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Burkhardt F, Schirmeister CG, Wesemann C, Baur L, Vach K, Nutini M, Licht EH, Metzger MC, Mülhaupt R, Spies BC. Dimensional accuracy and simulation-based optimization of polyolefins and biocopolyesters for extrusion-based additive manufacturing and steam sterilization. J Mech Behav Biomed Mater 2024; 153:106507. [PMID: 38503082 DOI: 10.1016/j.jmbbm.2024.106507] [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: 01/31/2024] [Revised: 03/04/2024] [Accepted: 03/12/2024] [Indexed: 03/21/2024]
Abstract
Polyolefins exhibit robust mechanical and chemical properties and can be applied in the medical field, e.g. for the manufacturing of dentures. Despite their wide range of applications, they are rarely used in extrusion-based printing due to their warpage tendency. The aim of this study was to investigate and reduce the warpage of polyolefins compared to commonly used filaments after additive manufacturing (AM) and sterilization using finite element simulation. Three types of filaments were investigated: a medical-grade polypropylene (PP), a glass-fiber reinforced polypropylene (PP-GF), and a biocopolyester (BE) filament, and they were compared to an acrylic resin (AR) for material jetting. Square specimens, standardized samples prone to warpage, and denture bases (n = 10 of each group), as clinically relevant and anatomically shaped reference, were digitized after AM and steam sterilization (134 °C). To determine warpage, the volume underneath the square specimens was calculated, while the deviations of the denture bases from the printing file were measured using root mean square (RMS) values. To reduce the warpage of the PP denture base, a simulation of the printing file based on thermomechanical calculations was performed. Statistical analysis was conducted using the Kruskal-Wallis test, followed by Dunn's test for multiple comparisons. The results showed that PP exhibited the greatest warpage of the square specimens after AM, while PP-GF, BE, and AR showed minimal warpage before sterilization. However, warpage increased for PP-GF, BE and AR during sterilization, whereas PP remained more stable. After AM, denture bases made of PP showed the highest warpage. Through simulation-based optimization, warpage of the PP denture base was successfully reduced by 25%. In contrast to the reference materials, PP demonstrated greater dimensional stability during sterilization, making it a potential alternative for medical applications. Nevertheless, reducing warpage during the cooling process after AM remains necessary, and simulation-based optimization holds promise in addressing this issue.
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Affiliation(s)
- Felix Burkhardt
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
| | - Carl G Schirmeister
- Freiburg Materials Research Center FMF and Institute for Macromolecular Chemistry, Albert-Ludwigs-University Freiburg, Stefan-Meier-Str. 21, 79104, Freiburg, Germany; Basell Sales & Marketing B.V., LyondellBasell Industries, Industriepark Höchst, 65926, Frankfurt a.M, Germany
| | - Christian Wesemann
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Lukas Baur
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Kirstin Vach
- Medical Center - University of Freiburg, Institute for Medical Biometry and Statistics, Faculty of Medicine, University of Freiburg, Stefan-Meier-Str. 26, 79104, Freiburg, Germany
| | - Massimo Nutini
- Basell Poliolefine Italia Srl, LyondellBasell Industries, P. le Privato G. Donegani 12, 44122, Ferrara, Italy
| | - Erik H Licht
- Basell Sales & Marketing B.V., LyondellBasell Industries, Industriepark Höchst, 65926, Frankfurt a.M, Germany
| | - Marc C Metzger
- Medical Center - University of Freiburg, Center of Dental Medicine, Department of Oral and Maxillofacial Surgery, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Rolf Mülhaupt
- Freiburg Materials Research Center FMF and Institute for Macromolecular Chemistry, Albert-Ludwigs-University Freiburg, Stefan-Meier-Str. 21, 79104, Freiburg, Germany; Sustainability Center Freiburg, Ecker-Str. 4, 79104, Freiburg, Germany
| | - Benedikt C Spies
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
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Burkhardt F, Handermann L, Rothlauf S, Gintaute A, Vach K, Spies BC, Lüchtenborg J. Accuracy of additively manufactured and steam sterilized surgical guides by means of continuous liquid interface production, stereolithography, digital light processing, and fused filament fabrication. J Mech Behav Biomed Mater 2024; 152:106418. [PMID: 38295512 DOI: 10.1016/j.jmbbm.2024.106418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 01/16/2024] [Accepted: 01/23/2024] [Indexed: 02/02/2024]
Abstract
