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Pozzi A, Carosi P, Laureti A, Mattheos N, Pimkhaokham A, Chow J, Arcuri L. Accuracy of navigation guided implant surgery for immediate loading complete arch restorations: Prospective clinical trial. Clin Implant Dent Relat Res 2024. [PMID: 38967100 DOI: 10.1111/cid.13360] [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: 02/03/2024] [Revised: 06/20/2024] [Accepted: 06/22/2024] [Indexed: 07/06/2024]
Abstract
OBJECTIVES To assess navigation accuracy for complete-arch implant placement with immediate loading of digitally prefabricated provisional. MATERIALS AND METHODS Consecutive edentulous and terminal dentition patients requiring at least one complete-arch FDP were treated between December 2020 and January 2022. Accuracy was evaluated by superimposing pre-operative and post-operative cone beam computed tomography (CBCT), recording linear (mm) and angular (degrees) deviations. T-tests were performed to investigate the potential effect of the registration algorithm (fiducial-based vs. fiducial-free), type of references for the fiducial-free algorithm (teeth vs. bone screws), site characteristic (healed vs. post-extractive), implant angulation (axial vs. tilted), type of arch (maxilla vs. mandible) on the accuracy with p-value <0.05. RESULTS Twenty-five patients, 36 complete-arches, and 161 implants were placed. The overall mean angular deviation was 2.19° (SD 1.26°). The global platform and apex mean deviations were 1.17 mm (SD 0.57 mm), and 1.30 mm (SD 0.62 mm). Meaningful global platform (p = 0.0009) and apical (p = 0.0109) deviations were experienced only between healed and post-extraction sites. None of the analyzed variables significantly influenced angular deviation. Minor single-axis deviations were reported for the type of jaw (y-axis at implant platform and apex), registration algorithm (y-axis platform and z-axis deviations), and type of references for the fiducial-free algorithm. No statistically significant differences were found in relation to implant angulation. CONCLUSIONS Within the study limitations navigation was reliable for complete-arch implant placement with immediate loading digitally pre-fabricated FDP. AI-driven surface anatomy identification and calibration protocol made fiducial-free registration as accurate as fiducial-based, teeth and bone screws equal as references. Implant site characteristics were the only statistically significant variable with healed sites reporting higher accuracy compared to post-extractive. Live-tracked navigation surgery enhanced operator performance and accuracy regardless of implant angulation and type of jaw. A mean safety room of about 1 mm and 2° should be considered.
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Affiliation(s)
- Alessandro Pozzi
- Department of Clinical Science and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Harbor, USA
- Department of Restorative, Sciences Augusta University, Augusta, Georgia, USA
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Paolo Carosi
- Department of Clinical Science and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
- Department of Chemical Science and Technologies, University of Rome Tor Vergata, Rome, Italy
| | - Andrea Laureti
- Department of Chemical Science and Technologies, University of Rome Tor Vergata, Rome, Italy
| | - Nikos Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
- Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Atiphan Pimkhaokham
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - James Chow
- Brånnemark Osseointegration Centre, Hong Kong, China
| | - Lorenzo Arcuri
- Department of Odontostomatological and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy
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Mitrani R, Papaspyridakos P, Bedrossian EA, Goldberg J, Tsigarida A, Chochlidakis K. Treatment planning algorithm for patients with a terminal dentition. J Prosthet Dent 2024:S0022-3913(24)00351-2. [PMID: 38797577 DOI: 10.1016/j.prosdent.2024.04.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 04/13/2024] [Accepted: 04/15/2024] [Indexed: 05/29/2024]
Abstract
This article discusses the variables that affect the diagnostic process in patients with a compromised dentition and addresses the clinical decision of whether to extract or maintain teeth. A decision tree algorithm is proposed to guide clinicians in planning complete arch rehabilitations.
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Affiliation(s)
- Ricardo Mitrani
- Affiliate Associate Professor, University of Washington, Seattle, Wash
| | - Panos Papaspyridakos
- Associate Professor, Department of Prosthodontics, Tufts School of Dental Medicine, Boston, Mass.; and Adjunct Associate Professor, Eastman Institute for Oral Health, Department of Prosthodontics, University of Rochester, Rochester, NY
| | | | - Jack Goldberg
- Affiliate Associate Professor, University of Washington, Seattle, Wash
| | - Alexandra Tsigarida
- Associate Professor and Program Director, Department of Periodontology and Implant Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, NY
| | - Konstantinos Chochlidakis
- Associate Professor and Program Director, Department of Prosthodontics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY.
