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Shusterman A, Nashef R, Tecco S, Mangano C, Lerner H, Mangano FG. Accuracy of implant placement using a mixed reality-based dynamic navigation system versus static computer-assisted and freehand surgery: An in Vitro study. J Dent 2024; 146:105052. [PMID: 38734298 DOI: 10.1016/j.jdent.2024.105052] [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: 04/02/2024] [Revised: 05/01/2024] [Accepted: 05/02/2024] [Indexed: 05/13/2024] Open
Abstract
PURPOSE This in vitro study aimed to compare the accuracy of dental implant placement in partially edentulous maxillary models using a mixed reality-based dynamic navigation (MR-DN) system to conventional static computer-assisted implant surgery (s-CAIS) and a freehand (FH) method. METHODS Forty-five partially edentulous models (with teeth missing in positions #15, #16 and #25) were assigned to three groups (15 per group). The same experienced operator performed the model surgeries using an MR-DN system (group 1), s-CAIS (group 2) and FH (group 3). In total, 135 dental implants were placed (45 per group). The primary outcomes were the linear coronal deviation (entry error; En), apical deviation (apex error; Ap), XY and Z deviations, and angular deviation (An) between the planned and actual (post-surgery) position of the implants in the models. These deviations were computed as the distances between the stereolithographic (STL) files for the planned implants and placed implants captured with an intraoral scanner. RESULTS Across the three implant sites, the MR-DN system was significantly more accurate than the FH method (in XY, Z, En, Ap and An) and s-CAIS (in Z, Ap and An), respectively. However, S-CAIS was more accurate than MR-DN in XY, and no difference was found between MR-DN and s-CAIS in En. CONCLUSIONS Within the limits of this study (in vitro design, only partially edentulous models), implant placement accuracy with MR-DN was superior to that of FH and similar to that of s-CAIS. STATEMENT OF CLINICAL RELEVANCE In vitro, MR-DN showed greater accuracy in implant positioning than FH, and similar accuracy to s-CAIS: it could, therefore, represent a new option for the surgeon. However, clinical studies are needed to determine the feasibility of MR-DN.
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Affiliation(s)
| | - Rizan Nashef
- Oral and Maxillofacial Surgery Unit, Shaare Zedek Medical center, Jerusalem Israel.
| | - Simona Tecco
- Department of Dental Sciences, San Raffaele University, Milan Italy
| | - Carlo Mangano
- Department of Dental Sciences, San Raffaele University, Milan Italy
| | - Henriette Lerner
- Academic Teaching and Research Institution of Johann Wolfgang Goethe University, Frankfurt, Germany.
| | - Francesco Guido Mangano
- Department of Pediatric, Preventive Dentistry and Orthodontics, I. M. Sechenov First State Medical University, Moscow, Russian Federation.
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Fornara R, Pisano M, Salvati G, Malvicini G, Iandolo A, Gaeta C. Management of Calcified Canals with a New Type of Endodontic Static Guide: A Case Report. Dent J (Basel) 2024; 12:166. [PMID: 38920867 PMCID: PMC11202512 DOI: 10.3390/dj12060166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 02/03/2024] [Accepted: 04/19/2024] [Indexed: 06/27/2024] Open
Abstract
(1) Background: Pulp canal obliteration (PCO) is a common condition characterized by an abnormal dentinal apposition within the canal wall, which often rises as a consequence of dental trauma. In recent years, "guided endodontics" has offered a reliable and safer procedure for endodontic access in case of PCO. The present case report aims to introduce a new endodontic guided system with a sleeveless, open-frame titanium guide designed to reduce costs compared to traditional templates. (2) Methods: The patient is a 19-year-old female who was referred to a private clinic to treat a calcified and symptomatic tooth (3.3) with apical periodontitis. Following the first unsuccessful treatment attempt using the operating microscope, a three-dimensional cone beam computed tomography (CBCT) examination and an optical impression were performed in agreement with the patient. The Digital Imaging and Communications in Medicine (DICOM) and Standard Tessellation Language (STL) files were sent to the lab for the template packaging, and the patient was scheduled for a second appointment. The endodontic guide was accurately positioned, and shaping and filling were concluded with success. The canal was sealed with the single-cone technique and bioceramic sealer. (3) Results: The patient reported no significant post-operative symptoms. Notably, the treatment achieved total symptom resolution, as evidenced by radiographic assessments conducted 3 and 24 months post-treatment, confirming the procedure's success. (4) Conclusions: This innovative sleeveless, open-frame static titanium guide presents a promising advancement in guided endodontics for PCO treatment. The advantages include preserving healthy dental tissue, reduced chairside operating time, and cost savings compared to conventional templates. This approach holds promise for enhancing the quality and efficiency of endodontic procedures in cases of PCO. While the static guide holds promise, larger prospective studies are necessary to validate its efficacy, safety, and broader applicability in routine endodontic procedures.
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Affiliation(s)
| | - Massimo Pisano
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy (A.I.)
| | - Giovanni Salvati
- Unit of Endodontics and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy; (G.S.); (C.G.)
| | - Giulia Malvicini
- Unit of Endodontics and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy; (G.S.); (C.G.)
| | - Alfredo Iandolo
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy (A.I.)
| | - Carlo Gaeta
- Unit of Endodontics and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy; (G.S.); (C.G.)
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Fang T, Gao J, Wu Q, Xie C, Zhang Y, Lu J, Yu H. Digital workflow of labial guides for alveolar ridge reduction during implant-supported full-arch rehabilitation. J Prosthodont 2024; 33:506-511. [PMID: 37632329 DOI: 10.1111/jopr.13759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 08/25/2023] [Indexed: 08/28/2023] Open
Abstract
This article presents a technique for fabricating two-piece labial guides using resin and cobalt-chromium for guided alveoloplasty, implant placement, and immediate full-arch implant-supported fixed complete denture placement. This technique reduces tissue damage and overcomes the negative effect of the anatomical position of the palatal neuropore and mobility of the tissue flap on the positioning and stability of the guide. The use of labial retention metal guides with improved mechanical properties of cobalt-chromium and fixation plugs allows the unilateral placement of the guide. Thus, minimally invasive implant surgery can be performed owing to the absence of large palatal flap elevation and obstruction. Such a design provides better stability of the guides and clear visual access during surgery.
