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Wang M, Liu F, Zhao X, Wu Y. Robot-assisted surgery for dental implant placement: A narrative review. J Dent 2024; 146:105034. [PMID: 38729287 DOI: 10.1016/j.jdent.2024.105034] [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: 12/05/2023] [Revised: 04/29/2024] [Accepted: 04/30/2024] [Indexed: 05/12/2024] Open
Abstract
OBJECTIVE To determine the current status and accuracy of robotic computer-assisted implant surgery (CAIS) applications by examining the associated clinical and experimental outcomes. DATA AND SOURCES PubMed, Medline, and Cochrane Library databases were searched for relevant studies published between January 2000 and November 2023, and focusing on robotic CAIS in dental implant surgery. All search results were then manually reviewed to identify only the pertinent articles. Only in vitro and clinical studies were included in this narrative review, with implant placement accuracy considered the main outcome. RESULT Based on our inclusion and exclusion criteria, we included 21 studies (with 1085 implant sites); of them, 8 were clinical studies, 12 were in vitro studies, and 1 included both an in vitro study and a case series. The ranges of the mean implant shoulder, apical, and angular deviations were respectively 0.43-1.04 mm, 0.53-1.06 mm, and 0.77°-3.77° in the clinical studies and 0.23-1.04 mm, 0.24-2.13 mm, and 0.43°-3.78° in the in vitro studies, respectively. CONCLUSION The accuracy of robotic CAIS in dental implant procedures appears to be within the clinically acceptable ranges. However, further relevant clinical trials validating the existing evidence are needed. CLINICAL SIGNIFICANCE Robotic CAIS can achieve clinically acceptable implant placement accuracy. This innovative technology may improve the precision and success rates of dental implant procedures, with benefit for surgeons and patients.
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Affiliation(s)
- MiaoZhen Wang
- First Clinical Division, Peking University School and Hospital for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology for Stomatology & Beijing Key Laboratory for Digital Stomatology, Beijing, PR China
| | - Feng Liu
- First Clinical Division, Peking University School and Hospital for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology for Stomatology & Beijing Key Laboratory for Digital Stomatology, Beijing, PR China.
| | - Xu Zhao
- First Clinical Division, Peking University School and Hospital for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology for Stomatology & Beijing Key Laboratory for Digital Stomatology, Beijing, PR China
| | - Yuwei Wu
- Second Clinical Division, Peking University School and Hospital for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology for Stomatology & Beijing Key Laboratory for Digital Stomatology, Beijing, PR China
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Wu XY, Shi JY, Qiao SC, Tonetti MS, Lai HC. Accuracy of robotic surgery for dental implant placement: A systematic review and meta-analysis. Clin Oral Implants Res 2024; 35:598-608. [PMID: 38517053 DOI: 10.1111/clr.14255] [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: 11/01/2023] [Revised: 02/22/2024] [Accepted: 02/25/2024] [Indexed: 03/23/2024]
Abstract
OBJECTIVES To systematically analyze the accuracy of robotic surgery for dental implant placement. MATERIALS AND METHODS PubMed, Embase, and Cochrane CENTRAL were searched on October 25, 2023. Model studies or clinical studies reporting the accuracy of robotic surgery for dental implant placement among patients with missing or hopeless teeth were included. Risks of bias in clinical studies were assessed. Meta-analyses were undertaken. RESULTS Data from 8 clinical studies reporting on 109 patients and 242 implants and 13 preclinical studies were included. Positional accuracy was measured by comparing the implant plan in presurgery CBCT and the actual implant position in postsurgery CBCT. For clinical studies, the pooled (95% confidence interval) platform deviation, apex deviation, and angular deviation were 0.68 (0.57, 0.79) mm, 0.67 (0.58, 0.75) mm, and 1.69 (1.25, 2.12)°, respectively. There was no statistically significant difference between the accuracy of implants placed in partially or fully edentulous patients. For model studies, the pooled platform deviation, apex deviation, and angular deviation were 0.72 (0.58, 0.86) mm, 0.90 (0.74, 1.06) mm, and 1.46 (1.22, 1.70)°, respectively. No adverse event was reported. CONCLUSION Within the limitation of the present systematic review, robotic surgery for dental implant placement showed suitable implant positional accuracy and had no reported obvious harm. Both robotic systems and clinical studies on robotic surgery for dental implant placement should be further developed.
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Affiliation(s)
- Xin-Yu Wu
- Shanghai Perio-Implant Innovation Center, Department of Oral Implantology, Shanghai Ninth People Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center of Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Jun-Yu Shi
- Shanghai Perio-Implant Innovation Center, Department of Oral Implantology, Shanghai Ninth People Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center of Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Shi-Chong Qiao
- Shanghai Perio-Implant Innovation Center, Department of Oral Implantology, Shanghai Ninth People Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center of Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Maurizio S Tonetti
- Shanghai Perio-Implant Innovation Center, Department of Oral Implantology, Shanghai Ninth People Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center of Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- European Research Group on Periodontology, Genova, Italy
| | - Hong-Chang Lai
- Shanghai Perio-Implant Innovation Center, Department of Oral Implantology, Shanghai Ninth People Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center of Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
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Sun Z, Lou Y, Liu Z, Wang B, Yu M, Wang H. Anatomy and function of the canalis sinuosus and its injury prevention and treatment strategies in implant surgery. Zhejiang Da Xue Xue Bao Yi Xue Ban 2024:1-8. [PMID: 38763767 DOI: 10.3724/zdxbyxb-2023-0502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/21/2024]
Abstract
The canalis sinuosus, a canal containing the anterior superior alveolar nerve bundle, originates from the infraorbital canal and extends along the maxillary sinus and nasal cavity edges to the anterior maxilla. It was once regarded as an anatomical variation. However, with the widespread application of cone beam computed tomography (CBCT), the detection rate of canalis sinuosus in the population has increased. The canalis sinuosus exhibits diverse courses, branching into multiple accessory canals and terminating at the nasal floor or the anterior tooth region, with the majority traversing the palatal side of the central incisor. The anterior superior alveolar nerve bundle within the canalis sinuosus not only innervates and nourishes the maxillary anterior teeth, their corresponding soft tissues, and the maxillary sinus mucosa, but also relates to the nasal septum, lateral nasal wall, and parts of the palatal mucosa. To minimize surgical complications, implantologists need to investigate strategies for preventing and treating canalis sinuosus injuries. Preoperatively, implantologists should use CBCT to identify the canalis sinuosus and virtually design implant placement at a distance of more than 2 mm from the canalis sinuosus. Intraoperatively, implantologists should assess bleeding and patient comfort, complemented by precision surgical techniques such as the use of implant surgical guide plates. Postoperatively, CBCT can be employed to examine the relationship between the implant and the canalis sinuosus, and treatment of canalis sinuosus injuries can be tailored based on the patient's symptoms. This review summarizes the detection of canalis sinuosus in the population, its anatomical characteristics, and its physiological functions in the anterior maxilla, and discusses strategies for effectively avoiding canalis sinuosus injuries during implant surgery, thereby enhancing implantologists' awareness and providing references for clinical decision-making.
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Affiliation(s)
- Zheyuan Sun
- The Stomatology Hospital, Zhejiang University School of Medicine, Zhejiang University School of Stomatology, Zhejiang Provincial Clinical Research Center for Oral Diseases, Zhejiang Provincial Key Laboratory of Oral Biomedical Research, Zhejiang University Cancer Center, Hangzhou 310006, China.
| | - Yiting Lou
- The Stomatology Hospital, Zhejiang University School of Medicine, Zhejiang University School of Stomatology, Zhejiang Provincial Clinical Research Center for Oral Diseases, Zhejiang Provincial Key Laboratory of Oral Biomedical Research, Zhejiang University Cancer Center, Hangzhou 310006, China
| | - Zhichao Liu
- The Stomatology Hospital, Zhejiang University School of Medicine, Zhejiang University School of Stomatology, Zhejiang Provincial Clinical Research Center for Oral Diseases, Zhejiang Provincial Key Laboratory of Oral Biomedical Research, Zhejiang University Cancer Center, Hangzhou 310006, China
| | - Baixiang Wang
- The Stomatology Hospital, Zhejiang University School of Medicine, Zhejiang University School of Stomatology, Zhejiang Provincial Clinical Research Center for Oral Diseases, Zhejiang Provincial Key Laboratory of Oral Biomedical Research, Zhejiang University Cancer Center, Hangzhou 310006, China
| | - Mengfei Yu
- The Stomatology Hospital, Zhejiang University School of Medicine, Zhejiang University School of Stomatology, Zhejiang Provincial Clinical Research Center for Oral Diseases, Zhejiang Provincial Key Laboratory of Oral Biomedical Research, Zhejiang University Cancer Center, Hangzhou 310006, China
| | - Huiming Wang
- The Stomatology Hospital, Zhejiang University School of Medicine, Zhejiang University School of Stomatology, Zhejiang Provincial Clinical Research Center for Oral Diseases, Zhejiang Provincial Key Laboratory of Oral Biomedical Research, Zhejiang University Cancer Center, Hangzhou 310006, 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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Wang ZY, Gong Y, Liu F, Chen D, Zheng JW, Shen JF. Influence of intraoral scanning coverage on the accuracy of digital implant impressions - An in vitro study. J Dent 2024; 143:104929. [PMID: 38458380 DOI: 10.1016/j.jdent.2024.104929] [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: 01/04/2024] [Revised: 02/15/2024] [Accepted: 03/05/2024] [Indexed: 03/10/2024] Open
Abstract
OBJECTIVES To evaluate the influence of intraoral scanning coverage (IOSC) on digital implant impression accuracy in various partially edentulous situations and predict the optimal IOSC. METHODS Five types of resin models were fabricated, each simulating single or multiple tooth loss scenarios with inserted implants and scan bodies. IOSC was subgrouped to cover two, four, six, eight, ten, and twelve teeth, as well as full arch. Each group underwent ten scans. A desktop scanner served as the reference. Accuracy was evaluated by measuring the Root mean square error (RMSE) values of scan bodies. A convolutional neural network (CNN) was trained to predict the optimal IOSC with different edentulous situations. Statistical analysis was performed using one-way ANOVA and Tukey's test. RESULTS For single-tooth-missing situations, in anterior sites, significantly better accuracy was observed in groups with IOSC ranging from four teeth to full arch (p < 0.05). In premolar sites, IOSC spanning four to six teeth were more accurate (p < 0.05), while in molar sites, groups with IOSC encompassing two to eight teeth exhibited better accuracy (p < 0.05). For multiple-teeth-missing situations, IOSC covering four, six, and eight teeth, as well as full arch showed better accuracy in anterior gaps (p < 0.05). In posterior gaps, IOSC of two, four, six or eight teeth were more accurate (p < 0.05). The CNN predicted distinct optimal IOSC for different edentulous scenarios. CONCLUSIONS Implant impression accuracy can be significantly impacted by IOSC in different partially edentulous situations. The selection of IOSC should be customized to the specific dentition defect condition. CLINICAL SIGNIFICANCE The number of teeth scanned can significantly affect digital implant impression accuracy. For missing single or four anterior teeth, scan at least four or six neighboring teeth is acceptable. In lateral cases, two neighboring teeth may suffice, but extending over ten teeth, including contralateral side, might deteriorate the scan.
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Affiliation(s)
- Zhen-Yu Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chengdu, Sichuan Province, China; West China School of Stomatology, Sichuan University, Chengdu, Sichuan Province, China
| | - Yu Gong
- College of Computer Science, Sichuan University, Chengdu, Sichuan Province, China
| | - Fei Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chengdu, Sichuan Province, China; West China School of Stomatology, Sichuan University, Chengdu, Sichuan Province, China; West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan Province, China
| | - Du Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chengdu, Sichuan Province, China; West China School of Stomatology, Sichuan University, Chengdu, Sichuan Province, China
| | - Jia-Wen Zheng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chengdu, Sichuan Province, China; West China School of Stomatology, Sichuan University, Chengdu, Sichuan Province, China
| | - Jie-Fei Shen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chengdu, Sichuan Province, China; West China School of Stomatology, Sichuan University, Chengdu, Sichuan Province, China; West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan Province, China.
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Xie R, Liu Y, Wei H, Zhang T, Bai S, Zhao Y. Clinical evaluation of autonomous robotic-assisted full-arch implant surgery: A 1-year prospective clinical study. Clin Oral Implants Res 2024; 35:443-453. [PMID: 38318691 DOI: 10.1111/clr.14243] [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: 09/16/2023] [Revised: 01/10/2024] [Accepted: 01/19/2024] [Indexed: 02/07/2024]
Abstract
OBJECTIVES This prospective clinical study aimed to evaluate the accuracy and 1-year clinical follow-up performance of dental implant placement with an autonomous dental implant robot (ADIR) system in full-arch implant surgery. MATERIALS AND METHODS Twelve patients with edentulous arches or final dentition received 102 implants using the ADIR system. Global platform deviation, global apex deviation, and global angular deviation between the planned and actual implants were calculated after surgery. Data were statistically analyzed for factors including jaws, implant positions, patient sequences, implant systems, and implant length. Surgery duration was recorded. Patients were followed for 3 months and 1 year after surgery. Periodontal parameters, buccal bone thickness (BBT), and facial vertical bone wall peak (IP-FC) were recorded. RESULTS Among the 102 implants, the mean (SD) global platform deviation, global apex deviation, and global angular deviation were 0.53 (0.19) mm, 0.58 (0.17) mm, and 1.83 (0.82)°, respectively. The deviation differences between the mandible and maxilla did not show statistical significance (p > .05). No statistically significant differences were found for the jaws, implant positions, patient sequences, implant systems, and implant length to the deviations (p > .05). The periodontal parameters, the BBT, and IP-FC remained stable during 1-year follow-up. CONCLUSION The ADIR system showed excellent positional accuracy. The 1-year follow-up after full-arch implant surgery indicated that the ADIR system could achieve promising clinical performance. Additional clinical evidence is requisite to furnish guidelines for the implementation of the ADIR system in full-arch implant surgery.