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Wang Y, Yu S, Wang Y, Feng Y, Yan Q, Zhang Y. Effect of implant shape and length on the accuracy of robot-assisted immediate implant surgery: An in vitro study. Clin Oral Implants Res 2024; 35:350-357. [PMID: 38174662 DOI: 10.1111/clr.14232] [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: 08/03/2023] [Revised: 12/16/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024]
Abstract
OBJECTIVES To compare the accuracy of immediate implant placement of cylindrical implants (CI) and tapered implants (TI) of different lengths using a robotic dental implant system. MATERIALS AND METHODS CI and TI of three lengths (8, 10, and 12 mm) each were digitally planned and placed in a three-dimensional printed extraction socket model under robotic guidance. There were six groups with three samples in each group, resulting in a total of 18 samples. Implant angular deviation, platform point deviation (total, lateral, depth), and implant apical point deviation (total, lateral, depth) were recorded and compared between the different groups. RESULTS The angular deviations for CI 8 mm, CI 10 mm, CI 12 mm, TI 8 mm, TI 10 mm, and TI 12 mm were 1.32° ± 0.19°, 1.03° ± 0.56°, 1.31° ± 0.38°, 1.27° ± 0.64°, 1.10° ± 0.43° and 1.05° ± 0.45°, respectively. The total deviations of platform and apical points for CI 8 mm, CI 10 mm, CI 12 mm, TI 8 mm, TI 10 mm, and TI 12 mm were 0.79 ± 0.18 mm, 0.77 ± 0.33 mm; 0.64 ± 0.21 mm, 0.55 ± 0.17 mm; 0.64 ± 0.37 mm, 0.65 ± 0.34 mm; 0.68 ± 0.26 mm, 0.71 ± 0.20 mm; 0.70 ± 0.12 mm, 0.66 ± 0.23 mm; and 0.71 ± 0.15 mm, 0.77 ± 0.29 mm, respectively, and had no significant differences. CONCLUSIONS Within the limitation of this study, acceptable accuracy can be achieved for both TI and CI using robotic systems. Our study demonstrated that the implant shape and length did not affect the accuracy of immediate implant placement under robotic guidance in vitro. However, further trials are required to confirm their efficacy in clinical practice.
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Affiliation(s)
- Yunxiao Wang
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Oral Implantology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Shimin Yu
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Oral Implantology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Yulan Wang
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Oral Implantology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Yi Feng
- Department of Oral Implantology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Qi Yan
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Oral Implantology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Yufeng Zhang
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Oral Implantology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Oral Biomaterials and Application Technology Engineering Research Center of Hubei Province, Wuhan, China
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Tang W, Zhang H, Wang H, Li L. A digital technique of bone reduction for a maxillary full-arch implant-supported fixed dental prosthesis. J Prosthodont 2023. [PMID: 37811545 DOI: 10.1111/jopr.13782] [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: 08/11/2023] [Revised: 09/14/2023] [Accepted: 09/23/2023] [Indexed: 10/10/2023] Open
Abstract
When fabricating a maxillary full-arch implant-supported fixed dental prosthesis, it is often challenging to systematically reduce alveolar bone to create prosthetic space and hide the prosthesis-tissue junction. This article presents a digital technique that allows for precise bone reduction while simultaneously placing implants and interim prostheses. By using this technique, clinicians can perform surgical procedures in a systematic manner without compromising the functional or esthetic outcomes.
