freehand technique. MATERIAL AND METHODS A total of 24 subjects requiring immediate implant placement in maxillary anterior teeth were randomly assigned to either the control (freehand by an experienced surgeon, n = 12) or the test group (MV-DN, n = 12). Implant platform, implant apex, angular, and depth deviations with respect to prosthetically guided digital planning and differences in implant insertion torque (ITV) and implant stability quotient (ISQ) were compared between the groups. RESULTS MV-DN resulted in more accurate immediate implant position: significantly smaller global platform deviation (1.01 ± 0.41 mm vs. 1.51 ± 0.67 mm, p = .038), platform depth deviation (0.44 ± 0.46 mm vs. 0.95 ± 0.68 mm, p = .045), global apex deviation (0.88 ± 0.43 mm vs. 1.94 ± 0.86 mm, p = .001), and lateral apex deviation (0.68 ± 0.30 mm vs. 1.61 ± 0.88 mm, p = .004) were found in MV-DN compared to controls. No significant intergroup differences were observed for ITV and ISQ. CONCLUSIONS MV-DN achieved more precise immediate implant position and comparable primary stability. Further trials are necessary to assess the benefits in terms of esthetics and tissue health/stability.
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Affiliation(s)
- Shi-Min Wei
- Shanghai PerioImplant Innovation Center and Department of Oral and Maxillo-Facial Implantology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Yuan Li
- Shanghai PerioImplant Innovation Center and Department of Oral and Maxillo-Facial Implantology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Ke Deng
- Shanghai PerioImplant Innovation Center and Department of Oral and Maxillo-Facial Implantology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Hong-Chang Lai
- Shanghai PerioImplant Innovation Center and Department of Oral and Maxillo-Facial Implantology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Maurizio S Tonetti
- Shanghai PerioImplant Innovation Center and Department of Oral and Maxillo-Facial Implantology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China.,European Research Group on Periodontology, Genova, Italy
| | - Jun-Yu Shi
- Shanghai PerioImplant Innovation Center and Department of Oral and Maxillo-Facial Implantology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
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23
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Li J, Meneghetti PC, Galli M, Mendonca G, Chen Z, Wang HL. Open-sleeve templates for computer-assisted implant surgery at healed or extraction sockets: An in vitro comparison to closed-sleeve guided system and free-hand approach. Clin Oral Implants Res 2022; 33:757-767. [PMID: 35578783 DOI: 10.1111/clr.13957] [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: 05/05/2021] [Revised: 11/09/2021] [Accepted: 01/30/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE A buccal opening guide provides better view and better irrigation. The aim of this study was to investigate the accuracy of this open-sleeve system. MATERIAL AND METHODS Thirty duplicated maxillary models, each with 6 extraction sockets and 4 healed sites, were used. Based on the same digital plan, three modalities, sCAIS with open-sleeves, closed-sleeves, and free-hand approach, were used to place implants. The global, horizontal, depth, and angular deviations between the virtual and actual implant positions were measured. RESULTS Both sCAIS groups exhibited better accuracy than the free-hand group in two clinical scenarios. At healed sites, the closed-sleeve group showed a significantly fewer error than the open-sleeve group in global apical (0.68 ± 0.33 vs. 0.96 ± 0.49 mm), horizontal coronal (0.28±0.15 vs. 0.44±0.25 mm), horizontal apical (0.64±0.32 vs. 0.94±0.48 mm), and angular deviations (1.83 ± 0.95 vs. 2.86 ± 1.46°). For extraction sockets, the open-sleeve group exhibited fewer deviations than the closed-sleeve group in terms of global (coronal: 0.77 ± 0.29 vs. 0.91 ±0.22 mm; apical: 1.08 ± 0.49 vs. 1.37 ±0.52 mm), and horizontal (coronal: 0.60±0.24 vs. 0.86±0.20 mm; apical: 0.95±0.50 vs. 1.32±0.51mm) deviations. However, the closed-sleeve group was more accurate in the depth control (0.26 ± 0.20 vs. 0.40 ± 0.31 mm). CONCLUSION In this in vitro investigation, open-sleeve sCAIS proved better accuracy than free-hand surgery for both delayed and immediate implant placement. Compared with a closed-sleeve sCAIS system, open-sleeve have the potential of providing better outcomes in extraction sockets but not in healed sites.
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Affiliation(s)
- Junying Li
- Department of Biologic and Materials Sciences, Division of Prosthodontics, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Priscila Ceolin Meneghetti
- Department of Biologic and Materials Sciences, Division of Prosthodontics, School of Dentistry, University of Michigan, Ann Arbor, MI, USA.,Department of Restorative Dentistry, Pontifical University Catholic of Rio Grande do Sul, Porto Alegre, Brazil
| | - Matthew Galli
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Gustavo Mendonca
- Department of Biologic and Materials Sciences, Division of Prosthodontics, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Zhaozhao Chen
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
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24
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Elliott T, Hamilton A, Griseto N, Gallucci GO. Additively Manufactured Surgical Implant Guides: A Review. J Prosthodont 2022; 31:38-46. [PMID: 35313020 DOI: 10.1111/jopr.13476] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/25/2021] [Indexed: 01/21/2023] Open
Abstract
Static computer assisted implant surgery (s-CAIS) is an integral part of the digital workflow in implant dentistry and provides the link between the virtual planning environment and surgical field. The accuracy of s-CAIS is influenced by many cumulative factors including the fit of the template which is related to the manufacturing process. This critical review provides an overview of the current research on additively manufactured surgical implant guides.
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Affiliation(s)
- Tom Elliott
- Division of Oral Restorative and Rehabilitative Sciences, University of Western Australia, Perth, Western Australia
| | - Adam Hamilton
- Division of Oral Restorative and Rehabilitative Sciences, University of Western Australia, Perth, Western Australia.,Division of Regenerative and Implant Sciences, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA
| | - Neil Griseto
- Division of Regenerative and Implant Sciences, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA
| | - German O Gallucci
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA
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25
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Afshari A, Shahmohammadi R, Mosaddad SA, Pesteei O, Hajmohammadi E, Rahbar M, Alam M, Abbasi K. Free-Hand versus Surgical Guide Implant Placement. ADVANCES IN MATERIALS SCIENCE AND ENGINEERING 2022; 2022:1-12. [DOI: 10.1155/2022/6491134] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
One of the most key areas of dentistry is dental implant surgery. The use of digital equipment and software in dentistry has developed considerably in recent years compared to other fields of medicine. Since examining the advantages and disadvantages of each approach, along with case studies, can help physicians make informed decisions, this review study aims to raise the awareness of dentists to make easier decisions about using guided or free-hand surgery. When planning for a dental implant, one of the most challenging questions that doctors face is which method to use (guided surgery or free-hand). Choosing the right method, such as other clinical considerations, will depend on the individual circumstances of each patient and the preference of the treating physician. Free-hand surgery is a cost-effective method in which the flap is reflected, and, according to the doctor's diagnostic information, an implant is placed, which in many cases is a useful method. Guided surgery has the highest level of accuracy and control, in which osteotomy is designed and printed through a digital surgery guide, and depending on the complexity of the case and the patient's anatomy, it has a higher level of value than free surgery. The surgical guide helps the surgeon make the implant surgery more accurate, safer, simpler, at a lower cost, and in less time. In fact, there are patterns that convey information about the position of the tooth to the dentist before the implant is placed.
