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Tommasato G, Piano S, Casentini P, De Stavola L, Chiapasco M. Digital planning and bone regenerative technologies: A narrative review. Clin Oral Implants Res 2024; 35:906-921. [PMID: 38591734 DOI: 10.1111/clr.14267] [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: 08/23/2023] [Revised: 03/07/2024] [Accepted: 03/27/2024] [Indexed: 04/10/2024]
Abstract
OBJECTIVES The aim of this narrative review was to explore the application of digital technologies (DT) for the simplification and improvement of bone augmentation procedures in advanced implant dentistry. MATERIAL AND METHODS A search on electronic databases was performed to identify systematic reviews, meta-analyses, randomized and non-randomized controlled trials, prospective/retrospective case series, and case reports related to the application of DT in advanced implant dentistry. RESULTS Seventy-nine articles were included. Potential fields of application of DT are the following: 1) the use of intra-oral scanners for the definition of soft tissue profile and the residual dentition; 2) the use of dental lab CAD (computer-aided design) software to create a digital wax-up replicating the ideal ridge and tooth morphology; 3) the matching of STL (Standard Triangulation Language) files with DICOM (DIgital COmmunication in Medicine) files from CBCTs with a dedicated software; 4) the production of stereolithographic 3D models reproducing the jaws and the bone defects; 5) the creation of surgical templates to guide implant placement and augmentation procedures; 6) the production of customized meshes for bone regeneration; and 7) the use of static or dynamic computer-aided implant placement. CONCLUSIONS Results from this narrative review seem to demonstrate that the use of a partially or fully digital workflow can be successfully used also in advanced implant dentistry. However, the number of studies (in particular RCTs) focused on the use of a fully digital workflow in advanced implant dentistry is still limited and more studies are needed to properly evaluate the potentials of DT.
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Affiliation(s)
- Grazia Tommasato
- Unit of Oral Surgery, Department of Biomedical, Surgical, and Dental Sciences, University of Milano, Milan, Italy
| | | | | | - Luca De Stavola
- Unit of Periodontology, Dental Clinic, Department of Neurosciences, University of Padova, Padova, Italy
| | - Matteo Chiapasco
- Unit of Oral Surgery, Department of Biomedical, Surgical, and Dental Sciences, University of Milano, Milan, Italy
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Kim JH, Min EJ, Ko Y, Kim DH, Park JB. Change in Maxillary Sinus Mucosal Thickness in Patients with Preoperative Maxillary Sinus Mucosal Thickening as Assessed by Otolaryngologists: A Retrospective Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1750. [PMID: 37893468 PMCID: PMC10608619 DOI: 10.3390/medicina59101750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 09/10/2023] [Accepted: 09/27/2023] [Indexed: 10/29/2023]
Abstract
Background and Objectives: Maxillary sinus pathologic conditions may increase the risk of complications during posterior maxillary sinus augmentation surgery. The purpose of this study was to evaluate the changes in participants with preoperative maxillary sinus mucosal thickening and to assess this factor as a preoperative risk indicator for sinusitis after maxillary dental implantation. Materials and Methods: We compared the preoperative and postoperative maxillary sinus mucosal thickness (MSMT), the distance between the maxillary sinus ostium and sinus floor (MOD), and the MSMT/MOD ratio. The participants were divided into three groups (sinus augmentation, bone grafting, and no grafting). Results: The mean preoperative MSMT was 4.3 ± 2.0 mm, and the mean MSMT/MOD ratio was 0.13 ± 0.05. No postoperative sinusitis was observed in these patients, including cases caused by anatomical variations. The mean postoperative MSMT was 4.5 ± 2.3 mm, and the mean postoperative MSMT/MOD ratio was 0.15 ± 0.06. There was no statistically significant difference between the groups at each time point (p > 0.05). Conclusions: The study found no significant change in MSMT at post-treatment evaluation, even when considering different subgroups. It underscores the importance of preoperative maxillary sinus radiographic assessments and collaboration between dentists and otolaryngologists for better outcomes in patients with preoperative maxillary sinus mucosal thickening.
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Affiliation(s)
- Jin-Hyeong Kim
- Department of Periodontics, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; (J.-H.K.); (Y.K.)
| | - Eun Jeong Min
- Department of Medical Life Science, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea;
- Department of Biomedicine & Health Sciences, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Youngkyung Ko
- Department of Periodontics, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; (J.-H.K.); (Y.K.)