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Affiliation(s)
- Rui Xie
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Xi'an, Shaanxi, China
- National Clinical Research Center for Oral Diseases, Xi'an, Shaanxi, China
- Shaanxi Key Laboratory of Stomatology, Xi'an, Shaanxi, China
- Digital Center, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Yuchen Liu
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Xi'an, Shaanxi, China
- National Clinical Research Center for Oral Diseases, Xi'an, Shaanxi, China
- Shaanxi Key Laboratory of Stomatology, Xi'an, Shaanxi, China
- Digital Center, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Hongbo Wei
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Xi'an, Shaanxi, China
- National Clinical Research Center for Oral Diseases, Xi'an, Shaanxi, China
- Shaanxi Key Laboratory of Stomatology, Xi'an, Shaanxi, China
- Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Tingmin Zhang
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Xi'an, Shaanxi, China
- National Clinical Research Center for Oral Diseases, Xi'an, Shaanxi, China
- Shaanxi Key Laboratory of Stomatology, Xi'an, Shaanxi, China
- Digital Center, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Shizhu Bai
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Xi'an, Shaanxi, China
- National Clinical Research Center for Oral Diseases, Xi'an, Shaanxi, China
- Shaanxi Key Laboratory of Stomatology, Xi'an, Shaanxi, China
- Digital Center, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Yimin Zhao
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Xi'an, Shaanxi, China
- National Clinical Research Center for Oral Diseases, Xi'an, Shaanxi, China
- Shaanxi Key Laboratory of Stomatology, Xi'an, Shaanxi, China
- Digital Center, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, China
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Michelinakis G, Apostolakis D, Nikolidakis D, Blum IR. A comprehensive review and update on the current state of computer-assisted rehabilitation in implant dentistry. Prim Dent J 2024; 13:64-73. [PMID: 38424692 DOI: 10.1177/20501684241231672] [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] [Indexed: 03/02/2024]
Abstract
AIM This paper provides a comprehensive review of the established concepts and newer developments related to computer-assisted implant rehabilitation. METHODS Two independent researchers searched the English literature published to 31st December 2023 in the PubMed/Medline database for primary and secondary research and related publications on computer-assisted implant planning, computer-assisted implant placement and computer-assisted implant restoration. RESULTS A total of 58,923 papers were identified, 198 relevant papers were read in full text and 110 studies were finally included. Computer-assisted implant rehabilitation was found to result in more precise implant positioning than freehand placement. Advantages include reduced trauma and surgery time; disadvantages include reduced primary implant stability and higher cost. CONCLUSION Computer-assisted surgery is particularly indicated in cases of critical anatomy, but may encounter limitations in terms of cost, restricted mouth opening, visibility and adjustment of the surgical guides and the need for prior familiarisation with the procedure. Nonetheless, this surgical technique reduces the post-implant placement complication rate.
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Affiliation(s)
- George Michelinakis
- George Michelinakis DDS, MSc, MPhil Prosthodontist, Crete Implants Private Dental Practice, Heraklion, Crete, Greece
- Dimitrios Apostolakis DDS, MSc, MSc Radiologist, Dental Radiology in Crete, Heraklion, Crete, Greece
- Dimitrios Nikolidakis DDS, MSc, PhD Periodontist, Clinic Perio, Private Dental Practice, Heraklion, Crete, Greece
- Igor R. Blum DDS, PhD, Dr Med Dent, MSc, MA (Educ), MFDS RCS (Eng), MFDS RCS (Edin), FDS (Rest Dent) RCS (Eng), FFDRCSI, FCGDent, PGCHE, FHEA, FICD, LLM (Medico-Legal Law) Professor/Consultant & Specialist in Restorative Dentistry, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Dimitrios Apostolakis
- George Michelinakis DDS, MSc, MPhil Prosthodontist, Crete Implants Private Dental Practice, Heraklion, Crete, Greece
- Dimitrios Apostolakis DDS, MSc, MSc Radiologist, Dental Radiology in Crete, Heraklion, Crete, Greece
- Dimitrios Nikolidakis DDS, MSc, PhD Periodontist, Clinic Perio, Private Dental Practice, Heraklion, Crete, Greece
- Igor R. Blum DDS, PhD, Dr Med Dent, MSc, MA (Educ), MFDS RCS (Eng), MFDS RCS (Edin), FDS (Rest Dent) RCS (Eng), FFDRCSI, FCGDent, PGCHE, FHEA, FICD, LLM (Medico-Legal Law) Professor/Consultant & Specialist in Restorative Dentistry, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Dimitrios Nikolidakis
- George Michelinakis DDS, MSc, MPhil Prosthodontist, Crete Implants Private Dental Practice, Heraklion, Crete, Greece
- Dimitrios Apostolakis DDS, MSc, MSc Radiologist, Dental Radiology in Crete, Heraklion, Crete, Greece
- Dimitrios Nikolidakis DDS, MSc, PhD Periodontist, Clinic Perio, Private Dental Practice, Heraklion, Crete, Greece
- Igor R. Blum DDS, PhD, Dr Med Dent, MSc, MA (Educ), MFDS RCS (Eng), MFDS RCS (Edin), FDS (Rest Dent) RCS (Eng), FFDRCSI, FCGDent, PGCHE, FHEA, FICD, LLM (Medico-Legal Law) Professor/Consultant & Specialist in Restorative Dentistry, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Igor R Blum
- George Michelinakis DDS, MSc, MPhil Prosthodontist, Crete Implants Private Dental Practice, Heraklion, Crete, Greece
- Dimitrios Apostolakis DDS, MSc, MSc Radiologist, Dental Radiology in Crete, Heraklion, Crete, Greece
- Dimitrios Nikolidakis DDS, MSc, PhD Periodontist, Clinic Perio, Private Dental Practice, Heraklion, Crete, Greece
- Igor R. Blum DDS, PhD, Dr Med Dent, MSc, MA (Educ), MFDS RCS (Eng), MFDS RCS (Edin), FDS (Rest Dent) RCS (Eng), FFDRCSI, FCGDent, PGCHE, FHEA, FICD, LLM (Medico-Legal Law) Professor/Consultant & Specialist in Restorative Dentistry, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
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Kang YF, Ge YJ, Ding MK, Liu-Fu JF, Cai ZG, Shan XF. A comparison of accuracy among different approaches of static-guided implant placement in patients treated with mandibular reconstruction: A retrospective study. Clin Oral Implants Res 2024; 35:251-257. [PMID: 38031527 DOI: 10.1111/clr.14219] [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: 03/15/2023] [Revised: 10/18/2023] [Accepted: 11/15/2023] [Indexed: 12/01/2023]
Abstract
OBJECTIVE This study aimed to evaluate the differences in the accuracy of immediate intraoral, immediate extraoral, and delayed dental implant placement with surgical guides (static computer-aided implant surgery) in patients treated with mandibular reconstruction. METHODS This was a retrospective study. The patients were divided into three groups: immediate intraoral placement (IIO), immediate extraoral placement (IEO), and delayed placement (DEL). Four variables were used to compare the planned and actual implant positions: angular deviation, three-dimensional (3D) deviation at the entry point of the implant, 3D deviation at the apical point of the implant, and depth deviation. RESULTS The angular deviation was significantly higher in the IIO group than in the IEO (p < .05) and DEL (p < .05) groups. The 3D deviation at the entry point was significantly higher in the IIO group than in the IEO (p < .05) and DEL (p < .01) groups. The 3D deviation at the apical point was significantly higher in the IIO group than in the IEO (p < .01) and DEL (p < .01) groups. The depth deviation was significantly higher in the IIO group than in the IEO (p < .05) and DEL (p < .05) groups. There was no statistical difference between the IEO and DEL group in angular and 3D deviation. CONCLUSION With surgical guides, among the different approaches for implant placement, delayed implant placement remains the most accurate approach for patients treated with mandibular reconstruction.
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Affiliation(s)
- Yi-Fan Kang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
- National Center of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing Key Laboratory of Digital Stomatology Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, National Medical Products Administration Key Laboratory for Dental Materials, Beijing, China
| | - Yan-Jun Ge
- National Center of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing Key Laboratory of Digital Stomatology Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, National Medical Products Administration Key Laboratory for Dental Materials, Beijing, China
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | - Meng-Kun Ding
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
- National Center of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing Key Laboratory of Digital Stomatology Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, National Medical Products Administration Key Laboratory for Dental Materials, Beijing, China
| | - Jian-Feng Liu-Fu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
- National Center of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing Key Laboratory of Digital Stomatology Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, National Medical Products Administration Key Laboratory for Dental Materials, Beijing, China
| | - Zhi-Gang Cai
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
- National Center of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing Key Laboratory of Digital Stomatology Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, National Medical Products Administration Key Laboratory for Dental Materials, Beijing, China
| | - Xiao-Feng Shan
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
- National Center of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing Key Laboratory of Digital Stomatology Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, National Medical Products Administration Key Laboratory for Dental Materials, Beijing, China
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Chen Z, Liu Y, Xie X, Deng F. Influence of bone density on the accuracy of artificial intelligence-guided implant surgery: An in vitro study. J Prosthet Dent 2024; 131:254-261. [PMID: 35469649 DOI: 10.1016/j.prosdent.2021.07.019] [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: 01/10/2021] [Revised: 07/10/2021] [Accepted: 07/12/2021] [Indexed: 11/27/2022]
Abstract
STATEMENT OF PROBLEM Artificial intelligence (AI) has been found to be applicable in medical tests and diagnostics. However, studies on the application of AI technology in oral implantology are lacking. In addition, whether bone density affects the accuracy of guided implant surgery has not been determined. PURPOSE The purpose of this in vitro study was to determine the clinical reliability of an AI-assisted implant planning software program with an in vitro model. An additional goal was to determine the effect of bone density on the accuracy of static computer-assisted implant surgery (CAIS). MATERIAL AND METHODS Ten participants with missing mandibular left first molars were selected for analysis, and surgical fully guided templates were designed by using an AI implant planning software program. Jaw models were produced in 3 filling rate groups (group L: 25%; group M: 40%; group H: 55%, higher filling rate with representatives of the denser simulated bone density) by 3-dimensional (3D) printing. The preoperative and postoperative positions of the implants were compared by measuring the value of deviation through oral scanning. The mean 3D shoulder and apical and angular deviations were calculated for each group. The data were analyzed using 1-way ANOVA (α=.05 corrected for multiple testing by using Bonferroni-Holm adjustment). RESULTS The mean ±standard deviation 3D shoulder and apical and angular deviations were 0.80 ±0.32 mm, 1.43 ±0.47 mm, and 3.68 ±1.30 degrees. These values were lower than the clinical safety distance of the fully guided implant template. A significantly lower mean 3D apical deviation (1.12 ±0.33 mm, P=.023) and angular deviation (2.81 ±1.11 degrees, P=.018) were observed in group L than in group H (1.68 ±0.37 mm, 4.32 ±0.99 degrees). However, no significant differences were found among the 3 groups in 3D deviation at the shoulder (P>.05). CONCLUSIONS AI implant planning software program could design the ideal implant position through self-learning. The accuracy of the AI-assisted designed implant template in this study indicated its clinical reliability. Higher bone density led to increased implant deviations.
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Affiliation(s)
- Zhicong Chen
- Graduate student, Department of Oral Implantology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, PR China
| | - Yun Liu
- Doctor, Department of Oral Implantology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, PR China
| | - Xin Xie
- Undergraduate, Department of Oral Implantology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, PR China
| | - Feilong Deng
- Professor, Department of Oral Implantology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, PR China.
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10
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Pupulin F, Oresta G, Sunar T, Parenti P. On the thermal impact during drilling operations in guided dental surgery: An experimental and numerical investigation. J Mech Behav Biomed Mater 2024; 150:106327. [PMID: 38104487 DOI: 10.1016/j.jmbbm.2023.106327] [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: 10/30/2023] [Revised: 12/10/2023] [Accepted: 12/11/2023] [Indexed: 12/19/2023]
Abstract
In recent years, a major development in dental implantology has been the introduction of patient-specific 3D-printed surgical guides. The utilization of dental guides offers advantages such as enhanced accuracy in locating the implant sites, greater simplicity, and reliability in performing bone drilling operations. However, it is important to note that the presence of such guides may contribute to a rise in cutting temperature, hence increasing the potential hazards of thermal injury to the patient's bone. The aim of this study is to examine the drilling temperature evolution in two distinct methods for 3D-printed surgical dental guides, one utilizing an internal metal bushing system and the other using external metal reducers. Cutting tests are done on synthetic polyurethane bone jaw models using a lab-scale automated Computer Numeric Control (CNC) machine to find out the temperature reached by different drilling techniques and compare them to traditional free cutting configurations. Thermal imaging and thermocouples, as well as the development of numerical simulations using finite element modeling, are used for the aim. The temperature of the tools' shanks experienced an average rise of 2.4 °C and 4.8 °C, but the tooltips exhibited an average increase of around 17 °C and 24 °C during traditional and guided dental surgery, respectively. This finding provides confirmation that both guided technologies have the capability to maintain temperatures below the critical limit for potential harm to bone and tissue. Numerical models were employed to validate and corroborate the findings, which exhibited identical outcomes when applied to genuine bone samples with distinct thermal characteristics.