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Affiliation(s)
- Aysooda Afshari
- Postgraduate Student of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Rojin Shahmohammadi
- Postgraduate Student of Periodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Ali Mosaddad
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ozra Pesteei
- Postgraduate Student of Periodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Emran Hajmohammadi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mahdi Rahbar
- Department of Restorative Dentistry, School of Dentistry, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mostafa Alam
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kamyar Abbasi
- Department of Prosthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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26
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Kunavisarut C, Santivitoonvong A, Chaikantha S, Pornprasertsuk-Damrongsri S, Joda T. Patient-reported outcome measures comparing static computer-aided implant surgery and conventional implant surgery for single-tooth replacement: A randomized controlled trial. Clin Oral Implants Res 2021; 33:278-290. [PMID: 34921690 DOI: 10.1111/clr.13886] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 11/03/2021] [Accepted: 11/29/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare static computer-aided implant surgery (s-CAIS) and conventional implant surgery (CIS) for single-tooth replacement in posterior sites in terms of patient-reported outcome measures (PROMs). METHODS Forty patients were divided into two groups for treatment with s-CAIS (Test) and CIS (Control). Patients' anxiety level was measured using the modified dental anxiety score before implant surgery. After surgery, patients completed two questionnaires for 7 days. The first questionnaire assessed pain level using a visual analog scale (VAS) and the incident rate of pain using a 5-point Likert scale; analgesic intake was also recorded. The second questionnaire investigated patients' oral health-related quality of life (OHRQoL) including postoperative symptoms, oral function, and daily activity. The difference between data was compared at significance level (α = 0.05). RESULTS There was no statistically significant difference in pretreatment dental anxiety level, postoperative pain scores, and OHRQoL between treatment groups. Overall, mild or moderate dental anxiety was reported by 70% and 20% of patients, respectively. Pain score was significantly reduced by postoperative Day 3 in the test group and Day 4 in the control group, compared with baseline. Both groups significant reduced analgesic intake by postoperative Day 5. Most OHRQoL-related complaints subsided approximately 3 days after surgery. CONCLUSIONS Overall, PROMs between s-CAIS and CIS were not significantly different for the single-tooth implant surgery in the posterior area. Postoperative symptoms after implant surgery still inevitably occurred, reflecting the normal process of oral wound healing.
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Affiliation(s)
| | | | - Sarunya Chaikantha
- Department of Oral and Maxillofacial Radiology, Mahidol University, Bangkok, Thailand
| | | | - Tim Joda
- Department of Reconstructive Dentistry, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland
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27
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Bishti S, Tuna T, Rittich A, Wolfart S. Patient-reported outcome measures (PROMs) of implant-supported reconstructions using digital workflows: A systematic review and meta-analysis. Clin Oral Implants Res 2021; 32 Suppl 21:318-335. [PMID: 34642981 DOI: 10.1111/clr.13846] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 07/09/2021] [Accepted: 07/20/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To summarize the existing evidence on patient-reported outcome measures (PROMs) of implant-supported restorations fabricated using a digital workflow in comparison to conventional manufacturing procedures. METHODS A PICO strategy was executed using an electronic and manual search focusing on clinical studies evaluating PROMs of implant-supported restorations. Only clinical trials assessing conventional versus digital workflows for implant-supported restorations were included. PROMS on implant impression procedures and fabrication of final restorations were evaluated using random and fixed effects meta-analyses, while implant planning/placement was reported descriptively. RESULTS Among 1062 titles identified, 14 studies were finally included, and only seven studies were eligible for meta-analysis. For implant planning and placement, only a qualitative analysis was possible due to heterogeneity between the studies. For impression procedures, the random effects model revealed statistically significant differences in taste, anxiety, nausea, pain, shortness of breath, and discomfort in favor of optical impressions. No significant difference in the subjective perception of the duration of an impression could be reported. For the final fabrication of restorations, no significant difference between veneered and monolithic posterior restorations was found in terms of esthetic, function, and general satisfaction. CONCLUSION Most of the studies reporting about PROMs were published during the last ten years and limited to implant-supported single crowns in the posterior region. Based on PROMs, no scientifically proven recommendation for guided implant placement could be given at this time. Patients showed high preference for optical impressions, whereas no differences between veneered and monolithic restorations could be reported.
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Affiliation(s)
- Shaza Bishti
- Department of Prosthodontics and Biomaterials, RWTH University, Aachen, Germany
| | - Taskin Tuna
- Department of Prosthodontics and Biomaterials, RWTH University, Aachen, Germany
| | - Anne Rittich
- Department of Prosthodontics and Biomaterials, RWTH University, Aachen, Germany
| | - Stefan Wolfart
- Department of Prosthodontics and Biomaterials, RWTH University, Aachen, Germany
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28
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Graf T, Keul C, Wismeijer D, Güth JF. Time and costs related to computer-assisted versus non-computer-assisted implant planning and surgery. A systematic review. Clin Oral Implants Res 2021; 32 Suppl 21:303-317. [PMID: 34642994 PMCID: PMC9292957 DOI: 10.1111/clr.13862] [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: 12/10/2020] [Revised: 03/25/2021] [Accepted: 05/05/2021] [Indexed: 12/03/2022]
Abstract
Aim To study the time and costs involved with computer‐assisted versus non‐computer‐assisted implant planning and placement. Material and methods Based on the PICO question, “In patients receiving dental implants, is computer‐assisted implant planning and surgery (CAIPS) compared to non‐computer‐assisted implant planning and surgery (non‐CAIPS) beneficial in terms of treatment related costs and time involved?”, a search path was created to perform an electronic search in the databases PubMed, PubMed Central, EMBASE, and Cochrane. The publication period of eligible publications extended from 01.01.2005 to 04.05.2020. Four independent reviewers reviewed the literature to identify studies that met the eligibility inclusion criteria. A further manual search of articles was performed, and gray literature was excluded. Corresponding authors of potentially eligible manuscripts were contacted for further information. Results Of the 1354 retrieved titles after the search were screened. Thirty‐one articles have been identified to read the full text, resulting in four articles to be analyzed for the present review all of which were RCTs. In total, 182 partially and completely edentulous patients were treated with 416 implants following either non‐computer‐assisted or computer‐assisted implant planning and surgery to determine the duration of the single working steps and the financial aspects of the different procedures. Conclusions When evaluating the time and costs involved with the diagnostic and planning procedures in computer‐assisted implant planning and surgery workflow protocols, one can summarize that these are higher than in the non‐computer‐assisted workflow protocols. The time involved with the procedures appears to be the driving factor when it comes to economic considerations. On the basis of the conclusions, also the time for the prosthetic restoration should be taken into account.