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Affiliation(s)
- Tinglu Fang
- Department of Dental Technology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Jing Gao
- Department of Prosthodontics, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Qin Wu
- Department of Prosthodontics, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Chenyang Xie
- Department of Dental Technology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Yuqiang Zhang
- Department of Prosthodontics, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Jiayi Lu
- Department of Prosthodontics, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Haiyang Yu
- Department of Prosthodontics, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, People's Republic of China
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Nagata K, Okubo M, Saito K, Nakashizu T, Atsumi M, Kawana H. Verification of the accuracy of dynamic navigation for conventional and mouthpiece methods: in vivo study. BMC Oral Health 2024; 24:596. [PMID: 38778269 PMCID: PMC11112779 DOI: 10.1186/s12903-024-04327-1] [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: 01/22/2024] [Accepted: 05/03/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Dynamic navigation for implant placement is becoming popular under the concept of top-down treatment. The purpose of this study is to verify the accuracy of a dynamic navigation system for implant placement. METHODS Implant placement was performed on 38 patients using 50 implant fixtures. Patients in group C were treated using a conventional method, in which thermoplastic clips were fixed to the teeth, and patients in group M were treated using thermoplastic clips fixed to a mouthpiece attached to the teeth. The groups were compared to verify whether an accuracy difference existed. A treatment planning support program for dental implants was used to superimpose the postoperative computed tomography data on the preoperative implant design data to measure the entry point, apex point, and angular deviation. RESULTS The accuracy of group C was 1.36 ± 0.51 mm for entry point, 1.30 ± 0.59 mm for apex point, and 3.20 ± 0.74° for angular deviation. The accuracy of group M was 1.06 ± 0.31 mm for the entry point, 1.02 ± 0.30 mm for the apex point, and 2.91 ± 0.97° for angular deviation. Significant differences were observed in the entry and apex points between the two groups. CONCLUSIONS The results indicate that group M exhibited better accuracy than group C, indicating that the stability of the thermoplastic clip is important for ensuring the accuracy of the dynamic navigation system. No previous studies have verified the accuracy of this system using the mouthpiece method, and additional data is required to confirm its accuracy for dental implant placement. The mouthpiece method improves the accuracy of implant placement and provides a safer implant treatment than the conventional method. TRIAL REGISTRATION University hospital Medical Information Network Clinical Trials Registry (UMIN-CTR), Registration Number: UMIN000051949, URL: https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view_his.cgi on August 21, 2023.
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Affiliation(s)
- Koudai Nagata
- Department of Oral and Maxillofacial Implantology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, 238-8580, Japan
| | - Manabu Okubo
- Department of Oral and Maxillofacial Implantology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, 238-8580, Japan
| | - Kurumi Saito
- Department of Oral and Maxillofacial Implantology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, 238-8580, Japan
| | - Toshifumi Nakashizu
- Division of the Dental Practice Support, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, 238-8580, Japan
| | - Mihoko Atsumi
- Department of Oral and Maxillofacial Implantology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, 238-8580, Japan
| | - Hiromasa Kawana
- Department of Oral and Maxillofacial Implantology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, 238-8580, Japan.
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Delarue M, Perez C, Lucidarme Q, Bornert F. Management of a solitary bone cyst using a custom-made surgical guide for a minimally invasive approach: technical note and case report. BMC Oral Health 2024; 24:560. [PMID: 38745168 PMCID: PMC11092003 DOI: 10.1186/s12903-024-04308-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 04/29/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Solitary Bone Cyst (SBC), also known as a simple bone cyst, hemorrhagic cyst, or traumatic cyst is classified by the WHO among non-odontogenic benign lesions of the jaw. The article explores the use of a static 3D-printed surgical guide to treat mandibular SBC, emphasizing a minimally surgical approach for this lesion. CASE PRESENTATION A 20-year-old woman was referred for a persistent mandibular SBC lacuna, without specific complaints. Her medical history included a previous bone trepanation for a SBC in the same area, radiologically and surgically confirmed. X-ray assessment showed a well-defined unilocular radiolucency surrounding the root of the first left lower molar (tooth #36), measuring 10 × 10 mm. Pulp sensitivity was normal. CBCT data and STL files of dental cast were obtained preoperatively and registered. A 3D-printed surgical guide was used for minimally invasive trepanation of the buccal cortical. The simulation used a targeted endodontic microsurgery approach in order to determine axis and diameter of the trephine. Surgery was performed under local anesthesia. The guide was tooth supported integrating tubes and a fork for guiding precise trepanation. A 3.5 mm round bone window was created, leaving an empty cavity confirming SBC diagnosis and permitting bone curettage. A blood clot was obtained to promote bone healing. Complete reossification was observed after 6 months. The follow-up at 2 years confirmed a complete bone healing with normal pulp sensitivity. DISCUSSION The 3D-printed windowed surgical guide with dental support offers big advantages, including improved visibility and reduced errors. Compared to traditional guides, it eliminates visual hindrance and allows easier and quick access to confined areas as well as an improved irrigation during drilling process. The article also highlights the importance of preoperative planning while acknowledging potential limitations and errors and surgical complications. CONCLUSION The use of the 3D-printed surgical guide could be used in routine for minimally invasive intervention of SBC. This case also demonstrates the potential utility of this approach in various procedures in oral and maxillofacial surgery. The technique provides precise localization, reducing complications and enhances operative efficiency.
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Affiliation(s)
- Maxime Delarue
- Faculty of Dental Surgery, University of Strasbourg, 8 Rue de Sainte Elisabeth, Strasbourg, 67000, France.
- Oral Surgery, UF8601, University Hospital of Strasbourg, 1 Place de l'Hôpital, Strasbourg, 67000, France.
| | - Cyril Perez
- Faculty of Dental Surgery, University of Strasbourg, 8 Rue de Sainte Elisabeth, Strasbourg, 67000, France
- Oral Surgery, UF8601, University Hospital of Strasbourg, 1 Place de l'Hôpital, Strasbourg, 67000, France
| | - Quentin Lucidarme
- Faculty of Dental Surgery, University of Strasbourg, 8 Rue de Sainte Elisabeth, Strasbourg, 67000, France
- Oral Surgery, UF8601, University Hospital of Strasbourg, 1 Place de l'Hôpital, Strasbourg, 67000, France
| | - Fabien Bornert
- Faculty of Dental Surgery, University of Strasbourg, 8 Rue de Sainte Elisabeth, Strasbourg, 67000, France
- Dental Care Unit, UF8611, University Hospital of Strasbourg, Hôpital de Hautepierre, 1 Avenue Molière, Strasbourg, 67098, France
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, CRBS, 1 Rue Eugène Boeckel, Strasbourg, 67000, France
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Lan D, Luo Y, Qu Y, Man Y. The three-dimensional stability and accuracy of 3D printing surgical templates: An In Vitro study. J Dent 2024; 144:104936. [PMID: 38492806 DOI: 10.1016/j.jdent.2024.104936] [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: 08/15/2023] [Revised: 02/23/2024] [Accepted: 03/10/2024] [Indexed: 03/18/2024] Open
Abstract
OBJECTIVE To evaluate the three-dimensional (3D) stability and accuracy of additively manufactured surgical templates fabricated using two different 3D printers and materials. MATERIALS AND METHODS Forty surgical templates were designed and printed using two different 3D printers: the resin group (n = 20) used a digital light processing (DLP) 3D printer with photopolymer resin, and the metal group (n = 20) employed a selective laser melting (SLM) 3D printer with titanium alloy. All surgical templates were scanned immediately after production and re-digitalized after one month of storage. Similarly, the implant simulations were performed twice. Three-dimensional congruency between the original design and the manufactured surgical templates was quantified using the root mean square (RMS), and the definitive and planned implant positions were determined and compared. RESULTS At the postproduction stage, the metal templates exhibited higher accuracy than the resin templates (p < 0.001), and these differences persisted after one month of storage (p < 0.001). The resin templates demonstrated a significant decrease in three-dimensional stability after one month of storage (p < 0.001), whereas the metal templates were not affected (p > 0.05). No significant differences in implant accuracy were found between the two groups. However, the resin templates showed a significant increase in apical and angular deviations after one month of storage (p < 0.001), whereas the metal templates were not affected (p > 0.05). CONCLUSION Printed metal templates showed higher fabrication accuracy than printed resin templates. The three-dimensional stability and implant accuracy of printed metal templates remained unaffected by one month of storage. CLINICAL SIGNIFICANCE With superior three-dimensional stability and acceptable implant accuracy, printed metal templates can be considered a viable alternative technique for guided surgery.