- Dental Implantology, Graduate School of Clinical Dental Science, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Do Hyun Kim
- Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Jun-Beom Park
- Department of Periodontics, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; (J.-H.K.); (Y.K.)
- Dental Implantology, Graduate School of Clinical Dental Science, The Catholic University of Korea, Seoul 06591, Republic of Korea
- Department of Medicine, Graduate School, The Catholic University of Korea, Seoul 06591, Republic of Korea
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Meneghetti PC, Sabri H, Dastouri E, Pereira RM, Teixeira W, Li J, Wang HL, Mendonça G, Siqueira R. Digitally Guided Lateral Sinus Floor Elevation With Simultaneous Implant Placement: 3 Case Reports With Technical Considerations. J ORAL IMPLANTOL 2023; 49:365-371. [PMID: 37706652 DOI: 10.1563/aaid-joi-d-22-00198r2] [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: 09/15/2023]
Abstract
A sinus floor elevation via lateral window (LSFE) is one of the most widely used bone augmentation procedures for implant therapy in the posterior area of the maxilla. Locating and preparing a correct opening window on the lateral sinus wall is a key step of this procedure. Conventionally, the surgeon designs and locates the window after the flap is reflected based on the information obtained from cone-beam computed tomography (CBCT) images or other diagnostic aids. Nevertheless, in spite of the advancements in CBCT imaging, clinicians may still experience hardships in situating and procuring meticulous access to the maxillary sinus by using CBCT alone. Therefore, in cases requiring an LSFE simultaneous to implant placement, a maxillary sinus surgical guide has been tested and reported to be the amiable method to be utilized as a conjunct to prevent unpredictable consequences according to its application in implying both the direction for the implant and the location of the lateral window. This article presents 3 clinical cases with a fully digital approach to guide the opening of the lateral wall of the maxillary sinus as well as the simultaneous placement of a single implant in an ideal 3D position. Based on the CBCT images and intraoral scan, a surgical guide was fabricated based on 3D software. During surgery, this teeth-supported template can be placed intraorally, guiding sinus window opening preparation. This technique makes the sinus window opening procedure simple and predictable, reduces surgical time and the risk of complications, and allows the placement of the implant in the ideal 3D position.
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Affiliation(s)
- Priscila C Meneghetti
- Postgraduate Program, Dental School, Pontifical University Catholic of Rio Grande do Sul, Porto Alegre, Brazil
- Department of Biological and Materials Sciences and Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Hamoun Sabri
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
- Cranio-Maxillofacial Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ebrahim Dastouri
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Rafael M Pereira
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Wendel Teixeira
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Junying Li
- Department of Biological and Materials Sciences and Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Gustavo Mendonça
- Department of Biological and Materials Sciences and Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Rafael Siqueira
- Department of Periodontics, Virginia Commonwealth University, Richmond, VA, USA
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Park SW, Yoon RG, Lee H, Lee HJ, Choi YD, Lee DH. Impacts of Thresholds of Gray Value for Cone-Beam Computed Tomography 3D Reconstruction on the Accuracy of Image Matching with Optical Scan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176375. [PMID: 32882986 PMCID: PMC7503962 DOI: 10.3390/ijerph17176375] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 08/29/2020] [Accepted: 08/31/2020] [Indexed: 12/11/2022]
Abstract
In cone-beam computed tomography (CBCT), the minimum threshold of the gray value of segmentation is set to convert the CBCT images to the 3D mesh reconstruction model. This study aimed to assess the accuracy of image registration of optical scans to 3D CBCT reconstructions created by different thresholds of grey values of segmentation in partial edentulous jaw conditions. CBCT of a dentate jaw was reconstructed to 3D mesh models using three different thresholds of gray value (-500, 500, and 1500), and three partially edentulous models with different numbers of remaining teeth (4, 8, and 12) were made from each 3D reconstruction model. To merge CBCT and optical scan data, optical scan images were registered to respective 3D reconstruction CBCT images using a point-based best-fit algorithm. The accuracy of image registration was assessed by measuring the positional deviation between the matched 3D images. The Kruskal-Wallis test and a post hoc Mann-Whitney U test with Bonferroni correction were used to compare the results between groups (α = 0.05). The correlations between the experimental factors were calculated using the two-way analysis of variance test. The positional deviations were lowest with the threshold of 500, followed by the threshold of 1500, and then -500. A significant interaction was found between the threshold of gray values and the number of remaining teeth on the registration accuracy. The most significant deviation was observed in the arch model with four teeth reconstructed with a gray-value threshold of -500. The threshold for the gray value of CBCT segmentation affects the accuracy of image registration of optical scans to the 3D reconstruction model of CBCT. The appropriate gray value that can visualize the anatomical structure should be set, especially when few teeth remain in the dental arch.