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Affiliation(s)
- Francesca Pupulin
- Department of Mechanical Engineering, Politecnico di Milano, via La Masa 1, 20156, Milan, Italy
| | - Giorgio Oresta
- Department of Mechanical Engineering, Politecnico di Milano, via La Masa 1, 20156, Milan, Italy
| | - Talha Sunar
- Department of Manufacturing Engineering, Karabuk University, 78050, Karabük, Turkey
| | - Paolo Parenti
- Department of Mechanical Engineering, Politecnico di Milano, via La Masa 1, 20156, Milan, Italy.
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11
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Wu HC, Huang HL, Fuh LJ, Tsai MT, Hsu JT. Influence of implant length and insertion depth on primary stability of short dental implants: An in vitro study of a novel mandibular artificial bone model. J Dent Sci 2024; 19:139-147. [PMID: 38303865 PMCID: PMC10829676 DOI: 10.1016/j.jds.2023.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 05/16/2023] [Indexed: 02/03/2024] Open
Abstract
Background/purpose Dental implants are a mainstream solution for missing teeth. For the improvement of dental implant surface treatment and design, short dental implants have become an alternative to various complex bone augmentation procedures, especially those performed at the posterior region of both the maxilla and mandible. The objective of this study was to evaluate the effect of various insertion methods on the primary stability of short dental implants. Materials and methods Commercial dental implants were inserted into artificial mandibular bone specimens using various insertion methods (equicrestal position, subcrestal position 1.5 mm, and lateral cortical anchorage) in accordance with an implant surgical guide. Insertion torque value (ITV) curves were recorded while implant procedures were performed. Both maximum ITVs (MITVs) and final ITVs (FITVs) were evaluated. Subsequently, Periotest values (PTVs) and implant stability quotients (ISQs) were measured for all specimens. A Kruskal-Wallis test was conducted to analyze the results for four primary stability parameters, and the Dunn test was used for a post hoc pairwise comparison when a difference was identified. Results For all groups, their mean MITVs ranged from 33.6 to 59.4 N cm, whereas their mean FITVs ranged from 17.5 to 43.5 N cm. Insertion torque value, ISQ, and PTV decreased significantly when implants were inserted into subcrestal positions. When implants were inserted in the lateral bicortical position, the four aforementioned parameters yielded greater values. Conclusion When 6-mm short implants were inserted in a lateral cortical anchorage position, high primary stability was yielded.
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Affiliation(s)
- Hsiang-Chun Wu
- School of Dentistry, China Medical University, Taichung, Taiwan
| | - Heng-Li Huang
- School of Dentistry, China Medical University, Taichung, Taiwan
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan
- Department of Biomedical Engineering, China Medical University, Taichung, Taiwan
| | - Lih-Jyh Fuh
- School of Dentistry, China Medical University, Taichung, Taiwan
- Department of Dentistry, China Medical University and Hospital, Taichung, Taiwan
| | - Ming-Tzu Tsai
- Department of Biomedical Engineering, Hungkuang University, Taichung, Taiwan
| | - Jui-Ting Hsu
- School of Dentistry, China Medical University, Taichung, Taiwan
- Department of Biomedical Engineering, China Medical University, Taichung, Taiwan
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12
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Shi JY, Liu BL, Wu XY, Liu M, Zhang Q, Lai HC, Tonetti MS. Improved positional accuracy of dental implant placement using a haptic and machine-vision-controlled collaborative surgery robot: A pilot randomized controlled trial. J Clin Periodontol 2024; 51:24-32. [PMID: 37872750 DOI: 10.1111/jcpe.13893] [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: 07/31/2023] [Revised: 09/05/2023] [Accepted: 10/03/2023] [Indexed: 10/25/2023]
Abstract
AIM To compare the implant accuracy, safety and morbidity between robot-assisted and freehand dental implant placement. MATERIALS AND METHODS Subjects requiring single-site dental implant placement were recruited. Patients were randomly allocated to freehand implant placement and robot-assisted implant placement. Differences in positional accuracy of the implant, surgical morbidity and complications were assessed. The significance of intergroup differences was tested with an intention-to-treat analysis and a per-protocol (PP) analysis (excluding one patient due to calibration error). RESULTS Twenty patients (with a median age of 37, 13 female) were included. One subject assigned to the robotic arm was excluded from the PP analysis because of a large calibration error due to the dislodgement of the index. For robot-assisted and freehand implant placement, with the PP analysis, the median (25th-75th percentile) platform global deviation, apex global deviation and angular deviation were 1.23 (0.9-1.4) mm/1.9 (1.2-2.3) mm (p = .03, the Mann-Whitney U-test), 1.40 (1.1-1.6) mm/2.1 (1.7-3.9) mm (p < .01) and 3.0 (0.9-6.0)°/6.7 (2.2-13.9)° (p = .08), respectively. Both methods showed limited damage to the alveolar ridge and had similar peri- and post-operative morbidity and safety. CONCLUSIONS Robot-assisted implant placement enabled greater positional accuracy of the implant compared to freehand placement in this pilot trial. The robotic system should be further developed to simplify surgical procedures and improve accuracy and be validated in properly sized trials assessing the full spectrum of relevant outcomes.
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Affiliation(s)
- Jun-Yu Shi
- Shanghai PerioImplant Innovation Center, Department of Oral and Maxillofacial Implantology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Bei-Lei Liu
- Shanghai PerioImplant Innovation Center, Department of Oral and Maxillofacial Implantology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Xin-Yu Wu
- Shanghai PerioImplant Innovation Center, Department of Oral and Maxillofacial Implantology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Min Liu
- Shanghai PerioImplant Innovation Center, Department of Oral and Maxillofacial Implantology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Qi Zhang
- Shanghai PerioImplant Innovation Center, Department of Oral and Maxillofacial Implantology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Hong-Chang Lai
- Shanghai PerioImplant Innovation Center, Department of Oral and Maxillofacial Implantology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Maurizio S Tonetti
- Shanghai PerioImplant Innovation Center, Department of Oral and Maxillofacial Implantology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- European Research Group on Periodontology, Genoa, Italy
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13
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Luongo F, Lerner H, Gesso C, Sormani A, Kalemaj Z, Luongo G. Accuracy in static guided implant surgery: Results from a multicenter retrospective clinical study on 21 patients treated in three private practices. J Dent 2024; 140:104795. [PMID: 38016619 DOI: 10.1016/j.jdent.2023.104795] [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: 11/07/2023] [Revised: 11/22/2023] [Accepted: 11/26/2023] [Indexed: 11/30/2023] Open
Abstract
PURPOSE To evaluate the accuracy of a static computer-assisted implant surgery (s-CAIS) system across different private practices. METHODS This retrospective clinical study was based on data retrieved from 21 patients who received 61 implants between 2018 and 2020 in 3 private practices run by surgeons with extensive experience with s-CAIS. All patients were treated using the same s-CAIS system, planning software, template manufacturing process, and surgical guides. The standard tessellation language (STL) file of the intraoral scan of the fixture taken immediately after implant placement was matched with that of the preoperative plan for comparisons of preoperative and planned implant positions with postoperative and actual implant positions. The study outcomes were linear and angular deviations between the planned and actual implant positions. RESULTS No surgical or postsurgical complications occurred. The overlap of the two STL files resulted in a mean angular deviation of 2.94° The mean linear deviation at the implant shoulder was 0.73 mm, and that at the apex was 1.06 mm. The mean vertical deviations at the implant shoulder and the apex were 0.29 mm and 0.01 mm, respectively. CONCLUSION All cases showed satisfactory accuracy within the limits of this study (small number of patients and retrospective design). These results might be related to the use of a standardized digital workflow by experienced operators. STATEMENT OF CLINICAL RELEVANCE The study shows that careful control of each step, from data acquisition to final execution, is key for the accuracy of stent-guided systems.
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Affiliation(s)
- Fabrizia Luongo
- MS, Private Practice, DDS, Via Frattina 27, Rome 00187, Italy.
| | | | | | - Alice Sormani
- Biomedical Engineer, International Consultant Medical Imaging and Guided Surgery Applications, 3Diemme srl Cantù, Italy
| | - Zamira Kalemaj
- PhD, MsC in Epidemiology and Statistics Private Practice, DDS, Milan, Italy
| | - Giuseppe Luongo
- MD, DDS, Department of Oral and Maxillofacial Surgery, Federico II University, Naples, Italy
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14
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Markovic J, Peña-Cardelles JF, Pedrinaci I, Hamilton A, Gallucci GO, Lanis A. Considerations for predictable outcomes in static computer- aided implant surgery in the esthetic zone. J ESTHET RESTOR DENT 2024; 36:207-219. [PMID: 38018396 DOI: 10.1111/jerd.13171] [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: 08/14/2023] [Revised: 10/21/2023] [Accepted: 11/07/2023] [Indexed: 11/30/2023]
Abstract
OBJECTIVE To provide technical and clinical recommendations for implementing a digital workflow in Static Computer-Aided Implant Surgery in the anterior maxilla. CLINICAL CONSIDERATIONS An optimal 3D implant position is crucial for achieving satisfying results in implant rehabilitation in the esthetic area. Due to its complexity, implant placement in the esthetic zone should be executed with precision and predictability. Static Computer-Aided Implant Surgery requires thorough planning and detailed attention to every step of the digital workflow protocol. CONCLUSIONS Implant positioning in the esthetic zone using Static Computer-Aided Implant Surgery is a technique-sensitive procedure that requires precise execution of each step. This approach ensures accurate prosthetically driven 3D implant placement and prevents potential errors that could lead to inaccurate positioning. CLINICAL SIGNIFICANCE The proper implementation of Static Computer-Aided Implant Surgery may increase the level of agreement between the planned and definitive implant 3D positions in the esthetic zone, thus enhancing the esthetic outcomes of implant rehabilitation.
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Affiliation(s)
- Jovana Markovic
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts, USA
- Department for Prosthodontics, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Juan Francisco Peña-Cardelles
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts, USA
| | - Ignacio Pedrinaci
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts, USA
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - Adam Hamilton
- Division of Oral Restorative and Rehabilitative Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - German O Gallucci
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts, USA
| | - Alejandro Lanis
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts, USA
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15
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Khoury N, Husseini B, Tahchy D, Saadeh C, Ghosn N, Younes R. Three-dimensional radiographic assessment of immediate implant placement in the posterior mandible: A novel parameter-based classification. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101590. [PMID: 37562714 DOI: 10.1016/j.jormas.2023.101590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/02/2023] [Accepted: 08/04/2023] [Indexed: 08/12/2023]
Abstract
OBJECTIVES To assess the implant position (IP), the interradicular septum width (ISW) and radiographic bone to implant contact (BIC), when simulating an immediate implant placement in first and second mandibular molars. STUDY DESIGN 75 patients (150 sites) were studied using cone beam computed tomography scans (CBCT) and computer aided design software. Implants were placed in a prosthetically driven position; subsequently, IP and BIC were digitally calculated. Linear ISW was also analyzed at 2, 4 and 6mm apically to the highest septal bony peak. Multiple linear regressions were performed to assess relationships between BIC and the different predictive variables. Additionally, the receiver operating characteristics (ROC) curve was used to create a model for BIC based on the ISW at 2mm. RESULTS BIC in implants replacing first molars was the highest at the septal (S) position when compared to those in septal-mesial (S-M) position (p-value 0.001). As for the second molar, the highest percentage of BIC was recorded at the septal (S) position, followed by those in S-M and mesial (M) positions (p<0.001). CONCLUSION According to the proposed classification, clinician must consider the ISW and IP when placing immediate implant in the first and second mandibular molar sites. When tackling first molars, S position is predominant, while S-M position is the most common in the second molars. ISW at 2mm should be at least respectively 2mm and 2.5mm at the first and second molar sites to achieve 50% of BIC.