Different printing technologies can be used for prosthetically oriented implant placement, however the influence of different printing orientations and steam sterilization remains unclear. In particular, no data is available for the novel technology Continuous Liquid Interface Production. The objective was to evaluate the dimensional accuracy of surgical guides manufactured with different printing techniques in vertical and horizontal printing orientation before and after steam sterilization. A total of 80 surgical guides were manufactured by means of continuous liquid interface production (CLIP; material: Keyguide, Keyprint), digital light processing (DLP; material: Luxaprint Ortho, DMG), stereolithography (SLA; Surgical guide, Formlabs), and fused filament fabrication (FFF; material: Clear Base Support, Arfona) in vertical and horizontal printing orientation (n = 10 per subgroup). Spheres were included in the design to determine the coordinates of 17 reference points. Each specimen was digitized with a laboratory scanner after additive manufacturing (AM) and after steam sterilization (134 °C). To determine the accuracy, root mean square values (RMS) were calculated and coordinates of the reference points were recorded. Based on the measured coordinates, deviations of the reference points and relevant distances were calculated. Paired t-tests and one-way ANOVA were applied for statistical analysis (significance p < 0.05). After AM, all printing technologies showed comparable high accuracy, with an increased deviation in z-axis when printed horizontally. After sterilization, FFF printed surgical guides showed distinct warpage. The other subgroups showed no significant differences regarding the RMS of the corpus after steam sterilization (p > 0.05). Regarding reference points and distances, CLIP showed larger deviations compared to SLA in both printing orientations after steam sterilization, while DLP manufactured guides were the most dimensionally stable. In conclusion, the different printing technologies and orientations had little effect on the manufacturing accuracy of the surgical guides before sterilization. However, after sterilization, FFF surgical guides exhibited significant deformation making their clinical use impossible. CLIP showed larger deformations due to steam sterilization than the other photopolymerizing techniques, however, discrepancies may be considered within the range of clinical acceptance. The influence on the implant position remains to be evaluated.
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Affiliation(s)
- Felix Burkhardt
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
| | - Leon Handermann
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Severin Rothlauf
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Aiste Gintaute
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Kirstin Vach
- Medical Center - University of Freiburg, Institute of Medical Biometry and Statistics, Faculty of Medicine, University of Freiburg, Stefan-Meier-Str. 26, 79104, Freiburg, Germany
| | - Benedikt C Spies
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Jörg Lüchtenborg
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
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Knipper A, Kuhn K, Luthardt RG, Schnutenhaus S. Accuracy of Dental Implant Placement with Dynamic Navigation-Investigation of the Influence of Two Different Optical Reference Systems: A Randomized Clinical Trial. Bioengineering (Basel) 2024; 11:155. [PMID: 38391641 PMCID: PMC10886004 DOI: 10.3390/bioengineering11020155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 01/31/2024] [Accepted: 02/01/2024] [Indexed: 02/24/2024] Open
Abstract
This randomized prospective clinical study aims to analyze the differences between the computer-assisted planned implant position and the clinically realized implant position using dynamic navigation. In the randomized prospective clinical study, 30 patients were recruited, of whom 27 could receive an implant (BLT, Straumann Institut AG, Basel, Switzerland) using a dynamic computer-assisted approach. Patients with at least six teeth in their jaws to be implanted were included in the study. Digital planning was performed using cone beam tomography imaging, and the visualization of the actual situation was carried out using an intraoral scan. Two different workflows with differently prepared reference markers were performed with 15 patients per group. The actual clinically achieved implant position was recorded with scan bodies fixed to the implants and an intraoral scan. The deviations between the planned and realized implant positions were recorded using evaluation software. The clinical examinations revealed no significant differences between procedures A and B in the mesiodistal, buccolingual and apicocoronal directions. For the mean angular deviation, group B showed a significantly more accurate value of 2.7° (95% CI 1.6-3.9°) than group A, with a value of 6.3° (95% CI 4.0-8.7°). The mean 3D deviation at the implant shoulder was 2.35 mm for workflow A (95% CI 1.92-2.78 mm) and 1.62 mm for workflow B (95% CI 1.2-2.05 mm). Workflow B also showed significantly higher accuracy in this respect. Similar values were determined at the implant apex. The clinical examination shows that sufficiently accurate implant placement is possible with the dynamic navigation system used here. The use of different workflows sometimes resulted in significantly different accuracy results. The data of the present study are comparable with the published findings of other static and dynamic navigation procedures.