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Affiliation(s)
- Weimao Tang
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Hai Zhang
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Washington, USA
| | - Haozhe Wang
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Lei Li
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
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Ahmed WM, Alhazmi A, Alharbi MT, Azhari AA, Alqarni H, Shaheen HF, Mitwalli ET. Maxillary and mandibular complete-arch implant rehabilitation using a complete digital workflow: A case report. J Prosthodont 2023; 32:662-668. [PMID: 36905084 DOI: 10.1111/jopr.13677] [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: 12/22/2022] [Accepted: 03/02/2023] [Indexed: 03/12/2023] Open
Abstract
This article summarizes the clinical steps involved in maxillary and mandibular complete-arch implant rehabilitation using a complete digital workflow. The maxillary arch was recorded using the double digital scan technique, and the mandibular arch using the triple digital scan technique. The digital protocol used in this case report allowed the recording of implant positions via scan bodies, soft tissues, and, most importantly, the interocclusal relationship in the same visit. A new technique for mandibular digital scan was described that uses soft tissue landmarks by creating windows in the patient's provisional prostheses to superimpose the three digital scans and consequently fabricate and verify the maxillary and mandibular prototype prostheses and definitive complete-arch zirconia prostheses.
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Affiliation(s)
- Walaa Magdy Ahmed
- Department of Restorative Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ahlam Alhazmi
- Division of Prosthodontics, Dental Department, King Fahad Armed Forces Hospital, Ministry of Defense, Jeddah, Saudi Arabia
| | - Mazin Talal Alharbi
- Division of Prosthodontics, Dental Department, King Fahad Armed Forces Hospital, Ministry of Defense, Jeddah, Saudi Arabia
| | - Amr Ahmed Azhari
- Department of Restorative Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Hatem Alqarni
- Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Hesham F Shaheen
- Division of Prosthodontics, Dental Department, King Fahad Armed Forces Hospital, Ministry of Defense, Jeddah, Saudi Arabia
| | - Ehab Tawfiq Mitwalli
- Division of Prosthodontics, Dental Department, King Fahad Armed Forces Hospital, Ministry of Defense, Jeddah, Saudi Arabia
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Azpiazu-Flores FX, Lee DJ, Jurado CA, Afrashtehfar KI, Alhotan A, Tsujimoto A. Full-Mouth Rehabilitation of a Patient with Sjogren's Syndrome with Maxillary Titanium-Zirconia and Mandibular Monolithic Zirconia Implant Prostheses Fabricated with CAD/CAM Technology: A Clinical Report. J Funct Biomater 2023; 14:jfb14040174. [PMID: 37103264 PMCID: PMC10143958 DOI: 10.3390/jfb14040174] [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: 02/14/2023] [Revised: 03/21/2023] [Accepted: 03/21/2023] [Indexed: 04/28/2023] Open
Abstract
Dental implants have become a well-established treatment modality for the management of complete and partial edentulism. Recent advancements in dental implant systems and CAD/CAM technologies have revolutionized prosthodontic practice by allowing for the predictable, efficient, and faster management of complex dental scenarios. This clinical report describes the interdisciplinary management of a patient with Sjogren's syndrome and terminal dentition. The patient was rehabilitated using dental implants and zirconia-based prostheses in the maxillary and mandibular arches. These prostheses were fabricated using a combination of CAD/CAM and analog techniques. The successful outcomes for the patient demonstrate the importance of appropriate use of biomaterials and the implementation of interdisciplinary collaboration in treating complex dental cases.
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Affiliation(s)
- Francisco X Azpiazu-Flores
- Department of Restorative Dentistry, Gerald Niznick College of Dentistry University of Manitoba, Winnipeg, MB R3E 0W3, Canada
| | - Damian J Lee
- Division of Restorative and Prosthetic Dentistry, College of Dentistry, The Ohio State University, Columbus, OH 43210, USA
| | - Carlos A Jurado
- Department of Prosthodontics, University of Iowa College of Dentistry, Iowa City, IA 52242, USA
| | - Kelvin I Afrashtehfar
- Division of Restorative Dental Sciences, Clinical Sciences Department, Ajman University College of Dentistry, Ajman City 346, United Arab Emirates
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland
| | - Abdulaziz Alhotan
- Dental Health Department, King Saud University College of Applied Medical Sciences, Riyadh 1145, Saudi Arabia
| | - Akimasa Tsujimoto
- Department of Operative Dentistry, University of Iowa College of Dentistry, Iowa City, IA 52242, USA
- Department of General Dentisry, Creigthon University School of Dentisry, Omaha, NE 68102, USA
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