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Affiliation(s)
- Nicolas Khoury
- Department of Oral Surgery, Faculty of Dental Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon; Cranio-Facial Research Laboratory, Faculty of Dental Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon.
| | - Bachar Husseini
- Cranio-Facial Research Laboratory, Faculty of Dental Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Daniel Tahchy
- Department of Oral Surgery, Faculty of Dental Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon; Cranio-Facial Research Laboratory, Faculty of Dental Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Carmen Saadeh
- Department of Fixed Prosthodontics, Faculty of Dental Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Nabil Ghosn
- Cranio-Facial Research Laboratory, Faculty of Dental Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Ronald Younes
- Department of Oral Surgery, Faculty of Dental Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon; Cranio-Facial Research Laboratory, Faculty of Dental Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon
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16
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Li P, Chen J, Li A, Luo K, Xu S, Yang S. Accuracy of autonomous robotic surgery for dental implant placement in fully edentulous patients: A retrospective case series study. Clin Oral Implants Res 2023; 34:1428-1437. [PMID: 37855331 DOI: 10.1111/clr.14188] [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: 04/19/2023] [Revised: 09/17/2023] [Accepted: 09/19/2023] [Indexed: 10/20/2023]
Abstract
OBJECTIVES This study evaluated the accuracy of dental implant placement using the robotic computer-assisted implant surgery (r-CAIS) technology in fully edentulous patients. MATERIALS AND METHODS Fully edentulous and terminal dentition patients were enrolled for r-CAIS technology. Based on the cone-beam computed tomography (CBCT) examination, a customized positioning marker and a preoperative surgical plan were created before surgery. During the implant surgery, the implant osteotomy and placement were automatically performed using an autonomous robotic surgery system under the surgeon's supervision. A postoperative CBCT scan was used to determine the discrepancies between the planned and placed implants. RESULTS Ten patients with 59 implants underwent autonomous robotic surgery. No adverse surgical events occurred. The deviations of global coronal, global apical, and angular were 0.67 ± 0.37 mm (95% CI: 0.58-0.77 mm), 0.69 ± 0.37 mm (95% CI: 0.59-0.78 mm), and 1.27° ± 0.59° (95% CI: 1.42°-1.11°), respectively. CONCLUSIONS The autonomous r-CAIS technology proved an accurate surgical approach for implant placement in fully edentulous patients due to the control of the angular deviation. Autonomous robotic surgery seems promising as an accurate technology for treating fully edentulous patients. However, further trials are required to provide more hard clinical evidence.
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Affiliation(s)
- Ping Li
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
- Department of Prosthodontics, School and Hospital of Stomatology, Guangzhou Medical University, Guangzhou, Guangdong, China
- School and Hospital of Stomatology, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Jiahao Chen
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
- Department of Stomatology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - An Li
- Department of Periodontology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Ke Luo
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, 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
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17
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Zhu N, Liu J, Ma T, Zhang Y. A fully digital workflow for prosthetically driven alveolar augmentation with intraoral bone block and implant rehabilitation in an atrophic anterior maxilla. J Prosthet Dent 2023; 130:668-673. [PMID: 35016796 DOI: 10.1016/j.prosdent.2021.11.034] [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: 10/07/2021] [Revised: 11/29/2021] [Accepted: 11/29/2021] [Indexed: 10/19/2022]
Abstract
A fully digital workflow for prosthetically driven alveolar augmentation and implant rehabilitation in the esthetic zone was planned and executed by using a bone harvest guide, trim guide, graft guide, and implant guide. A controllable procedure and predictable results can be realized by adopting this digital workflow.
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Affiliation(s)
- Ning Zhu
- Graduate student, Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, PR China
| | - Jiayu Liu
- Graduate student, Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, PR China
| | - Ting Ma
- Research assistant, Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, PR China
| | - Yu Zhang
- Associate Professor, Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, PR China.
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Manfredini M, Poli PP, Maiorana C, Salina FE, Tandurella M, Beretta M. Computer Aided Full Arch Restoration by Means of One-Piece Implants and Stackable Guide: A Technical Note. Dent J (Basel) 2023; 11:256. [PMID: 37999020 PMCID: PMC10670089 DOI: 10.3390/dj11110256] [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: 08/28/2023] [Revised: 10/22/2023] [Accepted: 10/30/2023] [Indexed: 11/25/2023] Open
Abstract
This technical note aims to present a recently developed computer-guided protocol characterized by titanium-reinforced stackable surgical guides during post-extractive implant placement and subsequent immediate loading. A full maxillary edentulism was rehabilitated with one-piece implants, starting from a pre-existing removable denture. 3D digital scans of the removable denture and upper and lower arches were performed. On this basis, a prototype with ideal esthetic and functional outcomes was realized and replicated into a custom-made radiological stent with markers. The superimposition of STL and DICOM files allowed virtual planning of one-piece implants in the ideal prosthetically driven position. The stackable guides, composed of a fixed base template and additional removable components, were then realized. The fixed template, initially secured with anchor pins to the bone, was no longer removed. The removable components, which were screwed to the base template, were used to perform implant surgery and immediate prosthetic loading. No surgical complications occurred, the implants achieved a minimum insertion torque of 35 Ncm, and immediate prosthetic loading was performed. The base template allowed for the maintenance of a fixed reference during the entire workflow, improving the transition between the digital project, the surgical procedure, and the prosthetic rehabilitation.
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Affiliation(s)
- Mattia Manfredini
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy; (M.M.); (C.M.); (F.E.S.); (M.T.); (M.B.)
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Pier Paolo Poli
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy; (M.M.); (C.M.); (F.E.S.); (M.T.); (M.B.)
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Carlo Maiorana
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy; (M.M.); (C.M.); (F.E.S.); (M.T.); (M.B.)
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Federica Eugenia Salina
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy; (M.M.); (C.M.); (F.E.S.); (M.T.); (M.B.)
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Marco Tandurella
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy; (M.M.); (C.M.); (F.E.S.); (M.T.); (M.B.)
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Mario Beretta
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy; (M.M.); (C.M.); (F.E.S.); (M.T.); (M.B.)
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
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19
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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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20
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Sakkas A, Westendorf S, Thiele OC, Schramm A, Wilde F, Pietzka S. Prosthetically guided oral implant surgery. A retrospective cohort study evaluating the 5-year surgical outcome. GMS INTERDISCIPLINARY PLASTIC AND RECONSTRUCTIVE SURGERY DGPW 2023; 12:Doc06. [PMID: 37693294 PMCID: PMC10486885 DOI: 10.3205/iprs000176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
Purpose This study primarily evaluated the 5-year implant survival and success rate of prosthetically guided inserted implants. The secondary aim was to evaluate the impact of clinical variables on the development of mucositis, peri-implant bone resorption, peri-implantitis, as well as early and late implant failure. Materials and methods An observational retrospective single-centre study was conducted on patients who were treated with dental implants in the department of oral and plastic maxillofacial surgery of the military hospital of Ulm University between 2008 and 2010. In all patients, computer-assisted 3D planning after wax-up of the prosthetic restoration and template-guided surgery with titanium implants were performed. Bone augmentation procedures were performed primarily if needed. Intraoperative and postoperative complications as well as technical and mechanical complications after prosthesis loading were evaluated. In a 5-year clinical and radiological follow-up, implant success and implant survival were assessed using descriptive statistics. A multivariable regression analysis evaluated the potential impact of augmentation procedures, wound healing complications, smoking, history of periodontitis, and preoperative API (approximal plaque index) and SBI (sulcus bleeding index) values on peri-implant mucositis, peri-implant bone resorption, peri-implantitis, as well as early and late implant failure. Results In this study, 466 implants in 283 patients were considered for inclusion, and sufficient data were obtained for analysis from 368 (78.9%) implants in 229 (80.9%) patients. An overall implant survival rate of 98.1% (n=361/368) at the 5-year follow-up was revealed. According to the success criteria of the study, the 5-year success rate was 97.04% (n=263/271). An early implant failure of 1.07% (n=5/466) was recorded. 48.2% of the implants were affected by peri-implant mucositis (n=122/253), while peri-implant bone resorption was detected in 21.7% of the radiologically examined implants (n=59/271). Fifteen cases of peri-implantitis (5.5%) were detected. Peri-implant bone resorption increased significantly after bone augmentation procedures (p=0.028). Wound healing complications after implantation significantly increased the prevalence of late implant failure in the maxilla (p<0.001). Peri-implant bone resorption and peri-implantitis were significantly more prevalent in smokers (p=0.022/p=0.043). Implants in patients with API>20% presented significantly higher rates of peri-implant mucositis (p=0.042). Wound healing complications after augmentation, history of periodontitis, and SBI>20% had no significant impact on the study parameters. Conclusions The study confirms the reliability of prosthetically guided implant surgery, showing a high implant survival and success rate in a 5-year follow-up. Intraoperative complications and technical or mechanical complications after prosthesis loading remain within acceptable clinical limits. The rate of peri-implant mucositis, peri-implant bone resorption, and peri-implantitis was within the current literature range. Optimizing periodontal health and reducing smoking would improve the outcome. Further studies need to clarify the clinical indications and investigate the long-term surgical outcome of this treatment concept.
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Affiliation(s)
- Andreas Sakkas
- Department of Cranio-Maxillo-Facial-Surgery, German Armed Forces Hospital Ulm, Germany
- Department of Cranio-Maxillo-Facial-Surgery, University Hospital Ulm, Germany
| | - Stefan Westendorf
- Department of Cranio-Maxillo-Facial-Surgery, German Armed Forces Hospital Ulm, Germany
| | - Oliver Christian Thiele
- Department of Oral and Plastic Maxillofacial Surgery, Ludwigshafen Hospital, Ludwigshafen, Germany
| | - Alexander Schramm
- Department of Cranio-Maxillo-Facial-Surgery, German Armed Forces Hospital Ulm, Germany
- Department of Cranio-Maxillo-Facial-Surgery, University Hospital Ulm, Germany
| | - Frank Wilde
- Department of Cranio-Maxillo-Facial-Surgery, German Armed Forces Hospital Ulm, Germany
- Department of Cranio-Maxillo-Facial-Surgery, University Hospital Ulm, Germany
| | - Sebastian Pietzka
- Department of Cranio-Maxillo-Facial-Surgery, German Armed Forces Hospital Ulm, Germany
- Department of Cranio-Maxillo-Facial-Surgery, University Hospital Ulm, Germany
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21
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Qiao SC, Wu XY, Shi JY, Tonetti MS, Lai HC. Accuracy and safety of a haptic operated and machine vision controlled collaborative robot for dental implant placement: A translational study. Clin Oral Implants Res 2023; 34:839-849. [PMID: 37309242 DOI: 10.1111/clr.14112] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 05/30/2023] [Accepted: 05/30/2023] [Indexed: 06/14/2023]
Abstract
OBJECTIVES Multiple generations of medical robots have revolutionized surgery. Their application to dental implants is still in its infancy. Co-operating robots (cobots) have great potential to improve the accuracy of implant placement, overcoming the limitations of static and dynamic navigation. This study reports the accuracy of robot-assisted dental implant placement in a preclinical model and further applies the robotic system in a clinical case series. MATERIALS AND METHODS In model analyses, the use of a lock-on structure at robot arm-handpiece was tested in resin arch models. In a clinical case series, patients with single missing teeth or edentulous arch were included. Robot-assisted implant placement was performed. Surgery time was recorded. Implant platform deviation, apex deviation, and angular deviation were measured. Factors influencing implant accuracy were analyzed. RESULTS The in vitro results showed that with a lock-on structure, the mean (SD) of platform deviation, apex deviation, and angular deviation were 0.37 (0.14) mm, 0.44 (0.17) mm, and 0.75 (0.29)°, respectively. Twenty-one patients (28 implants) were included in the clinical case series, 2 with arches and 19 with single missing teeth. The median surgery time for single missing teeth was 23 (IQ range 20-25) min. The surgery time for the two edentulous arches was 47 and 70 min. The mean (SD) of platform deviation, apex deviation, and angular deviation was 0.54 (0.17) mm, 0.54 (0.11) mm, and 0.79 (0.22)° for single missing teeth and for 0.53 (0.17) mm, 0.58 (0.17) mm, and 0.77 (0.26)° for an edentulous arch. Implants placed in the mandible had significantly larger apex deviation than those in the maxilla. CONCLUSION Cobot-assisted dental implant placement showed excellent positional accuracy and safety in both the in vitro study and the clinical case series. More technological development and clinical research are needed to support the introduction of robotic surgery in oral implantology. Trial registered in ChiCTR2100050885.
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Affiliation(s)
- Shi-Chong Qiao
- Shanghai PerioImplant Innovation Center, Department of Oral and Maxillofacial Implantology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Xin-Yu Wu
- Shanghai PerioImplant Innovation Center, Department of Oral and Maxillofacial Implantology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Jun-Yu Shi
- Shanghai PerioImplant Innovation Center, Department of Oral and Maxillofacial Implantology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Maurizio S Tonetti
- Shanghai PerioImplant Innovation Center, Department of Oral and Maxillofacial Implantology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- European Research Group on Periodontology, Genoa, Italy
| | - Hong-Chang Lai
- Shanghai PerioImplant Innovation Center, Department of Oral and Maxillofacial Implantology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
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22
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Martinho FC, Rollor C, Westbrook K, Aldahmash SA, Fay GG, Rivera E, Parsa A, Price JB, Tordik PA. A Cadaver-based comparison of Sleeve-Guided Implant-drill and Dynamic Navigation Osteotomy and Root-end Resections. J Endod 2023:S0099-2399(23)00288-1. [PMID: 37263496 DOI: 10.1016/j.joen.2023.05.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/20/2023] [Accepted: 05/22/2023] [Indexed: 06/03/2023]
Abstract
INTRODUCTION This study compared the accuracy and efficiency of fully guided static and dynamic computer-assisted surgical navigation techniques for osteotomy and root-end resection (RER). METHODS Fifty roots from cadaver heads were divided into two groups: fully guided static computer-assisted endodontic microsurgery (FG sCAEMS) and dynamic computer-assisted endodontic microsurgery (dCAEMS) (all, n = 25). CBCT scans were taken pre- and postoperatively. The osteotomy and RER were planned virtually in the preoperative CBCT scan and guided using 3D-printed surgical guides in the FG sCAEMS and 3D-dynamic navigation system in the dCAEMS. The 2D and 3D deviations and angular deflection (AD) were calculated. The osteotomy volume, resected root length, and resection angle were measured. The osteotomy and RER time and the number of procedural mishaps were recorded. RESULTS FG sCAEMS was as accurate as dCAEMS, with no difference in the 2D and 3D deviation values or AD (p >.05). The osteotomy and RER time were shortened using FG sCAEMS (p <.05). The FG sCAEMS showed a greater number of incomplete RERs than dCAEMS. Osteotomy volume, RER angle, and root length resected were similar in both groups (p >.05). FG sCAEMS and dCAEMS were feasible for osteotomy and RER. CONCLUSIONS Within the limitations of this cadaver-based study, FG sCAEMS was as accurate as dCAEMS. Both FG sCAEMS and dCAEMS were time-efficient for osteotomy and RER, but FG sCAEMS required less surgical time.