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Affiliation(s)
- Anne Knipper
- Center for Dentistry, Dr. Schnutenhaus Community Health Center (CHC) GmbH, Breiter Wasmen 10, 78247 Hilzingen, Germany
| | - Katharina Kuhn
- Department for Dentistry, Clinic for Prosthodontics, Ulm University, Albert-Einstein-Allee 11, 89081 Ulm, Germany
| | - Ralph G Luthardt
- Department for Dentistry, Clinic for Prosthodontics, Ulm University, Albert-Einstein-Allee 11, 89081 Ulm, Germany
| | - Sigmar Schnutenhaus
- Center for Dentistry, Dr. Schnutenhaus Community Health Center (CHC) GmbH, Breiter Wasmen 10, 78247 Hilzingen, Germany
- Department for Dentistry, Clinic for Prosthodontics, Ulm University, Albert-Einstein-Allee 11, 89081 Ulm, Germany
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Schnutenhaus S, Edelmann C, Wetzel M, Luthardt RG. Influence of the macrodesign of an implant and the sleeve system on the accuracy of template-guided implant placement: A prospective clinical study. J Prosthet Dent 2024; 131:212-219. [PMID: 35940950 DOI: 10.1016/j.prosdent.2021.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 09/18/2021] [Accepted: 09/21/2021] [Indexed: 11/28/2022]
Abstract
STATEMENT OF PROBLEM Three-dimensional (3D) implant planning facilitates determining the optimal position and number of implants, in terms of function and esthetics, by taking into account adjacent structures. Template-guided implant placement is an established procedure for implementing this planning, although the accuracy between the planned and the actual implant position is subject to many influences. The influences of the macrodesign of the implants and the sleeve materials used have rarely been investigated clinically. PURPOSE The purpose of this prospective clinical study was to investigate the accuracy of template-guided implant placement according to the macrodesign of different implants and the design of the drill sleeve. MATERIAL AND METHODS Implants were placed in 60 participants within 3 groups (n=20): tapered implant with a metal sleeve (T-MS), tapered implant with a polymeric sleeve (T-PS), and progressive tapered implant with a polymeric sleeve (XT-PS). After overlaying the 3D implant planning image with the postoperative intraoral scan, deviations were 2-dimensionally related to the implant shoulder (S) and the apex (A) in terms of height (2DHS/2DHA), mesiodistal (2DSmd/2DAmd) and buccolingual (2DSbo/2DAbo), as well as 3-dimensionally on the implant shoulder (3DS), on the apex (3DA), and on the axis deviation (Axis). The groups were compared by using the analysis of variance. The Tukey post hoc test was performed for normally distributed data to identify significant differences among groups (α=.05). RESULTS The errors for 2DSmd and 2DSbo were 0.26 to 0.40 mm across all groups. The 3DS group varied between 0.67 and 0.87 mm. No significant differences were found in terms of the material of the sleeves or the macrodesign of the implants (P>.05). Significant differences were found for 2DHS (P=.029) and 2DHA (P=.016) between the groups with the different sleeves. Group T-PS showed the least height deviation. CONCLUSIONS In terms of height deviation, significant differences were found among the groups, with deviations depending on the implant type and the sleeve type. Overall, the method showed a high level of accuracy, providing good predictability of the prosthetic rehabilitation.