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Affiliation(s)
- Tobias Graf
- Department of Prosthodontics, Center for Dentistry and Oral Medicine (Carolinum), Goethe-University Frankfurt am Main, Frankfurt am Main, Germany
| | - Christine Keul
- Department of Prosthodontics, Center for Dentistry and Oral Medicine (Carolinum), Goethe-University Frankfurt am Main, Frankfurt am Main, Germany
| | - Daniel Wismeijer
- Oral Implantology and Prosthodontics Private Practice, The Netherlands
| | - Jan Frederik Güth
- Department of Prosthodontics, University Clinic, LMU Munich, Muenchen, Germany.,Department of Prosthodontics, Center for Dentistry and Oral Medicine (Carolinum), Goethe-University Frankfurt am Main, Frankfurt am Main, Germany
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29
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De Souza AB, Kang M, Negreiros WM, El-Rafie K, Finkelman M, Papaspyridakos P. A comparative retrospective study of different surgical guide designs for static computer-assisted implant surgery in posterior single edentulous sites. Clin Oral Implants Res 2021; 33:45-52. [PMID: 34587320 DOI: 10.1111/clr.13858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 08/10/2021] [Accepted: 09/14/2021] [Indexed: 11/30/2022]
Abstract
AIM The aim of this retrospective clinical study was to compare the accuracy of static Computer-assisted implant surgery (sCAIS) in posterior single edentulous patients using different surgical guide designs. MATERIALS AND METHODS Thirty-seven partially edentulous patients with a total of 54 implants were included in the study. Seventeen implants were included in Group 1-Unbounded Tooth-Mucosa Supported; 18 implants in Group 2-Unbounded Tooth Supported; and 19 implants in Group 3 (Control)-Bounded Tooth Supported. All partially edentulous patients were treated with fully guided implant surgery using the corresponding surgical guide. Discrepancies between the pre-planned and post-operative implant position were evaluated. RESULTS The mean angular deviation ± standard deviation (SD) was 2.91 ± 1.56°, 3.33 ± 1.72° and 2.25 ± 1.13° for Groups 1, 2, and 3, respectively. The mean ± SD 3D offset at base was 0.66 ± 0.29 mm, 0.77 ± 0.24 mm, and 0.49 ± 0.22 mm; and 3D offset at tip was 0.84 ± 0.45 mm, 1.07 ± 0.38 mm, and 0.75 ± 0.25 mm for Groups 1, 2, and 3, respectively. No statistically significant differences between groups were found for angular deviation. There were statistically significant differences between Groups 2 and 3 for 3D offset at base (p = .002) and 3D offset at tip (p = .010). CONCLUSIONS Different surgical guide designs for posterior single edentulous areas appear to be associated with the accuracy level of sCAIS. In unbounded sites, having additional posterior attached soft tissue support is preferable.
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Affiliation(s)
| | - Michael Kang
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, MA, USA
| | | | - Khaled El-Rafie
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, MA, USA
| | - Matthew Finkelman
- Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston, MA, USA
| | - Panos Papaspyridakos
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, MA, USA
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30
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Guentsch A, Sukhtankar L, An H, Luepke PG. Precision and trueness of implant placement with and without static surgical guides: An in vitro study. J Prosthet Dent 2021; 126:398-404. [DOI: 10.1016/j.prosdent.2020.06.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 06/17/2020] [Accepted: 06/18/2020] [Indexed: 10/23/2022]
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31
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Orban K, Varga E, Windisch P, Braunitzer G, Molnar B. Accuracy of half-guided implant placement with machine-driven or manual insertion: a prospective, randomized clinical study. Clin Oral Investig 2021; 26:1035-1043. [PMID: 34401946 PMCID: PMC8791874 DOI: 10.1007/s00784-021-04087-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 07/18/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To compare the accuracy of implant placement performed with either a surgical motor or a torque wrench as part of a half-guided surgical protocol. MATERIALS AND METHODS Implant insertion with half-guided surgical protocol was utilized by surgical motor (machine-driven group) or torque wrench (manual group) in the posterior maxilla. After the healing period, accuracy comparison between planned and actual implant positions was performed based on preoperative cone beam computed tomography and postoperative digital intraoral scans. Coronal, apical, and angular deviations, insertion time, and insertion torque were evaluated. RESULTS Forty patients were treated with 1 implant each; 20 implants were inserted with a surgical motor and 20 implants with a torque wrench. Global coronal and apical deviations were 1.20 ± 0.46 mm and 1.45 ± 0.79 mm in the machine-driven group, and 1.13 ± 0.38 mm and 1.18 ± 0.28 mm in the manual group (respectively). The mean angular deviation was 4.82 ± 2.07° in the machine-driven group and 4.11 ± 1.63° in the manual group. Mean insertion torque was 21.75 ± 9.75 Ncm in the machine-driven group, compared to 18.75 ± 7.05 Ncm in the manual group. Implant placement duration was 9.25 ± 1.86 s in the machine-driven group at a speed of 50 rpm, and 36.40 ± 8.15 s in the manual group. CONCLUSION No significant difference was found between the two groups in terms of accuracy and mean insertion torque, while machine-driven implant placement was significantly less time-consuming. CLINICAL RELEVANCE Optimal implant placement accuracy utilized by half-guided surgical protocol can be achieved with both machine-driven and torque wrench insertion. TRIAL REGISTRATION ID: NCT04854239.
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Affiliation(s)
- Kristof Orban
- Faculty of Dentistry, Department of Periodontology, Semmelweis University, Budapest, Hungary.
| | | | - Peter Windisch
- Faculty of Dentistry, Department of Periodontology, Semmelweis University, Budapest, Hungary
| | | | - Balint Molnar
- Faculty of Dentistry, Department of Periodontology, Semmelweis University, Budapest, Hungary
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Lin J, Lin Z, Zheng Z. Case report: Fabrication of a dental implant guide based on tetrahedron positioning technology. BMC Oral Health 2021; 21:335. [PMID: 34233683 PMCID: PMC8265149 DOI: 10.1186/s12903-021-01694-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 06/30/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Conventional static computer-assisted implant surgery (s-CAIS) requires special equipment, such as 3D printers or computer numerical control (CNC) lathes. We present a low-cost workflow for manufacturing dental implant guides based on tetrahedron positioning technology (TPT). The aim of this case report was to use a surgical guide technique for dental implant placement using tetrahedron positioning technology. CASE PRESENTATION A 28-year-old man consulted for the treatment of a missing right first mandibular molar by implant placement. The cone-beam computed tomography (CBCT) data were imported into medical image processing software for analysis, and the implant design was simulated. The implant design on CBCT was transferred to the mandibular model using TPT, and the implant surgical guide was made to guide the dental implant operation. CBCT was performed postoperatively and compared with the preoperative design to check the accuracy. The central deviation of the implant head was 0.31 mm, the central deviation of the implant apex was 0.93 mm, and the implant angular deviation was 2.45°. CONCLUSION The use of tetrahedral positioning technology based on CBCT data is a new method for making implant guides. It is a promising technique offering a highly predictable outcome and lower risk of iatrogenic damage. However, these results should be interpreted with care since they are based on limited evidence from a case report. Larger population studies with longer follow-up periods and standardized experimental studies are required.
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Affiliation(s)
- Jie Lin
- Fujian Key Laboratory of Oral Diseases, School and Hospital of Stomatology, Fujian Medical University, 246 Yangqiao Zhong Road, Fuzhou, 350002 Fujian People’s Republic of China
- Department of Crown and Bridge, School of Life Dentistry At Tokyo, The Nippon Dental University, 1-9-20 Fujimi, Chiyoda-ku, Tokyo, 102-8159 Japan
| | - Zhenxiang Lin
- Department of Stomatology, Hospital of Fujian Provincial Authorities, 68 Guping Road, Fuzhou, 350001 Fujian People’s Republic of China
| | - Zhiqiang Zheng
- Fujian Key Laboratory of Oral Diseases, School and Hospital of Stomatology, Fujian Medical University, 246 Yangqiao Zhong Road, Fuzhou, 350002 Fujian People’s Republic of China
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33
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Engkawong S, Mattheos N, Pisarnturakit PP, Pimkhaokham A, Subbalekha K. Comparing patient-reported outcomes and experiences among static, dynamic computer-aided, and conventional freehand dental implant placement: A randomized clinical trial. Clin Implant Dent Relat Res 2021; 23:660-670. [PMID: 34231956 DOI: 10.1111/cid.13030] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 06/10/2021] [Accepted: 06/22/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The purpose of this study was to compare patient-reported outcomes and experiences (PROs and PREs) among three techniques of dental implant placement, including (a) conventional freehand, (b) dynamic, and (c) static computer-aided implant surgery (CAIS). MATERIAL AND METHODS Ninety patients were randomly assigned to have dental implant placed with one of the three protocols. Participants were asked to fill in a series of self-administered questionnaires assessing (1) preoperative expectations, (2) postoperative healing events during the first week after surgery, and (3) experiences and overall satisfaction with the procedures at 2 weeks. Differences within the groups were analyzed by Wilcoxson signed-rank test. Kruskal-Wallis test was used for comparisons among the three groups. RESULTS Eighty-eight patients completed the study. Patients' expectations on chewing difficulty, the postoperative experience of duration of pain, speaking limitations, and impact on routine activities were significantly different among groups (p = 0.04, 0.01, 0.038, and 0.046, respectively). Overall, patients appeared to significantly underestimate the duration of postoperative pain (p = 0.035) and swelling (p = 0.001). No significant difference in magnitude of postoperative pain, swelling, and painkiller consumption was found among the groups. The short-term functional limitations after surgery were deemed acceptable by most participants and 89% were satisfied by the overall procedure. CONCLUSIONS Surgical placement of dental implant with conventional freehand, static, and dynamic CAIS techniques did not result in any difference in the level of postoperative pain and swelling, and appeared to lead to equal levels of satisfaction as expressed by the patients postoperatively.