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Affiliation(s)
- Frederico C Martinho
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry - Baltimore - Maryland.
| | - Corey Rollor
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry - Baltimore - Maryland
| | - Kyle Westbrook
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry - Baltimore - Maryland
| | - Sara A Aldahmash
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry - Baltimore - Maryland
| | - Guadalupe G Fay
- Division of Prosthodontics - Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry - Baltimore - Maryland
| | - Elias Rivera
- Division of Prosthodontics - Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry - Baltimore - Maryland
| | - Azin Parsa
- Division of Oral Radiology, Department of Oncology and Diagnostic Sciences, University of Maryland, School of Dentistry, Baltimore, Maryland
| | - Jeffery B Price
- Division of Oral Radiology, Department of Oncology and Diagnostic Sciences, University of Maryland, School of Dentistry, Baltimore, Maryland
| | - Patricia A Tordik
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry - Baltimore - Maryland
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23
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Hu L, Rong R, Song W, Wu H, Jia S, He Z, Sa Y. Patient-specific 3D printed models for enhanced learning of immediate implant procedures and provisionalization. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2023. [PMID: 37246340 DOI: 10.1111/eje.12928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 05/07/2023] [Accepted: 05/14/2023] [Indexed: 05/30/2023]
Abstract
INTRODUCTION This study aimed to describe the fabrication, implementation and evaluation of 3D-printed patient-specific models for unskilled students to enhance learning in immediate implant procedures and provisionalization. MATERIALS AND METHODS The individualized simulation models were designed and processed based on CT and digital intraoral scanning of a patient. Thirty students performed simulation implant surgery and provisionalized the implant sites on the models and answered questionnaires to assess their perceptions before and after the training. The scores of the questionnaires were analysed using the Wilcoxon signed-rank test. RESULTS Significant differences before and after training were found in the students' responses. Students reported better results in understanding of surgical procedures, knowledge in prosthetically driven implantology, understanding of minimally invasive tooth extraction, confirming the accuracy of surgical template, usage of the guide rings and usage of the surgical cassette after simulation training. The overall expenditure on the simulation training involving 30 students amounted to 342.5 USD. CONCLUSIONS The patient-specific and cost-efficient 3D printed models are helpful for students to improve theoretical knowledge and practical skills. Such individualized simulation models have promising application prospects.
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Affiliation(s)
- Liqun Hu
- Department of Prosthodontics, The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China
| | - Rong Rong
- Department of Prosthodontics, The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China
| | - Wenjuan Song
- Department of Prosthodontics, The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China
| | - Hongzhao Wu
- Department of Prosthodontics, The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China
| | - Shuqing Jia
- Department of Prosthodontics, The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China
| | - Zhixiao He
- Department of Prosthodontics, The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China
| | - Yue Sa
- Department of Prosthodontics, The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China
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24
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Gallo F, Zingari F, Bolzoni A, Barone S, Giudice A. Accuracy of Zygomatic Implant Placement Using a Full Digital Planning and Custom-Made Bone-Supported Guide: A Retrospective Observational Cohort Study. Dent J (Basel) 2023; 11:dj11050123. [PMID: 37232774 DOI: 10.3390/dj11050123] [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: 02/27/2023] [Revised: 04/25/2023] [Accepted: 04/28/2023] [Indexed: 05/27/2023] Open
Abstract
The aim of the study was to evaluate the accuracy of zygomatic implant placement using customized bone-supported laser-sintered titanium templates. Pre-surgical computed tomography (CT) scans allowed to develop the ideal virtual planning for each patient. Direct metal laser-sintering was used to create the surgical guides for the implant placement. Post-operative CT scans were taken 6 months after surgery to assess any differences between the planned and placed zygomatic implants. Qualitative and quantitative three-dimensional analyses were performed with the software Slicer3D, recording linear and angular displacements after the surface registration of the planned and placed models of each implant. A total of 59 zygomatic implants were analyzed. Apical displacement showed a mean movement of 0.57 ± 0.49 mm on the X-axis, 1.1 ± 0.6 mm on the Y-axis, and 1.15 ± 0.69 mm on the Z-axis for the anterior implant, with a linear displacement of 0.51 ± 0.51 mm on the X-axis, 1.48 ± 0.9 mm on the Y-axis, and 1.34 ± 0.9 mm on the Z-axis for the posterior implant. The basal displacement showed a mean movement of 0.33 ± 0.25 mm on the X-axis, 0.66 ± 0.47 mm on the Y-axis, and 0.58 ± 0.4 mm on the Z-axis for the anterior implant, with a linear displacement of 0.39 ± 0.43 mm on the X-axis, 0.42 ± 0.35 mm on the Y-axis, and 0.66 ± 0.4 mm on the Z-axis for the posterior implant. The angular displacements recorded significative differences between the anterior implants (yaw: 0.56 ± 0.46°; pitch: 0.52 ± 0.45°; roll: 0.57 ± 0.44°) and posterior implants (yaw: 1.3 ± 0.8°; pitch: 1.3 ± 0.78°; roll: 1.28 ± 1.1°) (p < 0.05). Fully guided surgery showed good accuracy for zygomatic implant placement and it should be considered in the decision-making process.
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Affiliation(s)
- Francesco Gallo
- Istituto Stomatologico Italiano, Via Pace, 21, 20161 Milano, Italy
| | - Francesco Zingari
- Ospedale Galeazzi-Sant'Ambrogio, Via Belgioioso 173, 20161 Milano, Italy
| | | | - Selene Barone
- Unit of Oral Surgery and Pathology, Department of Health Sciences, Magna Graecia University of Catanzaro, Viale Europa, 88100 Catanzaro, Italy
| | - Amerigo Giudice
- Unit of Oral Surgery and Pathology, Department of Health Sciences, Magna Graecia University of Catanzaro, Viale Europa, 88100 Catanzaro, Italy
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25
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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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26
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FEM Analysis of Individualized Polymeric 3D Printed Guide for Orthodontic Mini-Implant Insertion as Temporary Crown Support in the Anterior Maxillary Area. Polymers (Basel) 2023; 15:polym15040879. [PMID: 36850161 PMCID: PMC9966125 DOI: 10.3390/polym15040879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/13/2023] [Accepted: 02/07/2023] [Indexed: 02/12/2023] Open
Abstract
Either due to trauma, extraction or congenital factors, the absence of teeth has aesthetic, functional, financial and psychological consequences. The aim of the current study is to assess an individualized polymeric 3D printed digitally planned surgical guide designed to achieve precision and predictability in non-standard mini-implant orthodontic cases. Twenty-seven patient records with missing anterior teeth were selected from the database of a private clinic in Timisoara, Romania. Based on the analysis of the cases included in the research, a surgical guide for the insertion of mini-implants as provisional crown support was designed. An FEM simulation was performed using the Abaqus numerical analysis software. Finite element simulation revealed the maximum displacements and stresses that occur in the surgical guide. Mini-implant supported provisional crowns can be a simple and low-cost method to increase patient self-esteem and compliance with the orthodontic treatment. Computer aided mechanical simulation is a useful tool in analyzing different polymeric surgical guide designs before being used in clinical situations in order to avoid failure.
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27
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Chen X, Yang Z, Wang Y, Fu G. Fixation Pins Increase the Accuracy of Implant Surgery in Free-End Models: An In Vitro Study. J Oral Maxillofac Surg 2023; 81:593-601. [PMID: 36716792 DOI: 10.1016/j.joms.2022.12.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 11/22/2022] [Accepted: 12/17/2022] [Indexed: 01/30/2023]
Abstract
PURPOSE Implant surgical guides, in combination with implant planning software, have been designed for accurate surgery, especially in partial edentulism. The purpose of this study was to examine the effect of fixation pins of surgical guides on the accuracy of static computer-assisted implant surgeries in a maxillary free-end situation. MATERIALS AND METHODS This in vitro study was conducted to compare surgical guides using various fixation pin protocols in implant surgery. A patient dental model with missing teeth from maxillary right first premolar to third molar was used as the study model… Implant placement was planned at maxillary right first premolar, right first molar, and right second molar; Straumann full guide templates were designed and fabricated using the coDiagnostiX software. The experiment involved surgical guides with no fixation pins (NF), buccal unilateral fixation pin (BF), palatal unilateral fixation pin (PF), and bilateral fixation pins on the buccal and palatal sides (BPF), based on the position and number of fixation pins. The deviation between the actual and planned positions was used to evaluate implant accuracy. The fixation pin protocols were the primary predictive variables. Angular, 3D platform, and 3D apex deviations were the primary outcome variables. Statistical analysis was performed using the one-way analysis of variance and Tukey's test (α = 0.05). RESULTS NF generated the maximum angular deviation (3.65 ± 1.39°), 3D platform deviation (1.58 ± 0.55 mm), and 3D apex deviation (2.18 ± 0.79 mm), whereas BPF produced the minimum angular deviation (1.88 ± 0.86°), 3D platform deviation (1.09 ± 0.51 mm), and 3D apex deviation (1.53 ± 0.45 mm). A statistically significant difference between NF and BPF in the angular deviation, 3D platform, and apex deviation (P < .0001, P = .009, and P = .002, respectively) was identified. The unilateral fixation pin exerted a significant effect only on the angular accuracy (BF, P = .0018; PF, P = .0001). CONCLUSION In a maxillary free-end situation, templates with a fixation pin generate better implant accuracy than those without it. A bilateral fixation pin protocol may produce less deviation than those without fixation pins. The implant accuracy does not appear to be affected by the position of the unilateral fixation pin.
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Affiliation(s)
- Xi Chen
- Resident, Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Zhenyu Yang
- Resident, Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Yuan Wang
- Resident, Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Gang Fu
- Resident, Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China; Professor, Chief Physician, Department of Implantology, Stomatological Hospital of Chongqing Medical University, Chongqing, China.
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Scolozzi P, Michelini F, Crottaz C, Perez A. Computer-Aided Design and Computer-Aided Modeling (CAD/CAM) for Guiding Dental Implant Surgery: Personal Reflection Based on 10 Years of Real-Life Experience. J Pers Med 2023; 13:jpm13010129. [PMID: 36675790 PMCID: PMC9863604 DOI: 10.3390/jpm13010129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 01/11/2023] Open
Abstract
Traditional dental implant surgery has been challenged by the phenomenal progression in computer-assisted surgery (CAS) that we have been witnessing in recent years. Among the computer-aided technologies, computer-aided design and computer-aided manufacturing (CAD/CAM) techniques represent by far the most attractive and accepted alternatives over their dynamic counterpart, navigational assistance. Based on many years of experience, we have determined that CAD/CAM technology for guiding dental implant surgery is valuable for rehabilitation of the anterior maxillary region and the management of complete or severe partial edentulism. The technology also guarantees the 3D parallelism of implants. The purpose of the present report is to describe indications for use of CAD/CAM dental implant guided surgery. We analyzed the clinical and radiological data of thirteen consecutive edentulous patients treated using CAD/CAM techniques. All of the patients had stable cosmetic results with a high rate of patient satisfaction at the final follow-up examination. No intra- and/or postoperative complications were encountered during any of the steps of the procedure. The application of CAD/CAM techniques produced successful outcomes in the patients presented in this series.