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Affiliation(s)
- Sigmar Schnutenhaus
- Private practice, Hilzingen Dental Care Center, Hilzingen, Germany; Clinic for Dental Prosthetics, Center for Dental, Oral and Maxillofacial Medicine, Ulm University, Ulm, Germany.
| | | | - Martin Wetzel
- Private practice, Hilzingen Dental Care Center, Hilzingen, Germany
| | - Ralph G Luthardt
- Professor and Head, Clinic for Dental Prosthetics, Center for Dental, Oral and Maxillofacial Medicine, Ulm University, Ulm, Germany
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Takács A, Hardi E, Cavalcante BGN, Szabó B, Kispélyi B, Joób-Fancsaly Á, Mikulás K, Varga G, Hegyi P, Kivovics M. Advancing accuracy in guided implant placement: A comprehensive meta-analysis: Meta-Analysis evaluation of the accuracy of available implant placement Methods. J Dent 2023; 139:104748. [PMID: 37863173 DOI: 10.1016/j.jdent.2023.104748] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 10/16/2023] [Accepted: 10/18/2023] [Indexed: 10/22/2023] Open
Abstract
OBJECTIVES This meta-analysis aimed to determine the accuracy of currently available computer-assisted implant surgery (CAIS) modalities under in vitro conditions and investigate whether these novel techniques can achieve clinically acceptable accuracy. DATA In vitro studies comparing the postoperative implant position with the preoperative plan were included. Risk of bias was assessed using the Quality Assessment Tool For In Vitro Studies (QUIN Tool) and a sensitivity analysis was conducted using funnel plots. SOURCES A systematic search was performed on April 18, 2023, using the following three databases: MEDLINE (via PubMed), EMBASE, and Cochrane Central Register of Controlled Trials. No filters or restrictions were applied during the search. RESULTS A total of 5,894 studies were included following study selection. Robotic- and static CAIS (sCAIS) had the most accurate and clinically acceptable outcomes. sCAIS was further divided according to the guidance level. Among the sCAIS groups, fully guided implant placement had the greatest accuracy. Augmented reality-based CAIS (AR-based CAIS) had clinically acceptable results for all the outcomes except for apical global deviation. Dynamic CAIS (dCAIS) demonstrated clinically safe results, except for horizontal apical deviation. Freehand implant placement was associated with the greatest number of errors. CONCLUSIONS Fully guided sCAIS demonstrated the most predictable outcomes, whereas freehand sCAIS demonstrated the lowest accuracy. AR-based and robotic CAIS may be promising alternatives. CLINICAL SIGNIFICANCE To our knowledge, this is the first meta-analysis to evaluate the accuracy of robotic CAIS and investigate the accuracy of various CAIS modalities.
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Affiliation(s)
- Anna Takács
- Department of Community Dentistry, Semmelweis University, Szentkirályi utca 40. 1088 Budapest, Hungary; Centre for Translational Medicine, Semmelweis University, Üllői út 26. 1085 Budapest, Hungary
| | - Eszter Hardi
- Centre for Translational Medicine, Semmelweis University, Üllői út 26. 1085 Budapest, Hungary; Department of Oro-Maxillofacial Surgery and Stomatology, Semmelweis University, Mária utca 52. 1085 Budapest, Hungary
| | - Bianca Golzio Navarro Cavalcante
- Centre for Translational Medicine, Semmelweis University, Üllői út 26. 1085 Budapest, Hungary; Department of Oral Biology, Semmelweis University, Nagyvárad tér 4. 1089 Budapest, Hungary
| | - Bence Szabó
- Centre for Translational Medicine, Semmelweis University, Üllői út 26. 1085 Budapest, Hungary
| | - Barbara Kispélyi
- Centre for Translational Medicine, Semmelweis University, Üllői út 26. 1085 Budapest, Hungary; Department of Prosthodontics, Semmelweis University, Szentkirályi utca 47. 1088 Budapest, Hungary
| | - Árpád Joób-Fancsaly
- Centre for Translational Medicine, Semmelweis University, Üllői út 26. 1085 Budapest, Hungary; Department of Oro-Maxillofacial Surgery and Stomatology, Semmelweis University, Mária utca 52. 1085 Budapest, Hungary