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Affiliation(s)
- Dongping Lan
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Yilin Luo
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Yili Qu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Yi Man
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China.
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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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Chandran K R S, Goyal M, Mittal N, George JS. Accuracy of freehand versus guided immediate implant placement: A randomized controlled trial. J Dent 2023; 136:104620. [PMID: 37454788 DOI: 10.1016/j.jdent.2023.104620] [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: 05/24/2023] [Revised: 07/10/2023] [Accepted: 07/12/2023] [Indexed: 07/18/2023] Open
Abstract
PURPOSE This randomized controlled trial (RCT) aimed to compare the accuracy of immediate implant placement with freehand and static guided surgery. METHODS An RCT was conducted on 61 subjects who received a total of 80 dental implants. The enrolled patients were randomly allocated to two groups: freehand surgery (control group, n = 40 implants) and static guided surgery with R2Gate® (Megagen, Gyeongbuk, South Korea, test group, n = 40 implants). Crestal and apical deviations in both mesiodistal and buccolingual dimensions, as well as depth and angular deviations, were calculated by comparing the three-dimensional (3D) position of the implant in the planning software with the final implant position, revealed by an intraoral scan of the fixture after placement. The Mann-Whitney test was used for comparative assessment. RESULTS In the freehand group (control), crestal deviations of 1.13 ± 0.89 mm and 1.00 ± 0.76 mm were found in the mesiodistal and buccolingual directions, respectively, versus 0.34 ± 0.26 mm (p<0.001) and 0.37 ± 0.24 mm (p = 0.03) in the static guided surgery group (test). Apical deviation was also higher in the freehand group (control) than in the static guided surgery group (test) in the mesiodistal (4.04 ± 1.90 mm vs. 0.97 ± 0.55 mm, p = 0.04) and buccolingual directions (3.46 ± 1.82 mm vs. 0.94 ± 0.67 mm, p = 0.02). Freehand surgery had greater angular deviation (6.09° ± 3.23) compared to guided surgery (0.83° ± 0.53, p = 0.02). However, depth deviation was similar in the freehand surgery group (2.24 ± 1.58 mm) and static guided surgery group (0.66 ± 0.43, p = 0.09). CONCLUSIONS Immediate implant placement with static guided surgery demonstrated better accuracy than freehand surgery. STATEMENT OF CLINICAL RELEVANCE Guided implant surgery showed fewer deviations compared to freehand surgery in fresh extraction sockets; therefore, the use of static guides should be given preference over the freehand modality.
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Affiliation(s)
- Segin Chandran K R
- Santosh University, No.1, Santosh Nagar, Pratap Vihar, Ghaziabad, Uttar Pradesh 201009, India.
| | - Manoj Goyal
- Santosh University, No.1, Santosh Nagar, Pratap Vihar, Ghaziabad, Uttar Pradesh 201009, India
| | - Neeti Mittal
- Santosh University, No.1, Santosh Nagar, Pratap Vihar, Ghaziabad, Uttar Pradesh 201009, India
| | - Jensy Sara George
- The Tamil Nadu Dr MGR Medical University 69, Anna Salai, Rd, Guindy, Chennai, Tamil Nadu 600032, India
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Zadrożny Ł, Górski B, Baldoni E, Lumbau AI, Meloni SM, Pisano M, Tallarico M. Minimally Invasive Treatment of Lateral Incisors with Guided One-Piece or Two-Piece Titanium-Made Narrow Diameter Implants: A Retrospective Comparative Study with Up to Two Years Follow-Up. J Clin Med 2023; 12:jcm12113711. [PMID: 37297907 DOI: 10.3390/jcm12113711] [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: 04/18/2023] [Revised: 05/17/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023] Open
Abstract
Restoring teeth with dental implants has become the gold standard in recent years, especially in the esthetic zone. However, limited amount of available bone as well as limited interdental space in the anterior zone may create problems for implant treatment. Narrow diameter implants (NDI) may be a treatment option to resolve the above-mentioned limitations and providing minimally invasive implant therapy without additional regenerative procedures. In this retrospective study, a comparison of clinical and radiographic outcomes between one-piece and two-piece titanium-made NDIs was done with the follow-up of two years after loading. Twenty-three NDI cases were analyzed, 11 in the one-piece implant group (group one) and 12 in the two-piece implant group (group two). The outcomes were implant and prosthetic failures, any complications occurred, peri-implant bone level changes, and as well as the Pink Esthetic score. No implant or prosthetic failures, as well as, no complications were reported at the two-year follow-up examination. At the same time the marginal bone loss was 0.23 ± 0.11 in the group one and 0.18 ± 0.12 in the group two. Difference was not statistically significant (p = 0.3339). The Pink Esthetic Score, recorded two years after definitive loading, was 12.6 ± 0.97 in the group one and 12.2 ± 0.92 in the group two, with no statistically significant difference between groups (p = 0.3554). With the limitations of the present study, including the small sample size and short follow-up, it is possible to conclude that either one and two-piece NDI can be successfully used to restore lateral incisors with comparable results within the two years of follow-up.
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Affiliation(s)
- Łukasz Zadrożny
- Department of Dental Propaedeutics and Prophylaxis, Medical University of Warsaw, Nowogrodzka 59 St., 02-006 Warsaw, Poland
| | - Bartłomiej Górski
- Department of Periodontology and Oral Mucosa Diseases, Medical University of Warsaw, Binieckiego 6 St., 02-097 Warsaw, Poland
| | - Edoardo Baldoni
- Department of Medicine, Surgery, and Pharmacy, University of Sassari, 07021 Sassari, Italy
| | | | - Silvio Mario Meloni
- Department of Medicine, Surgery, and Pharmacy, University of Sassari, 07021 Sassari, Italy
| | - Milena Pisano
- Department of Medicine, Surgery, and Pharmacy, University of Sassari, 07021 Sassari, Italy
| | - Marco Tallarico
- Department of Medicine, Surgery, and Pharmacy, University of Sassari, 07021 Sassari, Italy
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10
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Torres A, Dierickx M, Coucke W, Pedano MS, Lambrechts P, Jacobs R. In vitro study on the accuracy of sleeveless guided endodontics and treatment of a complex upper lateral incisor. J Dent 2023; 131:104466. [PMID: 36804580 DOI: 10.1016/j.jdent.2023.104466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/31/2023] [Accepted: 02/16/2023] [Indexed: 02/21/2023] Open
Abstract
PURPOSE The present study aims to assess the accuracy of sleeveless guided endodontics for root canal treatment of severe pulp canal obliteration (PCO) in 3D printed jaws. Additionally, the treatment of a complex lateral incisor is presented to illustrate the use of sleeveless guides in a clinical situation. METHODS Two cone-beam computed tomography (CBCT) volumes of an upper and lower jaw were selected to design 3D printed models with PCO. Virtual planning of the access cavities was performed from right to left second premolar. Then, the models were mounted into a phantom head to simulate an actual patient. Two operators with different levels of experience in endodontics performed guided access cavities. The handpiece was guided by guiding rails placed against each other on the sides of the tooth. A post-operative CBCT scan was taken for analysis. RESULTS Eighty-eight guided access cavities (44 per operator) were drilled on eight 3D printed models. The mean length of the access cavities was 15.3 mm, with a mean coronal and apical deviation of 0.5 mm and 0.7 mm respectively. The mean angular deviation was 1.5°. No statistically significant difference was found between operators for the three measured parameters. CONCLUSIONS This study demonstrates, within its limitations, that sleveless guides represent an accurate method for guided endodontic treatment. No statistically significant difference between operators was found when using the guide. CLINICAL SIGNIFICANCE This method offers a valuable alternative to conventional endodontic guides with similar accuracy results.