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Affiliation(s)
- Paolo Scolozzi
- Division of Oral and Maxillofacial Surgery, Department of Surgery, Faculty of Medicine, Hôpitaux Universitaire de Genève, 1211 Genève, Switzerland
- Correspondence: ; Tel.: +41-223-728-002; Fax: +41-223-728-005
| | - Francesco Michelini
- Division of Oral and Maxillofacial Surgery, Department of Surgery, Faculty of Medicine, Hôpitaux Universitaire de Genève, 1211 Genève, Switzerland
| | - Claude Crottaz
- Division of Oral and Maxillofacial Surgery, Department of Surgery, Faculty of Medicine, Hôpitaux Universitaire de Genève, 1211 Genève, Switzerland
| | - Alexandre Perez
- Unit of Oral Surgery and Implantology, Division of Oral and Maxillofacial Surgery, Department of Surgery, Faculty of Medicine, Hôpitaux Universitaire de Genève, 1211 Genève, Switzerland
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Leung T, Dam VV, Lee DH. Accuracy of Augmented Reality-Assisted Navigation in Dental Implant Surgery: Systematic Review and Meta-analysis. J Med Internet Res 2023; 25:e42040. [PMID: 36598798 PMCID: PMC9856431 DOI: 10.2196/42040] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 11/09/2022] [Accepted: 11/25/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The novel concept of immersive 3D augmented reality (AR) surgical navigation has recently been introduced in the medical field. This method allows surgeons to directly focus on the surgical objective without having to look at a separate monitor. In the dental field, the recently developed AR-assisted dental implant navigation system (AR navigation), which uses innovative image technology to directly visualize and track a presurgical plan over an actual surgical site, has attracted great interest. OBJECTIVE This study is the first systematic review and meta-analysis study that aimed to assess the accuracy of dental implants placed by AR navigation and compare it with that of the widely used implant placement methods, including the freehand method (FH), template-based static guidance (TG), and conventional navigation (CN). METHODS Individual search strategies were used in PubMed (MEDLINE), Scopus, ScienceDirect, Cochrane Library, and Google Scholar to search for articles published until March 21, 2022. This study was performed in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and registered in the International Prospective Register of Systematic Reviews (PROSPERO) database. Peer-reviewed journal articles evaluating the positional deviations of dental implants placed using AR-assisted implant navigation systems were included. Cohen d statistical power analysis was used to investigate the effect size estimate and CIs of standardized mean differences (SMDs) between data sets. RESULTS Among the 425 articles retrieved, 15 articles were considered eligible for narrative review, 8 articles were considered for single-arm meta-analysis, and 4 were included in a 2-arm meta-analysis. The mean lateral, global, depth, and angular deviations of the dental implant placed using AR navigation were 0.90 (95% CI 0.78-1.02) mm, 1.18 (95% CI 0.95-1.41) mm, 0.78 (95% CI 0.48-1.08) mm, and 3.96° (95% CI 3.45°-4.48°), respectively. The accuracy of AR navigation was significantly higher than that of the FH method (SMD=-1.01; 95% CI -1.47 to -0.55; P<.001) and CN method (SMD=-0.46; 95% CI -0.64 to -0.29; P<.001). However, the accuracies of the AR navigation and TG methods were similar (SMD=0.06; 95% CI -0.62 to 0.74; P=.73). CONCLUSIONS The positional deviations of AR-navigated implant placements were within the safety zone, suggesting clinically acceptable accuracy of the AR navigation method. Moreover, the accuracy of AR implant navigation was comparable with that of the highly recommended dental implant-guided surgery method, TG, and superior to that of the conventional FH and CN methods. This review highlights the possibility of using AR navigation as an effective and accurate immersive surgical guide for dental implant placement.
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Affiliation(s)
| | - Van Viet Dam
- Department of Implantology, Hanoi National Hospital of Odonto-stomatology, Hanoi, Vietnam.,VNU School of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam
| | - Du-Hyeong Lee
- Institute for Translational Research in Dentistry, Kyungpook National University, Daegu, Republic of Korea.,Department of Prosthodontics, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
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Han HS, Kim PJ, Kim KT, Kim S, Ku Y, Cho YD. Dental implant proximity to adjacent teeth: A retrospective study. Clin Implant Dent Relat Res 2022; 24:733-739. [PMID: 36131203 DOI: 10.1111/cid.13132] [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: 06/09/2022] [Revised: 08/30/2022] [Accepted: 09/01/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND PURPOSE The purpose of this study was to assess the occurrence and prognosis of dental implant proximity or direct contact with the adjacent tooth and to evaluate the symptoms and complications in both the implant and the adjacent tooth. We then elaborate on treatment modalities and discuss the prevention of this phenomenon. MATERIALS AND METHODS This retrospective study was conducted based on the dental clinical and radiographic records of 43 patients with implant-tooth proximity of <1.0 mm or direct implant-tooth contact. Multivariate Bayesian logistic regression was performed to examine the influence of individual variables on correcting major clinical variables. RESULTS In the multivariate regression analysis, the rate of occurrence of tooth symptom decreased by about 95% with every increase of 1.0 mm distance between implant and tooth (odds ratio [OR] = 0.1, 95% confidence interval [CI]: 0.004-0.680, p = 0.024). In the case of implant-tooth root proximity in the anterior area, the OR of peri-implantitis occurrence was 30.4-fold greater than in posterior sites (OR = 30.4, 95% CI: 1.189-785.914, p = 0.040). CONCLUSION Implant-tooth root proximity or direct implant-tooth contact is an iatrogenic factor that causes various complications, including devitalization of the adjacent tooth and peri-implantitis. Proactive prevention with surgical stents and intra-operative periapical radiographs is needed. If proximity or contact is found during surgery, repositioning of the fixture to the correct location is recommended in order to maintain peri-implant health and prevent complications.
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Affiliation(s)
- Hee-Seung Han
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, Seoul, Republic of Korea
| | - Pil-Jong Kim
- Biomedical Knowledge Engineering Laboratory, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Ki-Tae Kim
- Department of Molecular Genetics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Sungtae Kim
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, Seoul, Republic of Korea
| | - Young Ku
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, Seoul, Republic of Korea
| | - Young-Dan Cho
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, Seoul, Republic of Korea
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Novel and accurate 3D-Printed surgical guide for mandibular reconstruction with integrated dental implants. Comput Biol Med 2022; 151:106327. [PMID: 36442275 DOI: 10.1016/j.compbiomed.2022.106327] [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: 07/30/2022] [Revised: 10/25/2022] [Accepted: 11/14/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE Patients with mandibular defects due to trauma or infiltrated disease are in a need of functional mandibular implants that will completely restore the function of their lower jaw. One of the most important roles of well-functioning jaw is mastication, a complex mechanism. A conventional approach used in oral and maxillofacial surgery accomplish this aim via two major surgeries- mandibular reconstruction and surgical placement of dental implants. Little work has been done on combining the two surgeries into with using Additive Manufacturing (AM) and digital planning. MATERIAL AND METHODS This case study offers a mandibular implant design solution with pre-positioned dental implants that can reduce the requirement to only one surgery. Mandibular implant was designed using 3-Matic software (Materialise, Belgium). Positions for dental implants were restoratively-driven and planned on the designed mandibular implant in Blue Sky Plan 4 software (Blue Sky Bio, USA) and placed prior to mandibular reconstruction using a 3D-printed surgical guide. Finite Element Analysis (FEA) was used to evaluate the mechanical behaviour of the 3D-printed surgical guide during dental implant placement. RESULTS The surgical guide was fabricated using SLA and stress distribution was evaluated in ANSYS Workbench FEM software (Ansys Inc Swanson, Houston, USA). Results showed that the designed surgical guide can withstand the forces occurring during the surgery. CONCLUSION The proposed method substantially reduces the surgical procedure and recovery time, increases the accuracy, and allows for a predictable restorative solution that can be visualised from the beginning.
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Zhu N, Liu J, Ma T, Zhang Y, Lin Y. Fully digital versus conventional workflow for horizontal ridge augmentation with intraoral block bone: A randomized controlled clinical trial. Clin Implant Dent Relat Res 2022; 24:809-820. [PMID: 36068075 DOI: 10.1111/cid.13129] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/25/2022] [Accepted: 08/13/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To compare the outcome and efficiency of the computer-aided intraoral block bone grafting procedure with those of the conventional technique for the augmentation of horizontal ridge defects. MATERIALS AND METHODS A total of 28 patients with single missing tooth in esthetic zone with class IV horizontal alveolar bone defect in need of dental implant restoration were recruited. Computer-aided design of the implant restoration and intraoral block bone grafting was performed for all the participants. The patients were randomly and equally divided into guide and control groups. A fully guided bone harvesting, trimming, and grafting surgery was executed in the guide group. The control group patients underwent surgery without any guide. After 6 months, all the patients underwent implant placement. The primary outcomes were the root mean square estimate (RMSE) values between the outer contours of the actual implanted and planned bone block as well as the RMSE values between the inner surface of the implanted bone block and the original bone surface of the recipient site immediately after surgery. The secondary outcomes were the trimming time of bone block and the surgery-associated complications. The postoperative visual analog scale (VAS) of pain, swelling, and mouth opening difficulty was recorded. RESULTS All 28 patients underwent intraoral block bone grafting, followed by the placement of implant after 191.8 ± 19.69 days. The RMSE values between the outer contours of the implanted and planned bone blocks were significantly lower in the guide group (0.37 ± 0.16 mm) as compared to those in the control group (0.72 ± 0.29 mm) (p = 0.0007). The RMSE values between the inner contours of the graft block and original bone at the recipient site were lower in the guide group (0.35 ± 0.15 mm) as compared to those in the control group (0.48 ± 0.17 mm) (p = 0.043). The duration of bone block trimming was shorter in the guide group (401.51 ± 97.60 s) as compared to the control group (602.36 ± 160.57 s) (p = 0.0005). In the control group, two patients received secondary bone grafting, one patient experienced bleeding of donor site and temporary hypoesthesia of the lower lip and chin skin, and one patient developed temporary sensitivity of the adjacent tooth. CONCLUSIONS As compared to the conventional procedure, the fully digital workflow in the present study seemed to be a more accuracy and effective protocol for horizontal ridge augmentation with intraoral block bone. TRIAL REGISTRATION Chictr.org.cn (ChiCTR2000036390).
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Affiliation(s)
- Ning Zhu
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Jiayu Liu
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Ting Ma
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Yu Zhang
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Ye Lin
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
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Massuda CKM, de Carvalho MR, de Moraes JB, Pallos D, Kim YJ. Accuracy of guided dental implant surgery using a fully digital workflow: A case series. J Prosthet Dent 2022:S0022-3913(22)00635-7. [PMID: 36372587 DOI: 10.1016/j.prosdent.2022.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 09/30/2022] [Accepted: 09/30/2022] [Indexed: 11/11/2022]
Abstract
STATEMENT OF PROBLEM Computer-guided implant surgery facilitated by intraoral scanning may enhance the efficiency of the digital workflow. However, it is necessary to assess technique accuracy to evaluate the accuracy of implant placement. PURPOSE The purpose of this clinical study was to evaluate the accuracy of a virtual computer-aided design and computer-aided manufacturing (CAD-CAM) static guided surgery technique associated with intraoral scanning in partially edentulous participants by analyzing the overlap among preoperative and postoperative cone beam computed tomography (CBCT) scans, virtual planning, and the guided surgery performed. MATERIAL AND METHODS Eleven partially edentulous participants underwent CBCT and intraoral scanning (TRIOS3). Data were integrated into a software program (ImplantViewer 3.5) for the virtual planning of implants and 3-dimensional (3D) printing of the prototype CAD-CAM surgical guide. A total of 18 implants were placed using the CAD-CAM static computer-aided implant surgery technique (Strong SW). After 15 days, postoperative CBCT scans were made and 4 variables (angular, coronal, apical, and vertical deviation) were measured to compare the virtually planned implants and the implants placed by analyzing the overlap between preoperative and postoperative of the virtual planning and guided surgery performed using the ImplantViewer 3.5 and Rhino 6 software programs. RESULTS Deviations were found in all parameters analyzed. The mean angular deviation was 2.68 ±1.62 degrees; mean coronal deviation, 0.82 ±0.44 mm; mean apical deviation, 1.14 ±0.44 mm; and mean vertical deviation, 0.62 ±0.44 mm. CONCLUSIONS The implants placed using the CAD-CAM static guided surgery technique associated with intraoral scanning in partially edentulous participants exhibited angular and linear deviations when compared with virtual planning implants. However, these deviations were not clinically significant.
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Affiliation(s)
| | | | - João Baptista de Moraes
- PhD student, Oral Rehabilitation Post-Graduation Program, Veiga de Almeida University, UVA, Rio de Janeiro, RJ, Brazil
| | - Débora Pallos
- Professor, Department of Implantology, University of Santo Amaro, UNISA, São Paulo, SP, Brazil
| | - Yeon Jung Kim
- Professor, Department of Implantology, University of Santo Amaro, UNISA, São Paulo, SP, Brazil.
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A Novel Approach to Guided Implant Surgery: A Technical Note. PROSTHESIS 2022. [DOI: 10.3390/prosthesis4040043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Computer-guided software and kits have significantly improved the clinical applications of implant surgery. Nonetheless, some technical problems are still in evidence during clinical procedures because of cumbersome surgical tools that can limit access to implant sites, mainly in posterior areas of the mouth in the presence of bulky anatomical structures and in patients with reduced mouth-opening capacity. The present paper aimed to present a novel approach to guided implant surgery, describing the technical characteristics of an innovative guided surgical kit made up of modified sleeves and modular surgical drills. The proposed guided surgical kit is based on a novel patented system of sleeves and modular burs, with an increased length of the metal sleeves and a reduced height of the drills. The innovative design of the proposed system would allow the clinician to position guided fixtures in all clinical situations; the reduced encumbrance would be particularly helpful to gain access to the posterior areas of both maxilla and mandible, which have limited inter-arch space, with an easy and user-friendly approach. The modular system could overcome anatomical limitations, such as reduced mouth-opening capacity, and permit clinicians to maintain the stability and integrity of the surgical templates, even in cases where there is very limited intermaxillary space.