| | - Krisztina Mikulás
- Centre for Translational Medicine, Semmelweis University, Üllői út 26. 1085 Budapest, Hungary; Department of Prosthodontics, Semmelweis University, Szentkirályi utca 47. 1088 Budapest, Hungary
| | - Gábor Varga
- Centre for Translational Medicine, Semmelweis University, Üllői út 26. 1085 Budapest, Hungary; Department of Oral Biology, Semmelweis University, Nagyvárad tér 4. 1089 Budapest, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Üllői út 26. 1085 Budapest, Hungary; Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Szigeti út 12. 7624 Pécs, Hungary; Division of Pancreatic Diseases, Heart and Vascular Center, Semmelweis University, Városmajor utca 68. 1122 Budapest, Hungary
| | - Márton Kivovics
- Department of Community Dentistry, Semmelweis University, Szentkirályi utca 40. 1088 Budapest, Hungary; Centre for Translational Medicine, Semmelweis University, Üllői út 26. 1085 Budapest, Hungary.
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Száva I, Vlase S, Scutaru ML, Asztalos Z, Gálfi BP, Șoica A, Șoica S. Dimensional Methods Used in the Additive Manufacturing Process. Polymers (Basel) 2023; 15:3694. [PMID: 37765547 PMCID: PMC10534418 DOI: 10.3390/polym15183694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 07/15/2023] [Accepted: 07/27/2023] [Indexed: 09/29/2023] Open
Abstract
It is a well-known fact that in the field of modern manufacturing processes, additive manufacturing (AM) offers unexpected opportunities for creativity and rapid development. Compared with classical manufacturing technologies, AM offers the advantages of reducing weight and improving performance and offers excellent design capabilities for prototyping and rapid sample manufacture. To achieve its full potential regarding cost, durability, material consumption, and rigidity, as well as maintaining competitiveness, there are several research directions that have not been explored. One less frequently explored direction is the involvement of dimensional methods in obtaining an optimal and competitive final product. In this review, we intend to discuss the ways in which dimensional methods, such as geometric analogy, similarity theory, and dimensional analysis, are involved in addressing the problems of AM. To the best of our knowledge, it appears that this field of engineering has not fully maximized the advantages of these dimensional methods to date. In this review, we survey mainly polymer-based AM technology. We focus on the design and optimization of highly competitive products obtained using AM and also on the optimization of layer deposition, including their orientation and filling characteristics. With this contribution to the literature, we hope to suggest a fruitful direction for specialists involved in AM to explore the possibilities of modern dimensional analysis.
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Affiliation(s)
- Ioan Száva
- Department of Mechanical Engineering, Transylvania University of Brasov, B-dul Eroilor 29, 500036 Brasov, Romania; (M.L.S.); (Z.A.); (B.-P.G.)
| | - Sorin Vlase
- Department of Mechanical Engineering, Transylvania University of Brasov, B-dul Eroilor 29, 500036 Brasov, Romania; (M.L.S.); (Z.A.); (B.-P.G.)
- Romanian Academy of Technical Sciences, B-dul Dacia 26, 030167 Bucharest, Romania
| | - Maria Luminița Scutaru
- Department of Mechanical Engineering, Transylvania University of Brasov, B-dul Eroilor 29, 500036 Brasov, Romania; (M.L.S.); (Z.A.); (B.-P.G.)
| | - Zsolt Asztalos
- Department of Mechanical Engineering, Transylvania University of Brasov, B-dul Eroilor 29, 500036 Brasov, Romania; (M.L.S.); (Z.A.); (B.-P.G.)
| | - Botond-Pál Gálfi
- Department of Mechanical Engineering, Transylvania University of Brasov, B-dul Eroilor 29, 500036 Brasov, Romania; (M.L.S.); (Z.A.); (B.-P.G.)
| | - Adrian Șoica
- Department of Automotive Engineering, Transylvania University of Brasov, B-dul Eroilor 29, 500036 Brasov, Romania (S.Ș.)
| | - Simona Șoica
- Department of Automotive Engineering, Transylvania University of Brasov, B-dul Eroilor 29, 500036 Brasov, Romania (S.Ș.)