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Affiliation(s)
- Sunida Engkawong
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Nikos Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.,Department of Dental Medicine, Karolinska Institute, Solna, Sweden
| | | | - Atiphan Pimkhaokham
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Keskanya Subbalekha
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
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Yang JW, Liu Q, Yue ZG, Hou JX, Afrashtehfar KI. Digital Workflow for Full-Arch Immediate Implant Placement Using a Stackable Surgical Guide Fabricated Using SLM Technology. J Prosthodont 2021; 30:645-650. [PMID: 33938077 DOI: 10.1111/jopr.13375] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2021] [Indexed: 12/19/2022] Open
Abstract
The failing dentition of partially edentulous individuals may be used as an initial reference for stackable restrictive surgical guides during full-arch immediate implant placement. The stackable guide option derived from a digital workflow increases the predictability of the performance of bone reduction, immediate implant placement, and immediate loading of provisional implant-supported fixed dental prostheses. The present paper aims to report a practical approach to design and produce a metal framework with occlusal rests to facilitate the use of a tooth-supported surgical guide when full-arch immediate implant placement is indicated in patients with failing dentition.
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Affiliation(s)
- Jing-Wen Yang
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, PR China.,National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, PR China.,Research Center of Engineering and Technology for Digital Dentistry of Ministry of Health, Beijing Key Laboratory of Digital Stomatology, Beijing, PR China
| | - Qi Liu
- Private practice, Beijing, PR China
| | - Zhao-Guo Yue
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Jian-Xia Hou
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, PR China.,Research Center of Engineering and Technology for Digital Dentistry of Ministry of Health, Beijing Key Laboratory of Digital Stomatology, Beijing, PR China.,Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Kelvin I Afrashtehfar
- Division of Restorative Dental Sciences, Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman City, UAE.,Department of Reconstructive Dentistry & Gerodontology, School of Dental Medicine, Faculty of Medicine, University of Bern, Berne, Switzerland.,Center of Medical and Bio-allied Health Sciences Research, Ajman University, Dubai, United Arab Emirates
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Edelmann C, Wetzel M, Knipper A, Luthardt RG, Schnutenhaus S. Accuracy of Computer-Assisted Dynamic Navigation in Implant Placement with a Fully Digital Approach: A Prospective Clinical Trial. J Clin Med 2021; 10:jcm10091808. [PMID: 33919257 PMCID: PMC8122675 DOI: 10.3390/jcm10091808] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/20/2021] [Accepted: 04/20/2021] [Indexed: 02/06/2023] Open
Abstract
Background: This prospective clinical study aimed to investigate a possible deviation between the digitally planned implant position and the position achieved using dynamic navigation. The aim of the study was to establish clinical effectiveness and precision of implantation using dynamic navigation. Methods: Twenty consecutive patients received an implant (iSy-Implantat, Camlog, Wimsheim, Germany). One screw implant was placed in one jaw with remaining dentition of at least six teeth. The workflow was fully digital. Digital implant planning was conducted using cone-beam computed tomography (CBCT) and an intraoral scan of the actual condition. Twenty implants were subsequently placed using a dynamic computer-assisted procedure. The clinical situation of the implant position was recorded using an intraoral scan. Using these data, models were produced via 3D printing, and CBCTs of these models were made using laboratory analogs. Deviations of the achieved implant position from the planned position were determined using evaluation software. Results: The evaluation of 20 implants resulted in a mean angle deviation of 2.7° (95% CI 2.2–3.3°). The 3D deviation at the implant shoulder was 1.83 mm (95% CI 1.34–2.33 mm). No significant differences were found for any of the parameters between the implantation in the upper or lower jaw and an open or flapless procedure (p-value < 0.05). Conclusion: The clinical trial showed that sufficiently precise implantation was possible with the dynamic navigation system used here. Dynamic navigation can improve the quality of implant positioning. In particular, the procedure allows safe positioning of the implants in minimally invasive procedures, which usually cannot be performed freehand in this form. A clinical benefit and effectiveness can be determined from the results.
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Affiliation(s)
- Cornelia Edelmann
- Centre for Dentistry, Dr Schnutenhaus Community Health Centre (CHC) GmbH, 78247 Hilzingen, Germany; (C.E.); (M.W.); (A.K.)
| | - Martin Wetzel
- Centre for Dentistry, Dr Schnutenhaus Community Health Centre (CHC) GmbH, 78247 Hilzingen, Germany; (C.E.); (M.W.); (A.K.)
| | - Anne Knipper
- Centre for Dentistry, Dr Schnutenhaus Community Health Centre (CHC) GmbH, 78247 Hilzingen, Germany; (C.E.); (M.W.); (A.K.)
| | - Ralph G. Luthardt
- Department of Dentistry, Clinic for Prosthodontics, Ulm University, 89081 Ulm, Germany;
| | - Sigmar Schnutenhaus
- Centre for Dentistry, Dr Schnutenhaus Community Health Centre (CHC) GmbH, 78247 Hilzingen, Germany; (C.E.); (M.W.); (A.K.)
- Department of Dentistry, Clinic for Prosthodontics, Ulm University, 89081 Ulm, Germany;
- Correspondence:
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Matsumura A, Nakano T, Ono S, Kaminaka A, Yatani H, Kabata D. Multivariate analysis of causal factors influencing accuracy of guided implant surgery for partial edentulism: a retrospective clinical study. Int J Implant Dent 2021; 7:28. [PMID: 33870473 PMCID: PMC8053739 DOI: 10.1186/s40729-021-00313-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 03/01/2021] [Indexed: 11/10/2022] Open
Abstract
Abstract Background In dental implant treatment, the placement position of the implant body is important. The hypothesis is that there are factors that have a greater impact than the factors that have been studied so far. Material and Methods The deviation between planned and actually placed implants was measured three-dimensionally by modified treatment evaluation method in 110 patients who underwent implant placement with guided surgery for partial edentulism. Ten factors that seemed to affect errors in placement were selected: the type of tooth, type of edentulism, distance from the remaining teeth, the type of implant, implant length, number of implants, method of guidance, the number of teeth supporting the surgical guide, number of anchor pins, and presence or absence of a reinforcement structure. The effect of each factor that corrected each confounding was calculated using multivariate analysis. Results In this study, 188 implant bodies were set to target, and the errors measurement data of the implant position were as follows: average Angle, 2.5 ± 1.6° (95% CI 2.25–2.69); Base, 0.67 ± 0.37 mm (95% CI 0.62–0.72); and Apex, 0.92 ± 0.47 mm (95% CI 0.86–0.98). As the result of multivariate analysis, larger errors were present in the partially guided group than the fully guided group. The number of teeth supporting the surgical guide significantly influenced the error in placement position. The error caused by the number of anchor pins was significantly different for the Angle. Similarly, the presence of the reinforcement structure influenced the error significantly for the Angle. Conclusions It was suggested that the smaller errors could be present by performing guided surgery with full guidance and devising the design of the guide such as the number of teeth supporting the surgical guide, the setting of the anchor pin, and the reinforcement structure.