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Evaluation of Deviations between Computer-Planned Implant Position and In Vivo Placement through 3D-Printed Guide: A CBCT Scan Analysis on Implant Inserted in Esthetic Area. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12115461] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background: Implant rehabilitation in cases of monoedentulism in the esthetic area is a challenge for the clinician. The aim of our study was to test the diagnostic–therapeutic accuracy of computer-guided implant placement in the esthetic area. Methods: Postimplant surgery cone beam computed tomography (CBCT) scans were retrospectively analyzed to assess the accuracy of computer-guided implant placement compared to the preoperative computer-digital planned implant position. We selectively enrolled CBCT scans of patients who underwent immediate or delayed implant placement of a single maxillary incisor, treated with computer-guided implant surgery through a tooth-supported digitally designed 3D printed guide. Our analysis consisted of three digital measurements: the mean deviation of the implant axis, and the mean mesiodistal implant deviation measured both at the apex and at the head of the implant. Results: A total of 95 implants were placed in 95 patients (60 Males, 35 Females; age from 27 to 45-year-old). Congruence analysis showed a mean deviation of implant axis of 1.04° ± 0.56° in sagittal projection, a mean mesiodistal implant deviation between adjacent teeth of 0.14 mm ± 0.07 mm at implant head level and 0.8 mm ± 0.3 mm at the apex in axial projection. Conclusions: computer-guided implant placement through a tooth-supported guide was extremely accurate in the esthetic area because the deviations between the real implant position and the preoperative planning was not clinically relevant.
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Evaluation of different registration methods and dental restorations on the registration duration and accuracy of cone beam computed tomography data and intraoral scans: a retrospective clinical study. Clin Oral Investig 2022; 26:5763-5771. [PMID: 35538331 DOI: 10.1007/s00784-022-04533-7] [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: 12/21/2021] [Accepted: 05/03/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To evaluate whether the accuracy and duration of registration for cone beam computed tomography (CBCT) and intraoral scans differ according to the method of registration and ratio of dental restorations to natural teeth. MATERIALS AND METHODS CBCT data and intraoral scans of eligible patients were grouped as follows according to the ratio of the number of dental restorations to the number of natural teeth (N): group 1, N = 0%; group 2, 0% < N < 50%; group 3, 50% ≤ N < 100%; and group 4, 100% ≤ N. Marker-free registration was performed with a deep learning-based platform and four implant planning software with different registration methods (two point-based, one surface-based, and one manual registration software) by a single operator, and the time consumption was recorded. Registration accuracy was evaluated by measuring the distances between the three-dimensional models of CBCT data and intraoral scans. RESULTS A total of 36 patients, one jaw per patient, were enrolled. Although registration accuracy was similar, the time consumed for registration significantly differed for the different methods. The deep learning-based registration method consumed the least time. Greater proportions of dental restorations significantly reduced the registration accuracy for semi-automatic and deep learning-based methods and reduced the time consumed for semi-automatic registration. CONCLUSIONS No superiority in registration accuracy was found. The proportion of dental restorations significantly affects the accuracy and duration of registration for CBCT data and intraoral scans. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov Identifier: KCT0006710 CLINICAL RELEVANCE: Registration accuracy for virtual implant planning decreases when the proportion of dental restorations increases regardless of registration methods.
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Lan K, Tao B, Wang F, Wu Y. Accuracy evaluation of 3D-printed noninvasive adhesive marker for dynamic navigation implant surgery in a maxillary edentulous model: An in vitro study. Med Eng Phys 2022; 103:103783. [PMID: 35500986 DOI: 10.1016/j.medengphy.2022.103783] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 01/30/2022] [Accepted: 02/19/2022] [Indexed: 10/18/2022]
Abstract
Dynamic computer-aided implant surgery (DCAIS) can improve dental implantation accuracy and reduce surgical risks. In the registration procedure of DCAIS, the type and the number of registration markers significantly impact the accuracy of DCAIS. One problem of DCAIS in clinical application is that only invasive screw markers can be used for implantation in edentulous patients. It could cause additional trauma, scar formation and usually increase patient discomfort. In this experiment, a personalized 3D-printed edentulous maxillary model was used for simulating clinical situations, and a 3D-printed noninvasive adhesive marker (3D-PNAM) was designed to figure out the above problem. In this research, six target screws were implanted into the model's maxillary alveolar ridge as targets for accuracy analysis. This study used target registration error (TRE) as an index to evaluate the accuracy of invasive screw makers and noninvasive adhesive markers. Results showed that 3D-PNAMs had the same accuracy as screw markers, and placing at least six registration markers in the maxilla was needed for good registration accuracy. The registration markers should be further improved and designed according to application areas' clinical needs and anatomical characteristics in future clinical studies.
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Affiliation(s)
- Kengliang Lan
- Graduate student, Department of Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
| | - Baoxin Tao
- Graduate student, Department of Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
| | - Feng Wang
- Associated Professor, Department of Oral Implantology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
| | - Yiqun Wu
- Professor, Department of Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China.
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Roberto P, Luigi C, Paolo P, Valeria P, Carlo C, Luca S. Guided implant surgery and sinus lift in severely resorbed maxillae: a retrospective clinical study with up to 10 years of follow-up. J Dent 2022; 121:104137. [DOI: 10.1016/j.jdent.2022.104137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 03/18/2022] [Accepted: 04/19/2022] [Indexed: 11/29/2022] Open
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Li-Rodríguez JK, Díaz-Durany M, Romeo-Rubio M, Paz Salido M, Pradíes G. Accuracy of a guided implant system with milled surgical templates. J Oral Sci 2022; 64:145-150. [PMID: 35321962 DOI: 10.2334/josnusd.21-0361] [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: 11/01/2022]
Abstract
PURPOSE This in vitro study analyzed the accuracy of a computer-assisted design (CAD)/computer-assisted manufacturing (CAM) guided implant surgery system by comparing linear, angular, and coronal deviations between the planned and final implant placement. METHODS By using a fully guided surgery workflow, 32 dental implants were placed in 16 partially edentulous models. After virtual design of the restorations, radiological and CAD files were matched and implant positions were planned by using dedicated implant planning software (Galileo Implant version 1.9.2.). Templates were designed (Cerec Omnicam) and milled (Cerec MC XL) by using chairside workflow. Galileo Implant version 1.9.2. was used to evaluate accuracy. RESULTS Mean horizontal and angular-coronal total deviation values were 0.2 mm (SD = 0.126) and 1.1º (SD = 0.834) respectively. Multivariate analysis of variance showed significant differences in horizontal and angular-coronal total deviation in the 32 implants (P = 0.0001). Multivariate analysis with one-factor interaction showed no statistical difference in implant position or implant type (P = 0.139) between eight maxilla models and eight jaw models. CONCLUSION Horizontal and angular-coronal deviations of implants placed with chairside digital workflow were within the recommended safety margin for fully guided surgery.
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Affiliation(s)
- Jeanette K Li-Rodríguez
- Department of Conservative Dentistry and Buccofacial Prostheses, Complutense of Madrid University
| | | | - Marta Romeo-Rubio
- Department of Conservative Dentistry and Buccofacial Prostheses, Complutense of Madrid University
| | - María Paz Salido
- Department of Conservative Dentistry and Buccofacial Prostheses, Complutense of Madrid University
| | - Guillermo Pradíes
- Department of Conservative Dentistry and Buccofacial Prostheses, Complutense of Madrid University
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Ludwig B, Krause L, Venugopal A. Accuracy of Sterile and Non-Sterile CAD/CAM Insertion Guides for Orthodontic Mini-Implants. FRONTIERS IN DENTAL MEDICINE 2022. [DOI: 10.3389/fdmed.2022.768103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AimThe aim of this study was to measure the transfer accuracy of computer-aided design/computer-aided manufacturing (CAD/CAM) insertion guides using mini-implants. The target value is the virtual planned position (100%). It is also clinically mandatory to use sterilised surgical guides (autoclaved at 137°C). The results obtained using sterilised and non-sterilised insertion guides were compared. In addition, the actual position of the mini-implants, as implemented, was compared with the digitally planned positions.Materials and MethodsFollowing CAD/CAM planning and production of 60 insertion guides made from synthetic resins that had been previously tested for suitability, 120 mini-implants were inserted in pairs and in blocks of the bone of the substitute material. Half of the insertion guides were sterilised, while the other half were non-sterilised. Compared with the position of the mini-implants in the digital plans, deviations in the apical and coronal distances between the mini-implants and insertion depth, as well as the included angle of the mini-implants to one another and to the surface of the bone substitute material, were determined.ResultsIn post-sterilisation, the dimensional and material changes were observed. When compared, the deviations to the virtual planned position were achieved when the performed insertion using sterilised insertion guides were lower than those achieved when using non-sterilised insertion guides. The heat treatment during the sterilisation process improved the accuracy of the insertion guides. When comparing sterile insertion guides to the digital planned position (100%), the mean coronal deviation was 0.057 mm (0.81%), the apical deviation was 0.428 mm (6.11%), and insertion depth mean deviation at the right side was 0.15 mm (2.15%), while that on the left was 0.073 mm (1.04%).ConclusionThe CAD/CAM TAD insertion guide could not achieve 100% accuracy in translating the digitally planned position into the real anatomic location. Deviations to the ideal position between 0.81 and 6.11% were observed. Clinically, for appliances that fit post-mini-implant insertion, the coronal distance of the mid-mini-implant head is the most important. At this point, the mean deviation to the planned positions is 0.81%, which is clinically acceptable and most likely reproducible by using CAD/CAM insertion guides.
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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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Guentsch A, An H, Dentino AR. Precision and trueness of computer-assisted implant placement using static surgical guides with open and closed sleeves: An in-vitro analysis. Clin Oral Implants Res 2022; 33:441-450. [PMID: 35148444 PMCID: PMC9302989 DOI: 10.1111/clr.13904] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 12/28/2021] [Accepted: 02/03/2022] [Indexed: 12/02/2022]
Abstract
Objectives The aim of this in vitro study was to determine accuracy defined by trueness and precision of computer‐assisted implant surgery comparing two guided surgery kits designed for either closed sleeves or open sleeves with a lateral window. Material and methods Each n=20 implants were placed fully guided (sleeve‐bone distance of 2 or 4 mm) in identical replicas using a surgical guide with both closed sleeve or an open sleeve, partially guided, or free hand. The achieved implant position was digitized and compared with the planned position. Trueness and precision were determined. 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 and the Scheffé procedure. Results The accuracy of guided implant placement using closed and open sleeves was comparable when the sleeve‐bone distance was 2 mm. Accuracy decreased when the sleeve‐bone distance increased in both fully guided groups, more so in the open than in the closed sleeve group. The least accurate method was the free‐hand group. Partially guided implant surgery was more accurate than free‐hand placement, but less accurate than the fully guided groups with 2‐mm sleeve‐bone distance. Conclusions The closer the sleeve to the bone, the more accurate and precise is computer‐assisted implant surgery using a closed system and a system using open sleeves. Partially guided implant surgery using only the static guide for the pilot drill is less accurate than both fully guided approaches, but more accurate than free‐hand surgery.
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Affiliation(s)
- Arndt Guentsch
- Professor of Periodontics and Department Chair, Department of Surgical Sciences, Marquette University School of Dentistry, Milwaukee, Wisconsin, USA
| | - Hongseok An
- Assistant Professor of Restorative Dentistry, Department of Restorative Dentistry, School of Dentistry, Oregon Health & Science University, Portland, OR, 97201, USA
| | - Andrew R Dentino
- Professor of Periodontics and Associate Dean for Research and Graduate Studies, Marquette University School of Dentistry, Milwaukee, Wisconsin, USA
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Chackartchi T, Romanos GE, Parkanyi L, Schwarz F, Sculean A. Reducing errors in guided implant surgery to optimize treatment outcomes. Periodontol 2000 2022; 88:64-72. [PMID: 35103317 DOI: 10.1111/prd.12411] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Clinical considerations and treatment criteria in implant placement are constantly evolving. Prosthetically driven implant surgery has become the standard of care to improve short and long-term functional and esthetic outcomes. Therefore, implant position and angulation are planned according to the available bone, anatomical structures, and the requirements of the future prosthetic superstructure. In parallel with these developments, significant progress has been made in data imaging and different software technologies to allow the integration of data within a digital file format. Digitalization in implant surgery enables optimal planning of implant position, as well as the ability to transfer this planning to the surgical field-a process defined as "computer-supported implant planning and guided surgery." The aims of the present review are as follows: (a) to critically appraise the indications and potential "added value" of guided implant surgery, elaborating the main differences between dynamic and static guidance; and (b) to discuss the most important clinical considerations relevant for the different steps of the workflow that might influence the surgical outcome and to offer recommendations on how to avoid or reduce process errors in order to optimize treatment outcomes.