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Jelovac D, Micic M, Hajdarevic S, Kuzmanovic C, Cukic B, Stefanovic B, Zelic K, Bonfante E, Ewers R, Petrovic M. Immediate placement of extra-short implants in refined scapula tip microvascular free flaps: In house virtual planning and surgical technique - Proof of concept. Heliyon 2023; 9:e18021. [PMID: 37496908 PMCID: PMC10366439 DOI: 10.1016/j.heliyon.2023.e18021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 06/24/2023] [Accepted: 07/05/2023] [Indexed: 07/28/2023] Open
Abstract
Scapula tip flaps have been introduced in the literature as an ideal surgical treatment option for large defects in the horizontal plane of the maxilla. This article aims to present a unique step by step protocol for a near total maxillectomy with a pterygoid bone resection and consecutive microvascular reconstruction with a harvested scapula tip flap. The protocol includes immediate placement of extra-short implants in donor bone with the aid of Virtual Surgical Planning (VSP), and an in-house 3D printing of medical 3D models and surgical guides. So far, there has been no presented surgical technique combining immediate implant placement in the scapula region with simultaneous microvascular repair. This technique allows: tumour resection; flap harvesting; extra-short implant placements and reconstruction to be performed in one simultaneous procedure. The technique is presented with illustrations, VSP (presented on videos), radiographs, and surgical findings. We discovered that this refinement of the scapula tip surgery has enabled reconstructive procedures to be performed at the same time as implant placements, providing expedited functional and aesthetic outcomes in selected cases. Moreover, modification of the surgical technique could enhance the competence of the oropharyngeal edge. In conclusion, this new surgical protocol utilizing VSP, 3D models and simultaneous extra-short implant placement provides indispensable advantages for such a complicated surgical procedures, while significantly shortening the duration of surgery.
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Affiliation(s)
- Drago Jelovac
- Clinic for Maxillofacial Surgery, School of Dental Medicine, University of Belgrade, Dr Subotica 4, 1100, Belgrade, Serbia
| | - Milutin Micic
- Faculty of Medicine, Center of Bone Biology, University of Belgrade, Dr Subotica 4, 1100, Belgrade, Serbia
| | - Sanela Hajdarevic
- Clinic for Maxillofacial Surgery, School of Dental Medicine, University of Belgrade, Dr Subotica 4, 1100, Belgrade, Serbia
| | - Cedomir Kuzmanovic
- Clinic for Maxillofacial Surgery, School of Dental Medicine, University of Belgrade, Dr Subotica 4, 1100, Belgrade, Serbia
| | | | | | - Ksenija Zelic
- Faculty of Medicine, Center of Bone Biology, University of Belgrade, Dr Subotica 4, 1100, Belgrade, Serbia
- School of Dental Medicine, University of Belgrade, Dr Subotica 4, 1100, Belgrade, Serbia
| | - E.A. Bonfante
- Department of Prosthodontics and Periodontology, University of São Paulo – Bauru School of Dentistry, Bauru, SP, Brazil
| | - Rolf Ewers
- University Hospital for Cranio Maxillofacial and Oral Surgery, Medical University of Vienna, Waehringer Guertel 18 - 20, 1090, Vienna, Austria
| | - Milan Petrovic
- Clinic for Maxillofacial Surgery, School of Dental Medicine, University of Belgrade, Dr Subotica 4, 1100, Belgrade, Serbia
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Gupta A, Alifui-Segbaya F, Hasanov S, White AR, Ahmed KE, Love RM, Fidan I. Material extrusion of thermoplastic acrylic for intraoral devices: Technical feasibility and evaluation. J Mech Behav Biomed Mater 2023; 143:105950. [PMID: 37285773 DOI: 10.1016/j.jmbbm.2023.105950] [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: 02/08/2023] [Revised: 05/29/2023] [Accepted: 05/30/2023] [Indexed: 06/09/2023]
Abstract