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Affiliation(s)
- Atsushi Matsumura
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Tamaki Nakano
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - Shinji Ono
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Akihiro Kaminaka
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Hirofumi Yatani
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Daijiro Kabata
- Department of Medical Statistics, Osaka City University Graduate School of Medicine, 1-4-3 Asahi, Abeno-ku, Osaka, 545-8585, Japan
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Ozan O, Şeker E, Çakmak G, Guo X, Yilmaz B. Effect of guide sleeve material, region, diameter, and number of times drills were used on the material loss from sleeves and drills used for surgical guides: An in vitro study. J Prosthet Dent 2021; 128:746-753. [PMID: 33832763 DOI: 10.1016/j.prosdent.2020.12.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 12/24/2020] [Accepted: 12/28/2020] [Indexed: 11/15/2022]
Abstract
STATEMENT OF PROBLEM How material loss from sleeves and drills is affected when different guide sleeve materials and different sizes of implant drills are used for different regions of surgical guides is unclear. PURPOSE The purpose of this in vitro study was to compare the amount of material loss from different guide sleeves (zirconia and cobalt-chromium) and drills of different diameters during osteotomy preparation in different regions. MATERIAL AND METHODS Three tooth-supported surgical guides with sleeve holes positioned in the first premolar and second molar sites were prepared. Guide sleeves (Ø 2.20 mm, 3.40 mm, and 4.05 mm) were milled from zirconia (n=60) and cobalt-chromium (n=60) blocks. A total of 12 titanium nitride-coated stainless steel twisted drills (n=6 per sleeve material) of different diameters (Ø 2.00, 3.20, 3.85 mm) were used with corresponding sleeves during the drilling. The weight loss from the drills and the volume loss from the guide sleeves after drilling were analyzed by using multiple linear mixed effect models (α=.05). RESULTS According to the 4-way ANOVA for volume loss from sleeves, no significant interaction was found among the 4 main effects (number of times a drill was used, region, diameter, and material), but interactions between the number of times a drill was used and diameter (P=.001) and between the number of times the drill was used and material were significant (P<.001). For weight loss from the drills, a significant interaction was detected between the number of times the drill was used and diameter (P=.024). CONCLUSIONS Less sleeve material was lost when zirconia sleeves were used. All sleeves had more material loss in the molar region than in the premolar region. The diameter had varying effects on the amount of material loss from drills and sleeves. The sleeve material and the region did not affect the material loss from drills.
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Affiliation(s)
- Oğuz Ozan
- Professor, Department of Prosthodontics, Near East University Faculty of Dentistry, Mersin, Turkey
| | - Emre Şeker
- Associate Professor, Department of Prosthodontics, Dentarma Dental Clinic, Eskişehir, Turkey
| | - Gülce Çakmak
- Associate Professor, Department of Prosthodontics, Istanbul Okan University Faculty of Dentistry, Istanbul, Turkey.
| | - Xiaohan Guo
- PhD student, Division of Biostatistics, The Ohio State University College of Public Health, Columbus, Ohio
| | - Burak Yilmaz
- Associate Professor, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Associate Professor, Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Adjunct Professor, Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, Ohio
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Abduo J, Lau D. Accuracy of static computer-assisted implant placement in long span edentulous area by novice implant clinicians: A cross-sectional in vitro study comparing fully-guided, pilot-guided, and freehand implant placement protocols. Clin Implant Dent Relat Res 2021; 23:361-372. [PMID: 33817957 DOI: 10.1111/cid.12998] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 02/26/2021] [Accepted: 03/22/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND To ensure accurate implant placement, surgical guides are used to control the steps of implant placement surgery. PURPOSE Evaluation of the accuracy of implant placement in long span edentulous area by novice implant clinicians according to fully-guided (FG), pilot-guided (PG), and freehand (FH) placement protocols. MATERIALS AND METHODS Maxillary surgical models with four missing teeth from the right first canine to the first molar were produced by 3-dimensional printing. Fourteen clinicians new to implant dentistry participated in the study, and each one of them inserted one canine and one molar implant for every implant placement protocol. All implant placement steps were completed in phantom heads to simulate the clinical situation. To evaluate the accuracy, the implant vertical, horizontal platform, horizontal apex, angle, and interimplant distance deviations from the planned positions were calculated. RESULTS With the exception of vertical deviation, the FG placement was clearly more accurate than the PG and FH placements for all the variables for canine and molar implants. The PG placement was significantly more accurate than the FH placement for the horizontal platform and apex deviations, and interimplant distance deviation. The FG placement did not show a significant impact of the location of the implant, or the horizontal deviations of the platform or the apex. The PG and FH placements showed increased deviation at the canine implant than the molar implant, and at the apex of the implants than the platform of the implants. CONCLUSIONS Within the limitations of this in vitro study, novice clinicians achieved a significantly more accurate implant position with FG placement, followed by PG and FH placements respectively. Therefore, a form of guided surgery is beneficial for novice clinicians.
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Affiliation(s)
- Jaafar Abduo
- Melbourne Dental School, Melbourne University, Melbourne, Victoria, Australia
| | - Douglas Lau
- Melbourne Dental School, Melbourne University, Melbourne, Victoria, Australia
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Li J, Sommer C, Wang HL, Lepidi L, Joda T, Mendonca G. Creating a virtual patient for completely edentulous computer-aided implant surgery: A dental technique. J Prosthet Dent 2021; 125:564-568. [DOI: 10.1016/j.prosdent.2020.02.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 02/17/2020] [Accepted: 02/18/2020] [Indexed: 12/01/2022]
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Jorba-García A, González-Barnadas A, Camps-Font O, Figueiredo R, Valmaseda-Castellón E. Accuracy assessment of dynamic computer-aided implant placement: a systematic review and meta-analysis. Clin Oral Investig 2021; 25:2479-2494. [PMID: 33635397 DOI: 10.1007/s00784-021-03833-8] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 02/05/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVES To assess the accuracy of dynamic computer-aided implant surgery (dCAIS) systems when used to place dental implants and to compare its accuracy with static computer-aided implant surgery (sCAIS) systems and freehand implant placement. MATERIALS AND METHODS An electronic search was made to identify all relevant studies reporting on the accuracy of dCAIS systems for dental implant placement. The following PICO question was developed: "In patients or artificial models, is dental implant placement accuracy higher when dCAIS systems are used in comparison with sCAIS systems or with freehand placement? The main outcome variable was angular deviation between the central axes of the planned and final position of the implant. The data were extracted in descriptive tables, and a meta-analysis of single means was performed in order to estimate the deviations for each variable using a random-effects model. RESULTS Out of 904 potential articles, the 24 selected assessed 9 different dynamic navigation systems. The mean angular and entry 3D global deviations for clinical studies were 3.68° (95% CI: 3.61 to 3.74; I2 = 99.4%) and 1.03 mm (95% CI: 1.01 to 1.04; I2 = 82.4%), respectively. Lower deviation values were reported in in vitro studies (mean angular deviation of 2.01° (95% CI: 1.95 to 2.07; I2 = 99.1%) and mean entry 3D global deviation of 0.46 mm (95% CI: 0.44 to 0.48 ; I2 = 98.5%). No significant differences were found between the different dCAIS systems. These systems were significantly more accurate than sCAIS systems (mean difference (MD): -0.86°; 95% CI: -1.35 to -0.36) and freehand implant placement (MD: -4.33°; 95% CI: -5.40 to -3.25). CONCLUSION dCAIS systems allow highly accurate implant placement with a mean angular of less than 4°. However, a 2-mm safety margin should be applied, since deviations of more than 1 mm were observed. dCAIS systems increase the implant placement accuracy when compared with freehand implant placement and also seem to slightly decrease the angular deviation in comparison with sCAIS systems. CLINICAL RELEVANCE The use of dCAIS could reduce the rate of complications since it allows a highly accurate implant placement.