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Affiliation(s)
- Tali Chackartchi
- Department of Periodontology, Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Georgios E Romanos
- Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Laszlo Parkanyi
- Department of Periodontology, Faculty of Dentistry, University of Szeged, Szeged, Hungary
| | - Frank Schwarz
- Department of Oral Surgery and Implantology, Carolinum, Johann Wolfgang Goethe-University Frankfurt, Frankfurt, Germany
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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Yang Y, Hu C, Zhang Y, Wang L, Shao L, You J. Comparing digital and traditional guides in first molar implant surgery: A randomized clinical trial. Technol Health Care 2022; 30:403-412. [PMID: 35124615 PMCID: PMC9028674 DOI: 10.3233/thc-thc228037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND: There are few studies on the differences in clinical outcomes with implant guides made by different methods in cases with a single tooth loss and adjacent tooth support OBJECTIVE: To compare the use of digital and traditional implant guides in patients whose first molars are absent and who are undergoing implant restoration. METHODS: This study included 42 patients with first molars missing who were randomly divided into two groups: the digital group (n= 21) and the control group (n= 21). A CAD/CAM digital implant guide was used in the digital group, whereas a traditional impression was used in the control group. Then, the labor time, the intraoral fit of the implant guide, and the deviation of the screw access channel position were compared between the two groups. RESULTS: The impression time and implant surgery time in the digital group were less than in the traditional group. The intraoral first fit of the guide in the digital group was higher than in the control group (P< 0.05). The one-time satisfaction rate of the digital group was 100%, while five cases in the control group needed to be redone. In the digital group, there was no significant difference in the deviation of the screw access channel position between implants on the left and right sides. In the control group, the deviation of the screw access channel position on the right side was significantly lower than on the left side. Overall, the deviation of the screw access channel position was significantly lower in the digital group than in the control group. CONCLUSIONS: In a first molar implant, the digital implant guide can effectively reduce the clinical operative time and the screw access deviation and improve efficiency. The clinical results with the digital guide provide a basis for its use in implant therapy for single missing teeth.
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Affiliation(s)
- Yajie Yang
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Chen Hu
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yanli Zhang
- Stomatological Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Linlin Wang
- Department of Stomatology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China
| | - Longquan Shao
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
- Stomatological Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Jie You
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
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Ku JK, Lee J, Lee HJ, Yun PY, Kim YK. Accuracy of dental implant placement with computer-guided surgery: a retrospective cohort study. BMC Oral Health 2022; 22:8. [PMID: 35034613 PMCID: PMC8762866 DOI: 10.1186/s12903-022-02046-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 11/16/2021] [Indexed: 11/17/2022] Open
Abstract
Background The aim of this study was to assess the accuracy of virtual planning of computer-guided surgery based on the actual outcomes of clinical dental implant placement. Methods
This retrospective study enrolled patients among whom implant treatment was planned using computer-guided surgery with cone beam computed tomography (CBCT). The patients who received implant according to the guide with the flapless and flapped approach were classified as group 1 and 2, respectively, and the others who could not be placed according to the guide were allocated to the drop-out group. The accuracy of implant placement was evaluated with the superimposition of CBCT. Results We analyzed differences in the deviated distance of the entrance point and deviated angulation of the insertion of implant fixtures. With regard to the surgical approach, group 2 exhibited greater accuracy compared to group 1 in deviation distance (2.22 ± 0.88 and 3.18 ± 0.89 mm, respectively, P < 0.001) and angulation (4.27 ± 2.30 and 6.82 ± 2.71°, respectively, P = 0.001). The limitations of guided surgery were discussed while considering the findings from the drop-out group. Conclusions Computer-guided surgery demonstrates greater accuracy in implant placement with the flapless approach. Further research should be conducted to enhance the availability of guides for cases with unfavorable residual bone conditions.
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Affiliation(s)
- Jeong-Kui Ku
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, 211, Eonju-ro, Gangnam-gu, Seoul, 06273, Korea
| | - Junggon Lee
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, 82 Gumi-ro, 173 Beon-gil, Bundang-gu, Seongnam, 13620, Korea
| | - Hyo-Jung Lee
- Department of Periodontology, Section of Dentistry, Seoul National University Bundang Hospital, 82 Gumi-ro, 173 Beon-gil, Bundang-gu, Seongnam, 13620, Korea
| | - Pil-Young Yun
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, 82 Gumi-ro, 173 Beon-gil, Bundang-gu, Seongnam, 13620, Korea
| | - Young-Kyun Kim
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, 82 Gumi-ro, 173 Beon-gil, Bundang-gu, Seongnam, 13620, Korea. .,Department of Dentistry and Dental Research Institute, School of Dentistry, Seoul National University, 101, Daehak-ro Jongno-gu, Seoul, 03080, Korea.
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Gonçalves WF, Garcia LDFR, Vieira-Schuldt DP, Bortoluzzi EA, Dias-Júnior LCDL, Teixeira CDS. Guided Endodontics in Root Canals with Complex Access: Two Case Reports. Braz Dent J 2022; 32:115-123. [PMID: 35019015 DOI: 10.1590/0103-6440202104537] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 11/05/2021] [Indexed: 01/17/2023] Open
Abstract
This article reported two clinical cases in which the guided endodontics was used to perform the access to the root canals. The first case presents a 40-year-old female with a history of pain related to the left maxillary canine. After radiographic examination, the presence of severe calcification up to the apical third of the root canal, associated with a periapical radiolucency, was noted. In the second case, an 85-year-old male was referred to our service with pain upon palpation, at the right mandibular first molar. The radiographic images revealed the presence of endodontic treatment and a fiberglass post in the distal root canal, which was associated with extrusion of the filling material and a periapical lesion. The 3D-guides were planned based on cone beam computed tomography and intraoral digital scanning, which were aligned using a specific software. Therefore, implant drills could be guided up to the root canal length required for each case. In the first case, a surgical root canal was created and the patient was free of signs and symptoms after the treatment was completed. In the second case, it was observed that the fiber post was worn by the drill, allowing free access to the filling material. It was possible to perform the endodontic reintervention in a more predictable way and in less time. In both cases, the use of the guided endodontics allowed the preservation of a large part of the dental structure. The procedures were performed faster, without the occurrence of fractures and perforations.
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Affiliation(s)
- Wesley Fernandes Gonçalves
- Department of Dentistry - Endodontics Division, Health Sciences Center, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Lucas da Fonseca Roberti Garcia
- Department of Dentistry - Endodontics Division, Health Sciences Center, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Daniela Peressoni Vieira-Schuldt
- Department of Dentistry - Endodontics Division, Health Sciences Center, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Eduardo Antunes Bortoluzzi
- Department of Dentistry - Endodontics Division, Health Sciences Center, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Luiz Carlos de Lima Dias-Júnior
- Department of Dentistry - Endodontics Division, Health Sciences Center, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Cleonice da Silveira Teixeira
- Department of Dentistry - Endodontics Division, Health Sciences Center, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
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Wang ZY, Chao JR, Zheng JW, You M, Liu Y, Shen JF. The influence of crown coverage on the accuracy of static guided implant surgery in partially edentulous models: An in vitro study. J Dent 2021; 115:103882. [PMID: 34742831 DOI: 10.1016/j.jdent.2021.103882] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 10/28/2021] [Accepted: 11/01/2021] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVE To evaluate the influence of crown coverage of surgical guides on the accuracy of static computer-assisted implant surgeries (sCAISs) in different partially edentulous situations. METHODS Acrylic models with five types of partially edentulous situations were fabricated in this study. In coDiagnostiX software (Dental Wings, Montreal, Canada), surgical templates were designed and fabricated with reduced crown coverage (RCC), standard crown coverage (SCC) and extended crown coverage (ECC). Then, fully guided implant placement into the acrylic models was performed by dental surgeons with more than 10 years of experience. In total, 120 models and 120 guides were manufactured, and 168 bone-level Straumann replica implants (4.1 × 10 mm, Institut Straumann AG, Basel, Switzerland) were inserted. Postoperative implant positions were scanned (Trios 3, 3 shape, Copenhagen, Denmark) and compared with the preplanned virtual positions via coDiagnostiX (Dental Wings, Montreal, Canada). The angular, coronal and apical deviations were measured and analyzed to evaluate the accuracy of implant insertion. Statistical analysis was performed using one-way ANOVA and Tukey's test. RESULTS For single tooth missing situations, the RCC group was similar to the SCC group and ECC group in anterior sites. In premolar or molar sites, the SCC and ECC groups had no statistically significant difference (p > .05), while the RCC group had more coronal and apical deviation (p < .05). For multiple teeth missing situations, there was no difference among the RCC, SCC and ECC groups (p > .05). No difference was found among the five edentulous situations with different CCs (p > .05). CONCLUSION The CC of templates can significantly affect the accuracy of guided surgeries when implants are inserted in a single gap at posterior sites. Templates with CC extended to the undercut line may be an optimal choice for static guided surgeries. CLINICAL SIGNIFICANCE The accuracy of static guided implant surgery can be influenced by the CC of templates, and proper CC with the guide covering extending to the undercut line may contribute to improved accuracy. CC should be taken into consideration when designing surgical templates.
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Affiliation(s)
- Zhen-Yu Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chengdu, Sichuan Province, China; West China School of Stomatology, Sichuan University, Chengdu, Sichuan Province, China
| | - Jia-Rui Chao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chengdu, Sichuan Province, China; West China School of Stomatology, Sichuan University, Chengdu, Sichuan Province, China
| | - Jia-Wen Zheng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chengdu, Sichuan Province, China; West China School of Stomatology, Sichuan University, Chengdu, Sichuan Province, China
| | - Meng You
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chengdu, Sichuan Province, China; West China School of Stomatology, Sichuan University, Chengdu, Sichuan Province, China; Department of Radiology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan Province, China
| | - Yang Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chengdu, Sichuan Province, China; West China School of Stomatology, Sichuan University, Chengdu, Sichuan Province, China; The Department of Temporomandibular Joint, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan Province, China
| | - Jie-Fei Shen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chengdu, Sichuan Province, China; West China School of Stomatology, Sichuan University, Chengdu, Sichuan Province, China; Department of Prosthodontics II, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan Province, China.
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Wegmüller L, Halbeisen F, Sharma N, Kühl S, Thieringer FM. Consumer vs. High-End 3D Printers for Guided Implant Surgery-An In Vitro Accuracy Assessment Study of Different 3D Printing Technologies. J Clin Med 2021; 10:jcm10214894. [PMID: 34768413 PMCID: PMC8584299 DOI: 10.3390/jcm10214894] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/10/2021] [Accepted: 10/23/2021] [Indexed: 01/10/2023] Open
Abstract
This study evaluates the accuracy of drill guides fabricated in medical-grade, biocompatible materials for static, computer-aided implant surgery (sCAIS). The virtually planned drill guides of ten completed patient cases were printed (n = 40) using professional (Material Jetting (MJ)) and consumer-level three-dimensional (3D) printing technologies, namely, Stereolithography (SLA), Fused Filament Fabrication (FFF), and Digital Light Processing (DLP). After printing and post-processing, the drill guides were digitized using an optical scanner. Subsequently, the drill guide's original (reference) data and the surface scans of the digitized 3D-printed drill guide were superimposed to evaluate their incongruencies. The accuracy of the 3D-printed drill guides was calculated by determining the root mean square (RMS) values. Additionally, cast models of the planned cases were used to check that the drill guides fitted manually. The RMS (mean ± SD) values for the accuracy of 3D-printed drill guides were-MJ (0.09 ± 0.01 mm), SLA (0.12 ± 0.02 mm), FFF (0.18 ± 0.04 mm), and DLP (0.25 ± 0.05 mm). Upon a subjective assessment, all drill guides could be mounted on the cast models without hindrance. The results revealed statistically significant differences (p < 0.01) in all except the MJ- and SLA-printed drill guides. Although the measured differences in accuracy were statistically significant, the deviations were negligible from a clinical point of view. Within the limits of this study, we conclude that consumer-level 3D printers can produce surgical guides with a similar accuracy to a high-end, professional 3D printer with reduced costs.
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Affiliation(s)
- Lukas Wegmüller
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, 4123 Allschwil, Switzerland; (L.W.); (N.S.)
| | - Florian Halbeisen
- Basel Institute for Clinical Epidemiology and Biostatistics, Department of Clinical Research, University Hospital Basel, University of Basel, 4031 Basel, Switzerland;
| | - Neha Sharma
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, 4123 Allschwil, Switzerland; (L.W.); (N.S.)
- Clinic of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, 4031 Basel, Switzerland
| | - Sebastian Kühl
- Department of Oral Surgery, University Center for Dental Medicine, University of Basel, 4058 Basel, Switzerland;
| | - Florian M. Thieringer
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, 4123 Allschwil, Switzerland; (L.W.); (N.S.)
- Clinic of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, 4031 Basel, Switzerland
- Correspondence:
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Immediate Implant Placement and Provisionalization in the Esthetic Zone: A 6.5-Year Follow-Up and Literature Review. Case Rep Dent 2021; 2021:4290193. [PMID: 34567810 PMCID: PMC8457954 DOI: 10.1155/2021/4290193] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 08/13/2021] [Indexed: 11/17/2022] Open
Abstract
The success of dental implant therapy in the esthetic zone requires not only functional osseointegration but also a satisfactory esthetic outcome. To establish harmony, balance, and continuity of gingival architecture between an implant restoration and the adjacent natural dentition is challenging. Immediate implant placement and provisionalization following tooth extraction have been documented as a predictable treatment modality, with fewer surgical interventions needed, to replace a missing tooth in the esthetic zone. This case report illustrates immediate implant placement and provisionalization to replace a failing maxillary right central incisor while maintaining optimal gingival esthetics. The maxillary right central incisor was extracted without flap elevation to minimize soft and hard tissue trauma. Immediately afterwards, the implant was installed using a surgical stent and restored with a provisional crown that had no occlusal contacts. During healing, no significant adverse effects were observed clinically or radiographically. This proposed treatment modality provided the patient with immediate esthetics, function, and comfort without any complications during a follow-up period of 6.5 years.
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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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