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Affiliation(s)
- A Torres
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium; Department of Oral Health Sciences, Endodontology, University Hospitals Leuven, KU Leuven, Leuven, Belgium.
| | - M Dierickx
- Department of Oral Health Sciences, Endodontology, University Hospitals Leuven, KU Leuven, Leuven, Belgium.
| | - W Coucke
- Certified Freelance Statistician, Heverlee, Belgium.
| | - M S Pedano
- Department of Oral Health Sciences, Endodontology, University Hospitals Leuven, KU Leuven, Leuven, Belgium.
| | - P Lambrechts
- Department of Oral Health Sciences, Endodontology, University Hospitals Leuven, KU Leuven, Leuven, Belgium.
| | - R Jacobs
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium; Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
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11
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Mangano FG, Admakin O, Lerner H, Mangano C. Artificial Intelligence and Augmented Reality for Guided Implant Surgery Planning: a Proof of Concept. J Dent 2023; 133:104485. [PMID: 36965859 DOI: 10.1016/j.jdent.2023.104485] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 03/08/2023] [Accepted: 03/13/2023] [Indexed: 03/27/2023] Open
Abstract
PURPOSE To present a novel protocol for authentic three-dimensional (3D) planning of dental implants, using artificial intelligence (AI) and augmented reality (AR). METHODS The novel protocol consists of (1) 3D data acquisition, with an intraoral scanner (IOS) and cone-beam computed tomography (CBCT); (2) application of AI for CBCT segmentation to obtain standard tessellation language (STL) models and automatic alignment with IOS models; (3) loading of selected STL models within the AR system and surgical planning with holograms; (4) surgical guide design with open-source computer-assisted-design (CAD) software; and (5) surgery on the patient. RESULTS This novel protocol is effective and time-efficient when used for planning simple cases of static guided implant surgery in the partially edentulous patient. The clinician can plan the implants in an authentic 3D environment, without using any radiological guided surgery software. The precision of implant placement looks clinically acceptable, with minor deviations. CONCLUSIONS AI and AR technologies can be successfully used for planning guided implant surgery for authentic 3D planning that may replace conventional guided surgery software. However, further clinical studies are needed to validate this protocol. STATEMENT OF CLINICAL RELEVANCE The combined use of AI and AR may change the perspectives of modern guided implant surgery for authentic 3D planning that may replace conventional guided surgery software.
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Affiliation(s)
- Francesco Guido Mangano
- Department of Pediatric, Preventive Dentistry and Orthodontics, Sechenov First State Medical University, Moscow, Russian Federation; Honorary Professor in Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, China.
| | - Oleg Admakin
- Department of Pediatric, Preventive Dentistry and Orthodontics, Sechenov First State Medical University, Moscow, Russian Federation.
| | - Henriette Lerner
- Academic Teaching and Research Institution of Johann Wolfgang Goethe University, Frankfurt, Germany.
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12
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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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13
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Mo S, Xu Y, Zhang L, Cao Y, Zhou Y, Xu X. Accuracy of a 3D printed sleeveless guide system used for fiber post removal: An in vitro study. J Dent 2023; 128:104367. [PMID: 36402258 DOI: 10.1016/j.jdent.2022.104367] [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: 08/21/2022] [Revised: 11/11/2022] [Accepted: 11/15/2022] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES The removal of fiber post is often a challenging task. A 3D printed assembled sleeveless system that guides the head of the handpiece instead of the drill was developed to address this issue. This study aimed to evaluate the accuracy of this novel guide system using an in vitro approach. METHODS A standard maxillary typodont was digitized. The right first molar, the right central incisor, the left first premolar, and the left second molar in the digitized dentition were virtually crown-amputated. Four cylinders (diameter: 6 mm, height: 12 mm) were positioned along the directions of the main roots of these teeth to establish the virtual test model. Ten copies of the test model were printed using light-polymerizing resin. Four assembled sleeveless guide systems targeting the cylindrical axes were designed and printed using titanium alloy. One senior prosthodontist performed the drilling task targeting each cylindrical axis aided by the guide system or freehand (20 teeth each). The drilled models were scanned. The coordinates of the centers of all perforations and circular bases on the coronal and apical surfaces were obtained. The linear and angular deviations between the actual drilling path and the cylindrical axis for each tooth were calculated and analyzed. RESULTS The guided group exhibited significantly smaller linear and angular deviations than the freehand group (coronal linear deviation: 0.19 ± 0.09 mm vs. 0.35 ± 0.18 mm, p = 0.0012; apical linear deviation: 0.54 ± 0.19 mm vs. 1.71 ± 0.51 mm, p < 0.001; angular deviation: 2.67 ± 1.07° vs. 8.48 ± 2.86°, p < 0.001). CONCLUSION The accuracy of the 3D printed assembled sleeveless guide system used for fiber post removal is superior to that of the freehand method within the limits of an in vitro design. CLINICAL SIGNIFICANCE For the removal of fiber posts, the present 3D printed sleeveless guide system can provide better accuracy that the conventional freehand method. This may justify the diffusion of the guided technique for fiber post removal.
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Affiliation(s)
- Siyi Mo
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, National Center of 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, NMPA key Laboratory for Dental Materials, Zhongguancun South Avenue 22, Beijing 100081, China
| | - Yongwei Xu
- Department of dentistry, Peking University People's Hospital, Xizhimen South Street 11, Beijing 100044, China
| | - Lei Zhang
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, National Center of 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, NMPA key Laboratory for Dental Materials, Zhongguancun South Avenue 22, Beijing 100081, China
| | - Ye Cao
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, National Center of 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, NMPA key Laboratory for Dental Materials, Zhongguancun South Avenue 22, Beijing 100081, China
| | - Yongsheng Zhou
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, National Center of 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, NMPA key Laboratory for Dental Materials, Zhongguancun South Avenue 22, Beijing 100081, China
| | - Xiaoxiang Xu
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, National Center of 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, NMPA key Laboratory for Dental Materials, Zhongguancun South Avenue 22, Beijing 100081, China.