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Affiliation(s)
- Se-Won Park
- Department of Prosthodontics, School of Dentistry, Institute for Translational Research in Dentistry, Kyungpook National University, Daegu 41940, Korea; (S.-W.P.); (Y.-D.C.)
| | - Ra Gyoung Yoon
- Department of Radiology, Nowon Eulji Medical Center, Eulji University, Seoul 01830, Korea;
| | - Hyunwoo Lee
- Department of Dental Clinic, National Medical Center, Seoul 04564, Korea;
| | - Heon-Jin Lee
- Department of Microbiology and Immunology, School of Dentistry, Kyungpook National University, Daegu 41940, Korea;
| | - Yong-Do Choi
- Department of Prosthodontics, School of Dentistry, Institute for Translational Research in Dentistry, Kyungpook National University, Daegu 41940, Korea; (S.-W.P.); (Y.-D.C.)
| | - Du-Hyeong Lee
- Department of Prosthodontics, School of Dentistry, Institute for Translational Research in Dentistry, Kyungpook National University, Daegu 41940, Korea; (S.-W.P.); (Y.-D.C.)
- Correspondence: ; Tel.: +82-53-600-7676
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Cheon KJ, Yang BE, Cho SW, Chung SM, Byun SH. Lateral Window Design for Maxillary Sinus Graft Based on the Implant Position. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176335. [PMID: 32878152 PMCID: PMC7503740 DOI: 10.3390/ijerph17176335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 08/28/2020] [Accepted: 08/28/2020] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to devise a classification and lateral window design method based on implants and to evaluate whether these classifications and methods are applicable to clinical practice. When applying the maxillary sinus elevation technique using the lateral window, possible situations were classified into four: (A) two or more sites for implants are required for maxillary sinus augmentation, (B) a single implant is required when there are no adjacent teeth, (C) a single implant is required when one adjacent tooth is present at the mesial or distal area, and (D) a single implant is required when both mesial and distal adjacent teeth are present. In order to verify whether this classification can be used in all situations, 76 patients who underwent maxillary sinus elevation with a lateral window were selected and investigated. Of them, 47 (62%) were included in Group A, 9 (12%) in Group B, 8 (11%) in Group C, and 12 (15%) in Group D. Lateral window designing in the lateral approach of sinus augmentation can be classified into four clinical situations. There were no unclassified cases. This classification and window positioning method can be applied to most cases.
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Affiliation(s)
- Kyeong-Jun Cheon
- Department of Oral & Maxillofacial Surgery, Dentistry, Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Korea; (K.-J.C.); (B.-E.Y.); (S.-W.C.)
- Research Center of Clinical Dentistry, Graduate School of Clinical Dentistry, Hallym University, Chuncheon 24252, Korea
| | - Byoung-Eun Yang
- Department of Oral & Maxillofacial Surgery, Dentistry, Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Korea; (K.-J.C.); (B.-E.Y.); (S.-W.C.)
- Research Center of Clinical Dentistry, Graduate School of Clinical Dentistry, Hallym University, Chuncheon 24252, Korea
| | - Seoung-Won Cho
- Department of Oral & Maxillofacial Surgery, Dentistry, Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Korea; (K.-J.C.); (B.-E.Y.); (S.-W.C.)
- Research Center of Clinical Dentistry, Graduate School of Clinical Dentistry, Hallym University, Chuncheon 24252, Korea
| | | | - Soo-Hwan Byun
- Department of Oral & Maxillofacial Surgery, Dentistry, Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Korea; (K.-J.C.); (B.-E.Y.); (S.-W.C.)
- Research Center of Clinical Dentistry, Graduate School of Clinical Dentistry, Hallym University, Chuncheon 24252, Korea
- Correspondence: ; Tel.: +82-10-8787-2640
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