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Affiliation(s)
- Adrià Jorba-García
- Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Albert González-Barnadas
- Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,IDIBELL Institute, Barcelona, Spain
| | - Octavi Camps-Font
- Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,IDIBELL Institute, Barcelona, Spain
| | - Rui Figueiredo
- Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain. .,IDIBELL Institute, Barcelona, Spain. .,Facultat de Medicina i Ciències de la Salut, Campus de Bellvitge, Universitat de Barcelona (UB), Pavelló de Govern, 2a Planta, Despatx 2.9, C/Feixa Llarga s/n, E-08907 L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Eduard Valmaseda-Castellón
- Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,IDIBELL Institute, Barcelona, Spain
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Alaidrous M, Finkelman M, Kudara Y, Campos HC, Kim Y, De Souza AB. Influence of zirconia crown artifacts on cone beam computed tomography scans and image superimposition of tomographic image and tooth surface scan: An in vitro study. J Prosthet Dent 2021; 125:684.e1-684.e8. [PMID: 33549342 DOI: 10.1016/j.prosdent.2020.06.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 06/09/2020] [Accepted: 06/09/2020] [Indexed: 10/22/2022]
Abstract
STATEMENT OF PROBLEM Zirconia restorations create significant artifacts on 3D cone beam computed tomography (CBCT) imaging. Static computer-assisted implant surgery (s-CAIS) relies on the accuracy of superimposition between an intraoral surface scan and CBCT imaging. However, how the artifacts from zirconia on the tomographic image might affect the predictability of s-CAIS is unclear. PURPOSE The purpose of this in vitro study was to evaluate the effect of zirconia crown restorations on the superimposition process for s-CAIS. MATERIAL AND METHODS Four stone casts generated 4 groups: a control group (CG) with no crowns and 3 experimental groups with 4 (TG4), 7 (TG7), and 13 (TG13) zirconia crowns. A total of 40 CBCT scans were made for the 4 groups (n=10). All CBCTs were imported into a computer planning software program, and the casts from all 4 groups were scanned by using a high-resolution laboratory scanner. The standard tessellation language (STL) files were imported, segmented, and the 3 files superimposed for all groups. The accuracy of the superimposition was assessed, in millimeters, in 3 planes corresponding to anterior-posterior, horizontal, and vertical, as well as the overall measurement, and the results were analyzed statistically (α=.05). RESULTS The overall analysis demonstrated statistically significant differences between all groups (P<.001), except between CG and TG4. The anterior-posterior dimension demonstrated significant differences between CG and TG7 (P<.001), CG and TG13 (P<.001), TG4 and TG7 (P=.004), and TG4 and TG13 (P=.001). For the vertical dimension analysis, significant differences were found between CG and TG7 (P=.001), CG and TG13 (P<.001), and TG4 and TG13 (P<.001). For the horizontal variable, statistically significant differences were found between CG and TG7 (P=.049), CG and TG13 (P<.001), TG4 and TG13 (P<.001), and TG7 and TG13 (P=.003). CONCLUSIONS The accuracy of the superimposition of the images was influenced by the number of zirconia crowns, with an increased number reducing the superimposition accuracy.
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Affiliation(s)
- May Alaidrous
- Graduate Prosthodontics, Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass
| | - Matthew Finkelman
- Associate Professor, Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston, Mass
| | - Yukio Kudara
- Assistant Professor, Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass
| | - Hugo C Campos
- Assistant Professor, Interim Division Director Oral and Maxillofacial Radiology Department of Diagnostic Sciences, Tufts University School of Dental Medicine, Boston, Mass
| | - Yongjeong Kim
- Associate Professor, Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass
| | - Andre Barbisan De Souza
- Assistant Professor, Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass.
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Yu HY. Questions about the numerical value and quantitative data transfer of tooth preparation-from experience guidance to digital guidance. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2021; 39:9-19. [PMID: 33723931 PMCID: PMC7905401 DOI: 10.7518/hxkq.2021.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 12/07/2020] [Indexed: 02/05/2023]
Abstract
Tooth preparation is a common operation in dental clinical practice. This procedure is irreversible and invasive from the point of view of tooth preservation. Conditions of the abutment tooth, treatment methods, and restoration materials for target restoration affect tooth preparation. To achieve the goals of tooth tissue preservation, dental pulp protection, and periodontal health, dentistry professionals agreed on the importance of minimizing the amount of tooth reduction. The foundations for realizing this consensus are as follows. First, the available restoration materials with improved comprehensive performance need less target restoration space. Next, teeth can be prepared under a digital guide, and the real-time measurement of restoration space can be verified due to the invention of digital technologies for the analysis of the quantity and shape of the prepared tooth and tooth measurement. Moreover, guiding methods for preparation have been developed from freehand operation under the naked eye based on accumulated personal experience to digital-guidance jointing microscope. These innovations indicate the creation of a prototype of guided prosthodontics that is precise and applies real-time measurement throughout the process of tooth preparation. From the perspective of the evolution of digital, guided, and micro prosthodontics, this article raised seven questions about the numerical value and quantitative data transfer of tooth preparation and evaluated the authenticity of existing numerical requirements from the perspective of the four elements of measurement. Identifying unified measuring methods and developing measuring tools with a precision of hundred or ten microns will be the key to solving the problem about the authenticity of numerical measurement. Furthermore, this paper summarizes the methods of how to control tooth reduction and explains in depth why the currently dominant tooth preparation technology, which is based on empiricism, cannot effectively achieve the goals in digital prosthodontics. Therefore, we strongly call for rebuilding the digital foundation of prosthodontic treatment immediately.
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Affiliation(s)
- Hai-Yang Yu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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Nagata K, Fuchigami K, Hoshi N, Atsumi M, Kimoto K, Kawana H. Accuracy of guided surgery using the silicon impression and digital impression method for the mandibular free end: a comparative study. Int J Implant Dent 2021; 7:2. [PMID: 33432526 PMCID: PMC7801556 DOI: 10.1186/s40729-020-00281-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 12/13/2020] [Indexed: 11/16/2022] Open
Abstract
Background Implant treatment using guided surgery is becoming widespread in clinical dental practice. Furthermore, the development of digital technology has enabled the use of intraoral scanners (IOSs) to fabricate surgical guide plates. The objective of this study was to compare the accuracy of guided surgery using the silicone impression method with a three-dimensional (3D) scanner and the digital impression method with IOS for one side of the mandibular free end. In addition, we compared the accuracy of tooth-supported vs tooth/mucosa-supported surgical guide plates. Results The accuracy of the tooth-supported surgical guide plate using the new IOS method instead of the method of obtaining impressions with conventional silicone resulted in better measurements of 3D deviation at the crest, 3D deviation at the apex, and angular deviation. In terms of the accuracy of the tooth/mucosa-supported surgical guide plate, there were no significant differences in all measurements. The surgical guide plate using an IOS and the tooth/mucosa-supported surgical guide plate may enable more accurate guided surgery. Conclusion Tooth/mucosa-supported guided surgery involving preparation with an IOS may result in more accurate implant surgery.