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14
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Chandran S, Sers L, Picciocchi G, Luongo F, Lerner H, Engelschalk M, Omar S. Guided implant surgery with R2Gate®: A multicenter retrospective clinical study with 1 year of follow-up. J Dent 2022; 127:104349. [PMID: 36283626 DOI: 10.1016/j.jdent.2022.104349] [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: 09/23/2022] [Revised: 10/18/2022] [Accepted: 10/20/2022] [Indexed: 11/06/2022] Open
Abstract
PURPOSE To present the results obtained with a novel sleeveless and keyless guided implant surgery system. METHODS Inclusion criteria for this multicenter clinical retrospective study were fully or partially edentulous patients who had been treated with a sleeveless and keyless guided implant surgery system (R2Gate®, Megagen), and who had been rehabilitated with fixed restorations, with a minimum follow-up of 1 year. All surgeries and prosthetic procedures were conducted following the same protocol, and data were obtained from the patients' medical records. The outcomes were the fit and stability of the surgical guide, any intra-operative and immediate post-operative complications, any biologic and prosthetic complications that occurred during the 1-year follow-up period, implant survival, and prosthetic success. RESULTS Sixty patients were selected for the installation of 124 implants, through a guided procedure: 66 sleeveless, keyless surgical guides were manufactured. The incidence of immediate intra-operative (lack of space: 12.1%; lack of implant stability 2.6%) and immediate post-operative (pain and discomfort: 6.6%; mild swelling 3.3%) complications was low. In total, 112/124 implants (90.3%) were successfully placed with a guided procedure, in 52 patients; among them, 82 (73.2%) were placed with a flapless procedure. Thirty fixtures supported single crowns (SCs), 42 fixed partial dentures (FPDs) and 52 full-arch (FA) restorations. Sixty-two fixed prosthetic restorations (30 SCs, 22 FPDs and 10 FAs) were delivered; among these restorations, 15 (24.1%) were subjected to immediate functional loading. All implants (100%) survived. Two implants had peri‑implant mucositis (1.6%), two SCs had abutment screw loosenings (1.6%), two FAs and one FPD had ceramic chipping/fracture (2.4%), for an overall prosthetic success amounting to 88.7%. CONCLUSIONS Within the limits of this study, this novel guided surgery system appeared to be clinically reliable; further studies are needed to confirm these results. STATEMENT OF CLINICAL RELEVANCE The use of sleveless and keyless surgical guides can be clinically reliable and may be represent a valid option for the surgeon.
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Affiliation(s)
- Segin Chandran
- Research Fellow, Santosh University, No.1 Santosh Nagar, Pratap Vihar, Ghaziabad, Uttar Pradesh 201009, India
| | - Laurent Sers
- Private Practitioner, 54 Rue d'Antibes, Cannes 06400, France
| | - Guido Picciocchi
- Private Practitioner, via Brigata Liguria 3, Genova 16121, Italy
| | | | - Henriette Lerner
- Department of Oral, Maxillofacial and Plastic Surgery, Goethe University, Frankfurt, Germany
| | | | - Sam Omar
- Private Practitioner, OneDay Clinic, Shalz Mall, G2C4 2nd floor, El Sheikh Zayed City 7th District, Mogawra 2, Giza, Governorate 12593, Egypt; OneDay Digital Academy, Shalz Mall, G2C13 2nd Floor, El Sheikh Zayed City 7th District, Mogawra 2, Giza, Governorate 12593, Egypt.
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15
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Pimkhaokham A, Jiaranuchart S, Kaboosaya B, Arunjaroensuk S, Subbalekha K, Mattheos N. Can computer-assisted implant surgery improve clinical outcomes and reduce the frequency and intensity of complications in implant dentistry? A critical review. Periodontol 2000 2022; 90:197-223. [PMID: 35924457 PMCID: PMC9805105 DOI: 10.1111/prd.12458] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Computer-assisted implant surgery (CAIS), either static or dynamic, is well documented to significantly improve the accuracy of implant placement. Whether the increased accuracy leads to a corresponding improvement in clinical outcomes has not yet been systematically investigated. The aim of this critical review was to investigate whether the use of CAIS can lead to reduction of complications as well as improved clinical and patient-reported outcomes (PROs) when compared with conventional freehand implant surgery. A comprehensive online search was conducted to identify studies where implants were installed with static computer-assisted implant surgery (s-CAIS)or dynamic computer-assisted implant surgery(d-CAIS) or combinations of the two, either compared with conventional free-hand implant placement or not. Seventy-seven studies were finally included in qualitative analysis, while data from three studies assessing postsurgical pain were suitable for a meta-analysis. Only a small number of the available studies were comparative. The current evidence does not suggest any difference with regard to intraoperative complications, immediate postsurgical healing, osseointegration success, and survival of implants placed with CAIS or freehand protocols. Intraoperative and early healing events as reported by patients in randomized clinical trials (RCTs) did not differ significantly between CAIS used with flap elevation and conventional implant placement. There is limited evidence that increased accuracy of placement with CAIS is correlated with superior esthetic outcomes. Use of CAIS does not significantly reduce the length of surgeries in cases of single implants and partially edentulous patients, although there appears to be a more favorable impact in fully edentulous patients. Although CAIS alone does not seem to improve healing and the clinical and PRO, to the extent that it can increase the utilization of flapless surgery and predictability of immediacy protocols, its use may indirectly lead to substantial improvements in all of the above parameters.
