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Li J, Teixeira W, Saglik B, Liu F. A three-dimensionally printed template for locating the screw channel in a cement-retained implant-supported crown: A digital workflow. J Prosthet Dent 2024; 132:301-305. [PMID: 36123186 DOI: 10.1016/j.prosdent.2022.06.025] [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: 06/02/2022] [Revised: 06/27/2022] [Accepted: 06/28/2022] [Indexed: 11/25/2022]
Abstract
Locating the screw channel in a cement-retained implant-supported crown is challenging. This article describes a fully digital workflow for fabricating a 3D printed template which can accurately guide the dentist to find the screw channel. A definitive implant cast from the patient and an implant planning software program are used in the workflow. This technique provides precise guidance for finding the location and angulation of the abutment screw access hole.
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Affiliation(s)
- Junying Li
- Clinical Assistant Professor, Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, Mich
| | - Wendel Teixeira
- Research Fellow, Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, Mich
| | - Berna Saglik
- Clinical Associate Professor, Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, Mich
| | - Fei Liu
- Associate Professor, Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, Mich.
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Bukhari A, Dahshan S, Kotina E, Zhao N, Almujel S, Gallucci GO, Hamilton A. Application of 3D-printed guide for locating screw access channels in cement-retained complete arch implant-supported zirconia restorations. J Prosthet Dent 2023:S0022-3913(22)00489-9. [PMID: 36959002 DOI: 10.1016/j.prosdent.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 08/03/2022] [Accepted: 08/04/2022] [Indexed: 03/25/2023]
Abstract
Removal of cement-retained complete arch implant-supported zirconia restorations can be challenging. A predictable and minimally invasive technique combining cone beam computed tomography (CBCT) and intraoral scans with a virtual implant planning software program is described to identify the location of the screw access channels during the retrieval, thus minimizing damage to the existing restoration and allowing reuse.
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Affiliation(s)
- Asmaa Bukhari
- Demonstrator, Department of Prosthodontics, King Abdulaziz University, Jeddah, Saudi Arabia; AGE Implant program, Harvard School of Dental Medicine, Boston, Mass.
| | - Samantha Dahshan
- AGE Implant program, Harvard School of Dental Medicine, Boston, Mass
| | - Elli Kotina
- ITI Scholar Implant program, Harvard School of Dental Medicine, Boston, Mass
| | - Na Zhao
- AGE Implant program, Harvard School of Dental Medicine, Boston, Mass
| | - Saad Almujel
- Demonstrator, Department of Prosthodontics, King Saud University, Riyadh, Saudi Arabia; AGE Implant program, Harvard School of Dental Medicine, Boston, Mass
| | - German O Gallucci
- Associate Professor and Chairman, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Mass
| | - Adam Hamilton
- Discipline Lead in Prosthodontics and Graduate Program Convenor University of Western Australia Dental School, Nedland, Western Australia, Australia; Lecturer, Division of Regenerative and Implant Science, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Mass
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Bae S, Mai HN, Lee DH. Accuracy of digitally fabricated drilling guide to form screw-access channels in cement-retained implant prostheses: A randomized clinical trial. J Prosthet Dent 2022; 128:1282.e1-1282.e8. [PMID: 36123185 DOI: 10.1016/j.prosdent.2022.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 07/28/2022] [Accepted: 07/28/2022] [Indexed: 11/16/2022]
Abstract
STATEMENT OF PROBLEM Accurate intraoral preparation of screw channels in cement-retained implant prostheses could be a treatment challenge for tilted or badly positioned implants. PURPOSE The purpose of this randomized clinical trial was to evaluate screw channel accuracy for retrieving cement-retained implant prostheses by using a digitally fabricated drilling guide. MATERIAL AND METHODS Twenty-four participants requiring removal of cement-retained implant prostheses were recruited and consecutively assigned to 1 of 2 groups. In the first group, drilling guides were fabricated by using an intraoral scan, computer-aided design (CAD), and 3D printing to facilitate screw channel preparation (guide group). In the second group, screw channel preparation was based on panoramic radiographs without a drilling guide (freehand group). Screw channel accuracy was evaluated with a 3D analysis and subsequently compared with the ideal shape of the screw channel for linear deviation at coronal and apical levels, angular deviation, surface loss deviation, and volume loss deviation. The ideal shape of the screw-access channel was based on the Ø2.2-mm cylinder image marked along the long axis of the implant. The Mann-Whitney U and Kruskal-Wallis tests were used for statistical analyses (α=.05). RESULTS The drilling guide group showed higher dimensional accuracy than the freehand group for angular deviation (9.45 degrees versus 15.69 degrees; P=.014) and surface loss deviation (7.40 mm versus 9.53 mm; P=.001), especially when the implant was tilted more than 30 degrees. The deviation values of the screw channels were not significantly different according to implant tilt in either group (P>.05). CONCLUSIONS Digitally fabricated drilling guides for intraoral preparation of screw channels in cement-retained implant prostheses can improve accuracy and provide a less-destructive screw channel.
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Affiliation(s)
- Soohyun Bae
- Graduate student, Department of Prosthodontics, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
| | - Hang-Nga Mai
- Research Professor, Institute for Translational Research in Dentistry, Kyungpook National University, Daegu, Republic of Korea; Lecturer, Dental School of Hanoi University of Business and Technology, Hanoi, Vietnam
| | - Du-Hyeong Lee
- Associate Professor, Department of Prosthodontics, School of Dentistry, Institute for Translational Research in Dentistry, Kyungpook National University, Daegu, Republic of Korea.