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Affiliation(s)
- Koudai Nagata
- Department of Oral and Maxillofacial Implantology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, 238-8580, Japan
| | - Kei Fuchigami
- Department of Oral and Maxillofacial Implantology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, 238-8580, Japan.,Division of Prosthodontics and Oral Implantology, Department of Oral Interdisciplinary Medicine, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka, Japan
| | - Noriyuki Hoshi
- Division of Prosthodontics and Oral Implantology, Department of Oral Interdisciplinary Medicine, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka, Japan
| | - Mihoko Atsumi
- Division of Prosthodontics and Oral Implantology, Department of Oral Interdisciplinary Medicine, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka, Japan
| | - Katsuhiko Kimoto
- Division of Prosthodontics and Oral Implantology, Department of Oral Interdisciplinary Medicine, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka, Japan
| | - Hiromasa Kawana
- Department of Oral and Maxillofacial Implantology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, 238-8580, Japan.
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The Digital Abutment Check: An Improvement of the Fully Digital Workflow. Case Rep Dent 2020; 2020:8831862. [PMID: 33163237 PMCID: PMC7604591 DOI: 10.1155/2020/8831862] [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: 08/28/2020] [Accepted: 09/30/2020] [Indexed: 11/17/2022] Open
Abstract
By using modern digitalization techniques, an existing denture can be digitized and aid the provision of a new implant-supported denture according to a fully digital workflow. This includes fully navigated implant surgery and results in an immediately provided prosthetic restoration. However, even with the current digital workflow, it is challenging to achieve a definitive prosthetic restoration in a single treatment session. In order to achieve a definitive denture in as few treatment sessions as possible, we have implemented the digital abutment test. This test modified the existing data set and determined the final restoration. In the present case, the preexisting maxillary removable complete denture was converted into a fixed immediate restoration using the fully digital workflow. The workflow is divided into two treatment phases, each with three treatment sessions, where part of the second phase involves an innovative digital abutment check. The illustrated case shows an effective use of current digital possibilities. Special attention was also paid to a minimally invasive course of therapy.
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Ben Yehuda D, Weber H, Finkelman M, Sicilia E, Muftu A, Chochlidakis K, Papaspyridakos P. Accuracy of Guided Implant Surgery in 25 Edentulous Arches: A Laboratory Observational Study. J Prosthodont 2020; 29:718-724. [DOI: 10.1111/jopr.13224] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2020] [Indexed: 11/30/2022] Open
Affiliation(s)
- Daniel Ben Yehuda
- Department of Prosthodontics Tufts University School of Dental Medicine Boston MA
| | - Hans‐Peter Weber
- Department of Prosthodontics Tufts University School of Dental Medicine Boston MA
| | - Matthew Finkelman
- Department of Public Health and Community Service Tufts University School of Dental Medicine Boston MA
| | - Elena Sicilia
- Department of Prosthodontics Tufts University School of Dental Medicine Boston MA
| | - Ali Muftu
- Department of Prosthodontics Tufts University School of Dental Medicine Boston MA
| | | | - Panos Papaspyridakos
- Department of Prosthodontics Tufts University School of Dental Medicine Boston MA
- Department of Prosthodontics University of Rochester Eastman Institute for Oral Health Rochester NY
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Tattan M, Chambrone L, González-Martín O, Avila-Ortiz G. Static computer-aided, partially guided, and free-handed implant placement: A systematic review and meta-analysis of randomized controlled trials. Clin Oral Implants Res 2020; 31:889-916. [PMID: 32654230 DOI: 10.1111/clr.13635] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 06/25/2020] [Accepted: 06/28/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To analyze the outcomes of static computer-aided implant placement (sCAIP) compared to partially guided (PGIP) and free-handed (FHIP) implant placement. MATERIAL AND METHODS This study was registered in PROSPERO (CRD42019131397). A comprehensive literature search was performed by two independent examiners. Only randomized controlled trials (RCTs) were selected. Treatment modalities included sCAIP, PGIP, and FHIP. Data pertaining to the outcomes of interest were extracted. Random-effects meta-analyses were feasible for a subset of outcomes. RESULTS From an initial list of 2,870 records, fourteen articles for a total of ten RCTs were selected. Data from 7 of these studies allowed for the conduction of three meta-analyses comparing accuracy of implant placement across modalities. Survival rate up to 12 months post-loading was high (>98%) and comparable between treatments (low-quality evidence). No tangible differences in terms of patient perception of intra- or postoperative discomfort were observed (low-quality evidence). Quantitative analyses revealed significantly lower angular (MD = 4.41°, 95% CI 3.99-4.83, p < .00001), coronal (MD = 0.65 mm, 95% CI 0.50-0.79, p < .00001), and apical (MD = 1.13 mm, 95% CI 0.92-1.34, p < .00001) deviation values for sCAIP as compared to FHIP (8 studies, 383 patients, 878 implants, high-quality evidence). A similar discrepancy, in favor of sCAIP, was observed for angular deviation only as compared to PGIP (MD = 2.11°, 95% CI 1.06-3.16, p < .00001). CONCLUSIONS sCAIP is associated with superior accuracy compared to PGIP and FHIP.