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Affiliation(s)
- Atiphan Pimkhaokham
- Department of Oral and Maxillofacial Surgery, Faculty of DentistryChulalongkorn UniversityBangkokThailand
| | - Sirimanas Jiaranuchart
- Department of Oral and Maxillofacial Surgery, Faculty of DentistryChulalongkorn UniversityBangkokThailand
| | - Boosana Kaboosaya
- Department of Oral and Maxillofacial Surgery, Faculty of DentistryChulalongkorn UniversityBangkokThailand
| | - Sirida Arunjaroensuk
- Department of Oral and Maxillofacial Surgery, Faculty of DentistryChulalongkorn UniversityBangkokThailand
| | - Keskanya Subbalekha
- Department of Oral and Maxillofacial Surgery, Faculty of DentistryChulalongkorn UniversityBangkokThailand
| | - Nikos Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of DentistryChulalongkorn UniversityBangkokThailand,Department of Dental MedicineKarolinska InstituteStockholmSweden
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16
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Róth I, Czigola A, Fehér D, Vitai V, Joós-Kovács GL, Hermann P, Borbély J, Vecsei B. Digital intraoral scanner devices: a validation study based on common evaluation criteria. BMC Oral Health 2022; 22:140. [PMID: 35473932 PMCID: PMC9044896 DOI: 10.1186/s12903-022-02176-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 04/11/2022] [Indexed: 11/20/2022] Open
Abstract
Background The evolution of intraoral scanners (IOSs) is rapid, and new IOSs appear on the market with different properties depending on the manufacturers. There is no uniform rating system based on a defined set of aspects that has reported in the literature that can be used to compare these devices. This validation study aimed to compare different IOSs based on objective and comprehensive parameters. Methods In this study, 12 different IOSs were examined. The IOSs that were tested in this study in order of their delivery included the 3Shape Trios 3 Pod®, Planmeca Emerald®, Straumann DWIO®, GC Aadva®, iTero Element 2®, CEREC Primescan®, Medit i500®, 3Shape Trios 4 Move®, Carestream CS3600®, 3Shape Trios 4 Pod®, Carestream CS3700®, and Planmeca Emerald S®. IOSs were evaluated in four different ways: (a)summary chart, (b)comparative assessment, (c)data based on in vitro measurements and (d)accuracy measurements. A scoring system was created to enable an objective rating of IOSs. Results The differences among IOSs were demonstrated in point scores (summary chart[max. 10 points] + weight of IOSs[max. 2.5 points] + circumference of IOSs[max. 2.5 points] + in vitro scanning time[max. 2.5 points] + pauses in data capture[max. 2.5 points] + accuracy[max. 10 points] = summary[max. 30 points]). Trios 4 Pod achieved the greatest cumulative score (23.37 points), furthermore it earned the highest points for summary chart and scanning speed. Regarding scanning continuity, the best-performing IOSs, which tied at identical point scores, were the Trios 3 and 4 Pod, Trios 4 Move, iTero Element 2, CS3600 and CS3700. The most accurate IOS was the CEREC Primescan, although it earned the lowest points of the comparative assessment (heaviest IOS). GC Aadva scored 5.73 points of a maximum of 30 points, which was the poorest result in this study. Conclusion The scoring system reflects the differences among IOS devices based on the evaluated objective parameters and can be used to help clinicians select the right IOS device. The new generations of IOSs have more special properties, and their accuracy is higher than the previous versions. Trial registration The permission for this study was granted by University Ethics Committee of Semmelweis University (SE RKEB number:108/2019).
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Affiliation(s)
- Ivett Róth
- Department of Prosthodontics, Semmelweis University, Szentkiralyi Street 47, 1088, Budapest, Hungary.
| | - Alexandra Czigola
- Department of Prosthodontics, Semmelweis University, Szentkiralyi Street 47, 1088, Budapest, Hungary
| | - Dóra Fehér
- Department of Prosthodontics, Semmelweis University, Szentkiralyi Street 47, 1088, Budapest, Hungary
| | - Viktória Vitai
- Department of Prosthodontics, Semmelweis University, Szentkiralyi Street 47, 1088, Budapest, Hungary
| | | | - Péter Hermann
- Department of Prosthodontics, Semmelweis University, Szentkiralyi Street 47, 1088, Budapest, Hungary
| | - Judit Borbély
- Department of Prosthodontics, Semmelweis University, Szentkiralyi Street 47, 1088, Budapest, Hungary
| | - Bálint Vecsei
- Department of Prosthodontics, Semmelweis University, Szentkiralyi Street 47, 1088, Budapest, Hungary
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17
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Prosthetic Surgical Templates and Dental Implant Site Time Preparation: An In Vitro Study. PROSTHESIS 2022. [DOI: 10.3390/prosthesis4010004] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Numerous types of prosthodontics surgical guides, with and without metallic sleeves, have been found to be useful in clinical studies. The aim of this in vitro research was to compare the time required to complete the surgical procedure with two differently designed surgical prosthetic templates. Ten identical prototype models of mandible based on a CBCT and optical scan of a partially edentulous patient with missing teeth numbers 37, 46, and 47 were prepared and then printed. Five of these models were used for implant site preparation with a surgical guide without metal sleeves and dedicated surgical kit, and the other five models were used for the same procedure performed with a surgical guide with metal sleeves and a dedicated surgical kit. The time of implant site preparation was measured and recorded. Statistical analysis was performed using Student’s t-test for independent samples. Differences between groups were found to be statistically significant (t = −9.94; df = 28; p = 0.0000) with a lower value in favor of the surgical templates without metallic sleeves. Different types of prosthodontics surgical guides, with or without metallic sleeves, seemed to be an important factor which can significantly impact the time of implant site preparation and, therefore, the overall surgical procedure.
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18
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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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19
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Yang JW, Liu Q, Yue ZG, Hou JX, Afrashtehfar KI. Digital Workflow for Full-Arch Immediate Implant Placement Using a Stackable Surgical Guide Fabricated Using SLM Technology. J Prosthodont 2021; 30:645-650. [PMID: 33938077 DOI: 10.1111/jopr.13375] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2021] [Indexed: 12/19/2022] Open
Abstract
The failing dentition of partially edentulous individuals may be used as an initial reference for stackable restrictive surgical guides during full-arch immediate implant placement. The stackable guide option derived from a digital workflow increases the predictability of the performance of bone reduction, immediate implant placement, and immediate loading of provisional implant-supported fixed dental prostheses. The present paper aims to report a practical approach to design and produce a metal framework with occlusal rests to facilitate the use of a tooth-supported surgical guide when full-arch immediate implant placement is indicated in patients with failing dentition.
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Affiliation(s)
- Jing-Wen Yang
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, PR China.,National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, PR China.,Research Center of Engineering and Technology for Digital Dentistry of Ministry of Health, Beijing Key Laboratory of Digital Stomatology, Beijing, PR China
| | - Qi Liu
- Private practice, Beijing, PR China
| | - Zhao-Guo Yue
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Jian-Xia Hou
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, PR China.,Research Center of Engineering and Technology for Digital Dentistry of Ministry of Health, Beijing Key Laboratory of Digital Stomatology, Beijing, PR China.,Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Kelvin I Afrashtehfar
- Division of Restorative Dental Sciences, Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman City, UAE.,Department of Reconstructive Dentistry & Gerodontology, School of Dental Medicine, Faculty of Medicine, University of Bern, Berne, Switzerland.,Center of Medical and Bio-allied Health Sciences Research, Ajman University, Dubai, United Arab Emirates
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20
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Tallarico M, Lumbau AI, Park CJ, Puddu A, Sanseverino F, Amarena R, Meloni SM. In vitro evaluation of bioburden, three-dimensional stability, and accuracy of surgical templates without metallic sleeves after routinely infection control activities. Clin Implant Dent Relat Res 2021; 23:380-387. [PMID: 33611832 DOI: 10.1111/cid.12986] [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: 10/10/2020] [Revised: 12/28/2020] [Accepted: 01/24/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Surgical templates are classified as noncritical devices, and they do not need to be sterile. AIM Primary aim of this study was to assess the microbiological burden present on the surgical templates without metallic sleeves after disinfection. Furthermore, to evaluate trueness after disinfection and steam sterilization at 121°C/15 min, and over a 8-week storage period. Finally, to assess their accuracy after in vitro implant placement simulation. MATERIALS AND METHODS Forty surgical templates were printed and divided in five groups of eight templates each. Groups A to C were disinfected with 0.5% Chlorhexidine Gluconate and 70% ethyl alcohol base solution for 15 min. Templates in the group D were steam sterilized at 121°C for 15 min, while, the templates in the group E were used as control. Implant simulation was performed in the group A. Outcome measures were determination of bioburden, trueness assessment using GOM Inspect Professional software, and accuracy evaluated thought the mean angular deviation of simulated implants. RESULTS Total microbic charge measured as colony forming units (CFU) for sample, was 24.40 in the control group (group E; n = 8), and <4.40 in the test group (group C; n = 8), with a reduction of 84%. Colored representation from GOM inspection showed no differences after disinfection and implant simulation, disinfection alone, and steam sterilization, compared to the control group. A very small difference in the surface and volume dimensions was reported 1 month after templates fabrication. The mean roundness tolerances of the tested templates improved of 0.96 ± 0.56° (95% CI 0.57-1.35). CONCLUSION Surgical templates without metallic sleeves can be safely used after disinfection, demonstrating high level of accuracy, even when the surgical procedures should be postponed within a couple of weeks. Further in vivo study are needed to confirm these preliminary results.