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Martín Ortega N, Baños MÁ, Martínez J, Revilla-León M, Gómez-Polo M. Techniques for locating the screw access hole in cement-retained implant-supported prostheses: A systematic review. J Prosthet Dent 2021:S0022-3913(21)00530-8. [PMID: 34809995 DOI: 10.1016/j.prosdent.2021.09.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/27/2021] [Accepted: 09/28/2021] [Indexed: 11/17/2022]
Abstract
STATEMENT OF PROBLEM Different techniques for retrieving cement-retained implant-supported prostheses have been described to minimize damage to the prostheses. Nevertheless, a classification of the described techniques remains ambiguous. PURPOSE The purpose of this systematic review was to review and classify the described techniques for recording and locating the screw access hole in cement-retained implant-supported prostheses. MATERIAL AND METHODS A bibliographic search was completed on MEDLINE/PubMed, Web of Science, Scopus, and Cochrane databases. A manual search was also conducted. The articles that described or evaluated techniques for recording and locating the screw access hole of cement-retained implant-supported prostheses were included. Two investigators independently assessed the quality assessment of the studies using the Revised Cochrane risk of bias tool for randomized trials. A third examiner was consulted to resolve the lack of consensus. RESULTS A total of 30 articles were included. The different methods were classified according to whether the screw access hole location was registered before or after cementation. The precementation techniques were classified into 4 subgroups: identification marks, photographic records, digital files, and precementation screw access hole location guides. The postcementation techniques were subdivided into 2 subgroups: radiographic records and postcementation screw access hole location guides. CONCLUSIONS Different techniques have been proposed to facilitate the location of the screw access hole in cement-retained implant-supported restorations. Although the evidence is scarce, studies seem to ascertain that some techniques, such as the use of drilling guides, orientation with cone beam computed tomography images, or holes made in the metal framework, can increase the retrievability of cement-retained implant-supported prostheses and decrease complications in the location of the screw access hole. The proposed classification summarizes precementation and postcementation techniques and provides a tool to decide the most suitable for each specific clinical situation.
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Affiliation(s)
- Nuria Martín Ortega
- Postgraduate student of Advanced in Implant-Prosthodontics, Department of Conservative Dentistry and Prosthodontics, School of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Miguel Ángel Baños
- Adjunct Professor, Department of Conservative Dentistry and Prosthodontics, School of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Juan Martínez
- Associate Professor, Department of Conservative Dentistry and Prosthodontics, School of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Marta Revilla-León
- Affiliate Assistant Professor, Graduate Prosthodontics, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash; Director of Research and Digital Dentistry, Kois Center, Seattle, Wash; Researcher, Revilla Research Center, Madrid, Spain.
| | - Miguel Gómez-Polo
- Associate Professor, Department of Conservative Dentistry and Prosthodontics, School of Dentistry and Head of Postgraduate Specialist Program in Advanced Implant-Prosthodontics, Complutense University of Madrid, Madrid, Spain
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Choi YD, Mai HN, Mai HY, Ha JH, Li LJ, Lee DH. The Effects of Distribution of Image Matched Fiducial Markers on Accuracy of Computer-Guided Implant Surgery. J Prosthodont 2020; 29:409-414. [PMID: 32237001 DOI: 10.1111/jopr.13171] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 01/17/2020] [Accepted: 03/24/2020] [Indexed: 11/27/2022] Open
Abstract
PURPOSE Image registration of the optical intraoral scan to computed tomography image is essential for computer-guided implant surgery. The remaining teeth, which are considered to be congruent structures observed in the scan and radiographic images, are used to perform the image registration. The purpose of this study was to evaluate the effects of the distribution of matching fiducial points on the accuracy of the image registration. MATERIALS AND METHODS A partially edentulous model with three anterior remaining teeth was prepared. Two mini dental implants were inserted in the posterior edentulous areas on both sides, and computed tomography and surface scan data were obtained. Three groups were set according to the distribution of the image matching points used: localized distribution, unilateral distribution, and bilateral distribution. Fifteen graduate students performed the registration process in each group using the same image matching method. The accuracy of image registration was evaluated by measuring the geometric discrepancies between the radiographic and registered scan images in the anterior, middle, and posterior regions. One-way and two-way analysis of variance with the Tukey HSD post hoc test were used for statistical analysis (α = 0.05) RESULTS: In general, the registration discrepancy was lowest in the bilateral distribution group, followed by the unilateral distribution and localized distribution groups (p< 0.001). In the regional analysis, the registration error tended to increase as the measurement region moved farther from the matching points. The distribution of the matching points and measurement regions had a statistical interaction in the accuracy of image registration. CONCLUSION The accuracy of image registration of the surface scan to the computed tomography is affected by the matching point distribution that can be improved by placing artificial markers in the edentulous areas.
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Affiliation(s)
- Yong-Do Choi
- Department of Prosthodontics, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
| | - Hang-Nga Mai
- Institute for Translational Research in Dentistry, Kyungpook National University, Daegu, Republic of Korea
| | - Hai Yen Mai
- Department of Prosthodontics, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
| | - Jung-Hong Ha
- Department of Conservative Dentistry, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
| | | | - Du-Hyeong Lee
- Department of Prosthodontics, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea.,Institute for Translational Research in Dentistry, Kyungpook National University, Daegu, Republic of Korea
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Malpartida-Carrillo V, Tinedo-Lopez PL, Ortiz-Culca F, Guerrero ME, Amaya-Pajares SP. Techniques for retrievability and for registering screw access holes in cement-retained implant-supported prostheses: A scoping review of the literature. J Prosthet Dent 2020; 123:427-433. [DOI: 10.1016/j.prosdent.2019.03.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 03/11/2019] [Accepted: 03/11/2019] [Indexed: 11/26/2022]
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