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Affiliation(s)
- Mustafa Tattan
- Department of Periodontics, University of Iowa College of Dentistry, Iowa City, IA, USA
| | - Leandro Chambrone
- Department of Periodontics, University of Iowa College of Dentistry, Iowa City, IA, USA.,Ibirapuera University School of Dentistry, São Paulo, Brazil.,School of Dentistry, Universidad El Bosque, Bogotá, Colombia
| | - Oscar González-Martín
- Department of Periodontics, University of Iowa College of Dentistry, Iowa City, IA, USA.,Department of Periodontal Prosthesis, University of Pennsylvania School of Dental Medicine, Philadelphia, PA, USA.,Department of Periodontology, Complutense University of Madrid, Madrid, Spain
| | - Gustavo Avila-Ortiz
- Department of Periodontics, University of Iowa College of Dentistry, Iowa City, IA, USA
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47
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Papaspyridakos P, Vazouras K, Chen Y, Kotina E, Natto Z, Kang K, Chochlidakis K. Digital vs Conventional Implant Impressions: A Systematic Review and Meta‐Analysis. J Prosthodont 2020; 29:660-678. [DOI: 10.1111/jopr.13211] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2020] [Indexed: 11/27/2022] Open
Affiliation(s)
- Panos Papaspyridakos
- Department of Prosthodontics Tufts University School of Dental Medicine Boston MA
- Department of Prosthodontics, Eastman Institute for Oral Health University of Rochester Rochester NY
| | | | - Yo‐wei Chen
- Department of Prosthodontics Tufts University School of Dental Medicine Boston MA
| | | | - Zuhair Natto
- Department of Dental Public Health King Abdulaziz University Jeddah Saudi Arabia
- Department of Periodontology Tufts University School of Dental Medicine Boston MA
| | - Kiho Kang
- Department of Prosthodontics Tufts University School of Dental Medicine Boston MA
| | - Konstantinos Chochlidakis
- Department of Prosthodontics, Eastman Institute for Oral Health University of Rochester Rochester NY
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48
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Almahrous G, David-Tchouda S, Sissoko A, Rancon N, Bosson JL, Fortin T. Patient-Reported Outcome Measures (PROMs) for Two Implant Placement Techniques in Sinus Region (Bone Graft versus Computer-Aided Implant Surgery): A Randomized Prospective Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17092990. [PMID: 32344891 PMCID: PMC7246902 DOI: 10.3390/ijerph17092990] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 04/16/2020] [Accepted: 04/16/2020] [Indexed: 12/20/2022]
Abstract
Purpose: To assess patient-reported outcomes measures (PROMs) for two implant placement techniques in cases of sinus bone atrophy (bone graft surgery (BGS) versus computer-aided implant surgery (CAIS)), after surgery and one year later, and to evaluate the clinical success of both treatments. Methods: Sixty patients with bone atrophy in the posterior maxilla and in need of implant placement were randomly assigned to two groups, and in accordance with the case report form (CRF), 30 were treated with BGS and 30 with CAIS. Immediately after treatment and one year later, PROMs were assessed, and the clinical success of both treatments was evaluated. Results: No significant differences were found between BGS and CAIS with regard to the following: loss of implants (p = 492); patient recommendation (p = 210); duration of surgery (p = 987); pain on the intervention day (p = 512); pain in the week after intervention (p = 299); and complications in the stage of surgery (p = 1.00). Similarly, at one year, no differences were found with regard to the following: pain around implant (p = 481); infection of implants (p = 491); abnormal radiographic imaging (p = 226); occurrence of undesirable events (p = 1.00); loss of one of the implants (p = 1.00); plaque detection (p = 1.00); bleeding on probing (p = 236); and presence of keratinized mucosa (p = 226). However, a significant difference was found among BGS and CAIS with regard to the number of consultations (p = 0001); number of implants placed (p = 033); and treatment difficulty (p = 0369). Significant differences were found for peri-implantitis (p = 0481) and radiology of craterization (p = 020) in clinical examination at the first year. Conclusion: Treatment difficulty and number of consultations were higher for BGS than for CAIS, as well as peri-implantitis and bone craterization at one year, indicating significant differences between the two treatments. However, there were no statistically significant differences between BGS and CAIS regarding the other PROMs, at placement and after one year.
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Affiliation(s)
- Ghazwan Almahrous
- Department of Oral Surgery, Dental School, University Claude Bernard, 69003 Lyon, France;
- ThEMAS TIMC UMR CNRS 5525, Grenoble Joseph Fourier University, 38041 Grenoble, France; (S.D.-T.); (J.-L.B.)
| | - Sandra David-Tchouda
- ThEMAS TIMC UMR CNRS 5525, Grenoble Joseph Fourier University, 38041 Grenoble, France; (S.D.-T.); (J.-L.B.)
- Medical-Economic Evaluation Unit, University Hospital of Grenoble, 38700 Grenoble, France
| | - Aboubacar Sissoko
- Cellule Data Stat, University Hospital of Grenoble, 38700 Grenoble, France;
| | - Nathalie Rancon
- Department of Oral Surgery, Hospices Civils, 69003 Lyon, France;
| | - Jean-Luc Bosson
- ThEMAS TIMC UMR CNRS 5525, Grenoble Joseph Fourier University, 38041 Grenoble, France; (S.D.-T.); (J.-L.B.)
- Medical-Economic Evaluation Unit, University Hospital of Grenoble, 38700 Grenoble, France
| | - Thomas Fortin
- Department of Oral Surgery, Dental School, University Claude Bernard, 69003 Lyon, France;
- ThEMAS TIMC UMR CNRS 5525, Grenoble Joseph Fourier University, 38041 Grenoble, France; (S.D.-T.); (J.-L.B.)
- Medical-Economic Evaluation Unit, University Hospital of Grenoble, 38700 Grenoble, France
- Correspondence: ; Tel.: +33-6-84-01-51-60
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Chochlidakis K, Papaspyridakos P, Tsigarida A, Romeo D, Chen Y, Natto Z, Ercoli C. Digital Versus Conventional Full‐Arch Implant Impressions: A Prospective Study on 16 Edentulous Maxillae. J Prosthodont 2020; 29:281-286. [DOI: 10.1111/jopr.13162] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2020] [Indexed: 11/29/2022] Open
Affiliation(s)
| | - Panos Papaspyridakos
- Department of ProsthodonticsEastman Institute for Oral Health, University of Rochester NY
- Department of ProsthodonticsSchool of Dental MedicineTufts University Boston MA
| | - Alexandra Tsigarida
- Department of PeriodonticsEastman Institute for Oral Health, University of Rochester NY
| | - Davide Romeo
- Department of ProsthodonticsEastman Institute for Oral Health, University of Rochester NY
- Advanced Oral Surgery UnitVita Salute University, San Raffaele Hospital Milan Italy
| | - Yo‐wei Chen
- Department of ProsthodonticsSchool of Dental MedicineTufts University Boston MA
| | - Zuhair Natto
- Department of Dental Public HealthKing Abdulaziz University Jeddah Saudi Arabia
- Department of PeriodontologySchool of Dental Medicine, Tufts University Boston MA
| | - Carlo Ercoli
- Department of ProsthodonticsEastman Institute for Oral Health, University of Rochester NY
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50
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Cassetta M, Altieri F, Giansanti M, Bellardini M, Brandetti G, Piccoli L. Is there a learning curve in static computer-assisted implant surgery? A prospective clinical study. Int J Oral Maxillofac Surg 2020; 49:1335-1342. [PMID: 32217033 DOI: 10.1016/j.ijom.2020.03.007] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 12/11/2019] [Accepted: 03/05/2020] [Indexed: 11/30/2022]
Abstract
Static computer-assisted surgery (s-CAS) has been introduced to improve the results of implantology. A prospective cohort study was conducted following the STROBE guidelines to determine the presence of a learning curve in s-CAS. Six partially and six totally edentulous patients were treated by two surgeons experienced in implantology but completely inexperienced in s-CAS. Preoperative and postoperative computed tomography scans were matched to assess coronal, apical, and angular deviation and the positioning error. The accuracy data were used to evaluate the learning curve. Fifty-six implants were inserted. In partially and totally edentulous patients, the mean (range; standard deviation) coronal deviation was 0.87 (0.34-1.27; 0.35) and 1.24 (0.72-2.67; 0.79); the mean apical deviation was 1.13 (0.48-1.63; 0.39) and 1.52 (0.88-3.84; 1.15); the mean angular deviation was 2.63 (1.89-4.50; 0.98) and 3.59 (1.69-6.30; 1.65); and the mean positioning error was 0.80 (0.32-1.25; 0.35) and 1.14 (0.35-2.56; 0.77), respectively. A typical 'learning curve' effect was not identified for s-CAS.
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Affiliation(s)
- M Cassetta
- Department of Oral and Maxillofacial Sciences, School of Dentistry, "Sapienza" University of Rome, Rome, Italy.
| | - F Altieri
- Department of Oral and Maxillofacial Sciences, School of Dentistry, "Sapienza" University of Rome, Rome, Italy
| | - M Giansanti
- Department of Oral and Maxillofacial Sciences, School of Dentistry, "Sapienza" University of Rome, Rome, Italy
| | - M Bellardini
- Department of Oral and Maxillofacial Sciences, School of Dentistry, "Sapienza" University of Rome, Rome, Italy
| | - G Brandetti
- Department of Oral and Maxillofacial Sciences, School of Dentistry, "Sapienza" University of Rome, Rome, Italy
| | - L Piccoli
- Department of Oral and Maxillofacial Sciences, School of Dentistry, "Sapienza" University of Rome, Rome, Italy
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