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Affiliation(s)
| | | | - Chang-Joo Park
- Division of Oral and Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University, Seoul, South Korea
| | - Antonio Puddu
- School of Dentistry, University of Sassari, Sassari, Italy
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21
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Alauddin MS, Baharuddin AS, Mohd Ghazali MI. The Modern and Digital Transformation of Oral Health Care: A Mini Review. Healthcare (Basel) 2021; 9:healthcare9020118. [PMID: 33503807 PMCID: PMC7912705 DOI: 10.3390/healthcare9020118] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 12/31/2020] [Accepted: 01/12/2021] [Indexed: 12/13/2022] Open
Abstract
Dentistry is a part of the field of medicine which is advocated in this digital revolution. The increasing trend in dentistry digitalization has led to the advancement in computer-derived data processing and manufacturing. This progress has been exponentially supported by the Internet of medical things (IoMT), big data and analytical algorithm, internet and communication technologies (ICT) including digital social media, augmented and virtual reality (AR and VR), and artificial intelligence (AI). The interplay between these sophisticated digital aspects has dramatically changed the healthcare and biomedical sectors, especially for dentistry. This myriad of applications of technologies will not only be able to streamline oral health care, facilitate workflow, increase oral health at a fraction of the current conventional cost, relieve dentist and dental auxiliary staff from routine and laborious tasks, but also ignite participatory in personalized oral health care. This narrative article review highlights recent dentistry digitalization encompassing technological advancement, limitations, challenges, and conceptual theoretical modern approaches in oral health prevention and care, particularly in ensuring the quality, efficiency, and strategic dental care in the modern era of dentistry.
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Affiliation(s)
- Muhammad Syafiq Alauddin
- Department of Conservative Dentistry and Prosthodontics, Faculty of Dentistry, Universiti Sains Islam Malaysia, Kuala Lumpur 56100, Malaysia
- Correspondence:
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22
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Torres A, Lerut K, Lambrechts P, Jacobs R. Guided Endodontics: Use of a Sleeveless Guide System on an Upper Premolar with Pulp Canal Obliteration and Apical Periodontitis. J Endod 2020; 47:133-139. [PMID: 33045264 DOI: 10.1016/j.joen.2020.09.016] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 09/04/2020] [Accepted: 09/10/2020] [Indexed: 11/27/2022]
Abstract
Guided endodontics has been used for the treatment of anterior teeth with a successful outcome. This approach is not only limited to anterior teeth because it can also be used for the treatment of premolars and molars. However, in such cases, space may be a limitation because a long bur has to be used in addition to the guide being placed on top of the teeth. The aim of this case report was to present a novel guided endodontics technique using a sleeveless 3-dimensional-printed guide. This design can reduce vertical space, allowing an open view of the tooth and irrigation during drilling. A 46-year-old female patient consulted the endodontic department with intermittent pain around tooth #5. Tooth #5 presented pain upon percussion and responded negative to a cold test. The initial periapical radiograph revealed an apical radiolucency with pulp canal obliteration. Clinically, there was no sinus tract. The tooth was diagnosed with pulp necrosis and symptomatic apical periodontitis. Guided endodontic treatment was performed with a sleeveless 3-dimensional-printed guide and long neck carbide bur with a head diameter of 1 mm to drill a minimally invasive access cavity up to the root canal. A completely healed apical area of tooth #5 was visible after 1 year on periapical radiographs. This technique seems to be a promising alternative in comparison with the conventional guided endodontic guide design for the negotiation of pulp canal obliteration in cases in which vertical space is limited.
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Affiliation(s)
- Andres Torres
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, Leuven, Belgium; Department of Oral Health Sciences, University Hospitals Leuven, Endodontology, KU Leuven, Leuven, Belgium.
| | - Kathleen Lerut
- Department of Oral Health Sciences, University Hospitals Leuven, Endodontology, KU Leuven, Leuven, Belgium
| | - Paul Lambrechts
- Department of Oral Health Sciences, University Hospitals Leuven, Endodontology, KU Leuven, Leuven, Belgium
| | - Reinhilde Jacobs
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, Leuven, Belgium; Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
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23
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Zadrożny Ł, Czajkowska M, Mijiritsky E, Wagner L. Repeatability of Freehand Implantations Supported with Universal Plastic Sleeves-In Vitro Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124453. [PMID: 32575839 PMCID: PMC7345541 DOI: 10.3390/ijerph17124453] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/16/2020] [Accepted: 06/17/2020] [Indexed: 11/16/2022]
Abstract
Repeatability and precision are major factors which have an influence on final implant treatment results. The aim of this study was to evaluate the repeatability of freehand implant procedures assisted with special plastic sleeves which are placed on the drill to guarantee the proper mesiodistal distance from the landmark's surface. Patient data required for implant treatment, including images of mandibles from CBCT scans and virtual models of soft tissues and teeth, were used to prepare complete virtual models of patient clinical conditions. The models were saved as STL files and 3D printed in five copies. Drilling procedures were done at positions 37, 46 and 47. Each model was scanned with pins in the osteotomies and compared using digital aligning of the models' surfaces. The average deviation was -1.38 ± 1.4 mm. Average deviations on guide pins placed at position 37 were -0.46 ± 0.59 mm, at position 46 were -1.46 ± 0.88 mm (landmark's surface of both: distal tooth's surface), and at position 47 were the highest: -2.69 ± 1.62 mm (landmark's surface: surface of plastic sleeve). The following conclusion was drawn: Using universal plastic sleeves could improve implant procedure precision especially in the case of partially edentulous patients.
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Affiliation(s)
- Łukasz Zadrożny
- Department of Dental Propaedeutics and Prophylaxis, Medical University of Warsaw, 02-006 Warsaw, Poland; (Ł.Z.); (L.W.)
| | - Marta Czajkowska
- Department of Laryngology, Medical University of Silesia, 40-027 Katowice, Poland
- Correspondence: ; Tel.: +48-572138587
| | - Eitan Mijiritsky
- Department of Otolaryngology, Head and Neck and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv 6139001, Israel;
- The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Leopold Wagner
- Department of Dental Propaedeutics and Prophylaxis, Medical University of Warsaw, 02-006 Warsaw, Poland; (Ł.Z.); (L.W.)
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Almahrous G, David-Tchouda S, Sissoko A, Rancon N, Bosson JL, Fortin T. Patient-Reported Outcome Measures (PROMs) for Two Implant Placement Techniques in Sinus Region (Bone Graft versus Computer-Aided Implant Surgery): A Randomized Prospective Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17092990. [PMID: 32344891 PMCID: PMC7246902 DOI: 10.3390/ijerph17092990] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 04/16/2020] [Accepted: 04/16/2020] [Indexed: 12/20/2022]
Abstract
Purpose: To assess patient-reported outcomes measures (PROMs) for two implant placement techniques in cases of sinus bone atrophy (bone graft surgery (BGS) versus computer-aided implant surgery (CAIS)), after surgery and one year later, and to evaluate the clinical success of both treatments. Methods: Sixty patients with bone atrophy in the posterior maxilla and in need of implant placement were randomly assigned to two groups, and in accordance with the case report form (CRF), 30 were treated with BGS and 30 with CAIS. Immediately after treatment and one year later, PROMs were assessed, and the clinical success of both treatments was evaluated. Results: No significant differences were found between BGS and CAIS with regard to the following: loss of implants (p = 492); patient recommendation (p = 210); duration of surgery (p = 987); pain on the intervention day (p = 512); pain in the week after intervention (p = 299); and complications in the stage of surgery (p = 1.00). Similarly, at one year, no differences were found with regard to the following: pain around implant (p = 481); infection of implants (p = 491); abnormal radiographic imaging (p = 226); occurrence of undesirable events (p = 1.00); loss of one of the implants (p = 1.00); plaque detection (p = 1.00); bleeding on probing (p = 236); and presence of keratinized mucosa (p = 226). However, a significant difference was found among BGS and CAIS with regard to the number of consultations (p = 0001); number of implants placed (p = 033); and treatment difficulty (p = 0369). Significant differences were found for peri-implantitis (p = 0481) and radiology of craterization (p = 020) in clinical examination at the first year. Conclusion: Treatment difficulty and number of consultations were higher for BGS than for CAIS, as well as peri-implantitis and bone craterization at one year, indicating significant differences between the two treatments. However, there were no statistically significant differences between BGS and CAIS regarding the other PROMs, at placement and after one year.
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Affiliation(s)
- Ghazwan Almahrous
- Department of Oral Surgery, Dental School, University Claude Bernard, 69003 Lyon, France;
- ThEMAS TIMC UMR CNRS 5525, Grenoble Joseph Fourier University, 38041 Grenoble, France; (S.D.-T.); (J.-L.B.)
| | - Sandra David-Tchouda
- ThEMAS TIMC UMR CNRS 5525, Grenoble Joseph Fourier University, 38041 Grenoble, France; (S.D.-T.); (J.-L.B.)
- Medical-Economic Evaluation Unit, University Hospital of Grenoble, 38700 Grenoble, France
| | - Aboubacar Sissoko
- Cellule Data Stat, University Hospital of Grenoble, 38700 Grenoble, France;
| | - Nathalie Rancon
- Department of Oral Surgery, Hospices Civils, 69003 Lyon, France;
| | - Jean-Luc Bosson
- ThEMAS TIMC UMR CNRS 5525, Grenoble Joseph Fourier University, 38041 Grenoble, France; (S.D.-T.); (J.-L.B.)
- Medical-Economic Evaluation Unit, University Hospital of Grenoble, 38700 Grenoble, France
| | - Thomas Fortin
- Department of Oral Surgery, Dental School, University Claude Bernard, 69003 Lyon, France;
- ThEMAS TIMC UMR CNRS 5525, Grenoble Joseph Fourier University, 38041 Grenoble, France; (S.D.-T.); (J.-L.B.)
- Medical-Economic Evaluation Unit, University Hospital of Grenoble, 38700 Grenoble, France
- Correspondence: ; Tel.: +33-6-84-01-51-60
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Lerner H, Mouhyi J, Admakin O, Mangano F. Artificial intelligence in fixed implant prosthodontics: a retrospective study of 106 implant-supported monolithic zirconia crowns inserted in the posterior jaws of 90 patients. BMC Oral Health 2020; 20:80. [PMID: 32188431 PMCID: PMC7081700 DOI: 10.1186/s12903-020-1062-4] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 03/03/2020] [Indexed: 01/04/2023] Open
Abstract
Background Artificial intelligence (AI) is a branch of computer science concerned with building smart software or machines capable of performing tasks that typically require human intelligence. We present a protocol for the use of AI to fabricate implant-supported monolithic zirconia crowns (MZCs) cemented on customized hybrid abutments. Methods The study protocol consisted of: (1) intraoral scan of the implant position; (2) design of the individual abutment and temporary crown using computer-aided design (CAD) software; (3) milling of the zirconia abutment and the temporary polymethyl-methacrylate (PMMA) crown, with extraoral cementation of the zirconia abutment on the relative titanium bonding base, to generate an individual hybrid abutment; (4) clinical application of the hybrid abutment and the temporary PMMA crown; (5) intraoral scan of the hybrid abutment; (6) CAD of the final crown with automated margin line design using AI; (7) milling, sintering and characterisation of the final MZC; and (8) clinical application of the MZC. The outcome variables were mathematical (quality of the fabrication of the individual zirconia abutment) and clinical, such as (1) quality of the marginal adaptation, (2) of interproximal contact points and (3) of occlusal contacts, (4) chromatic integration, (5) survival and (6) success of MZCs. A careful statistical analysis was performed. Results 90 patients (35 males, 55 females; mean age 53.3 ± 13.7 years) restored with 106 implant-supported MZCs were included in the study. The follow-up varied from 6 months to 3 years. The quality of the fabrication of individual hybrid abutments revealed a mean deviation of 44 μm (± 6.3) between the original CAD design of the zirconia abutment, and the mesh of the zirconia abutment captured intraorally at the end of the provisionalization. At the delivery of the MZCs, the marginal adaptation, quality of interproximal and occlusal contacts, and aesthetic integration were excellent. The three-year cumulative survival and success of the MZCs were 99.0% and 91.3%, respectively. Conclusions AI seems to represent a reliable tool for the restoration of single implants with MZCs cemented on customised hybrid abutments via a full digital workflow. Further studies are needed to confirm these positive results.
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Affiliation(s)
- Henriette Lerner
- Private Practice, Ludwing-Wilhelm Strasse, 17, Baden-Baden, Germany. .,Lecturer, Academic Teaching and Research Institution of Johann Wolfgang Goethe-University, Frankfurt am Main, Germany.
| | - Jaafar Mouhyi
- Casablanca Oral Rehabilitation Training & Education Center (CORTEC), Casablanca, Morocco.,Biomaterials Research Department, International University of Agadir (Universiapolis), Agadir, Morocco
| | - Oleg Admakin
- Department of Prevention and Communal Dentistry, Sechenov First Moscow State Medical University, 119992, Moscow, Russia
| | - Francesco Mangano
- Lecturer, Department of Prevention and Communal Dentistry, Sechenov First Moscow State Medical University, Moscow, Russia
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