With global demand for 3D printed medical devices on the rise, the search for safer, inexpensive, and sustainable methods is timely. Herein, we assessed the practicality of the material extrusion process for acrylic denture bases of which successful outcomes can be extended to implant surgical guides, orthodontic splints, impression trays, record bases and obturators for cleft palates or other maxillary defects. Representative materials comprising denture prototypes and test samples were designed and built with in-house polymethylmethacrylate filaments using varying print directions (PDs), layer heights (LHs) and reinforcements (RFs) with short glass fiber. The study undertook a comprehensive evaluation of the materials to determine their flexural, fracture, and thermal properties. Additional analyses for tensile and compressive properties, chemical composition, residual monomer, and surface roughness (Ra) were completed for parts with optimum parameters. Micrographic analysis of the acrylic composites revealed adequate fiber-matrix compatibility and predictably, their mechanical properties improved simultaneously with RFs and decreased LHs. Fiber reinforcement also improved the overall thermal conductivity of the materials. Ra, on the other hand, improved visibly with decreased RFs and LHs and the prototypes were effortlessly polished and characterized with veneering composites to mimic gingival tissues. In terms of chemical stability, the residual methyl methacrylate monomer contents are well below standards threshold for biological reactions. Notably, 5 vol% acrylic composites built with 0.05 mm LH in 0° on z-axis produced optimum properties that are superior to those of conventional acrylic, milled acrylic and 3D printed photopolymers. Finite element modeling successfully replicated the tensile properties of the prototypes. It may well be argued that the material extrusion process is cost-effective; however, the speed of manufacturing could be longer than that of established methods. Although the mean Ra is within an acceptable range, mandatory manual finishing and aesthetic pigmentation are required for long-term intraoral use. At a proof-of-concept level, it is evident that the material extrusion process can be applied to build inexpensive, safe, and robust thermoplastic acrylic devices. The broad outcomes of this novel study are equally worthy of academic reflection, and further translation to the clinic.
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Affiliation(s)
- Ankit Gupta
- College of Engineering, Computer Science, and Technology, Department of Engineering and Technology, California State University, Los Angeles, USA.
| | - Frank Alifui-Segbaya
- School of Medicine and Dentistry, Ian O'Connor Building, Griffith Health, Gold Coast Campus, Griffith University, QLD, 4222, Australia.
| | - Seymur Hasanov
- Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, 02138, USA.
| | - Alan R White
- School of Environment and Science, Griffith Sciences, Nathan Campus, Griffith University, QLD, 4111, Australia.
| | - Khaled E Ahmed
- School of Medicine and Dentistry, Ian O'Connor Building, Griffith Health, Gold Coast Campus, Griffith University, QLD, 4222, Australia.
| | - Robert M Love
- School of Medicine and Dentistry, Ian O'Connor Building, Griffith Health, Gold Coast Campus, Griffith University, QLD, 4222, Australia.
| | - Ismail Fidan
- Tennessee Tech University, 920 N. Peachtree Avenue, MET Department, LEWS 103, Cookeville, TN, 38505-5003, USA.
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Otaghsara SST, Joda T, Thieringer FM. Accuracy of dental implant placement using static versus dynamic computer-assisted implant surgery: An in vitro study: Accuracy of static vs. dynamic CAIS. J Dent 2023; 132:104487. [PMID: 36948382 DOI: 10.1016/j.jdent.2023.104487] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 03/06/2023] [Accepted: 03/19/2023] [Indexed: 03/24/2023] Open
Abstract
OBJECTIVES This in-vitro study compared the accuracy of implant placement using static versus dynamic computer-assisted implant surgery (CAIS) at two implant sites. METHODS Partially edentulous maxillary models were 3D-printed, and two implants (Straumann TL RN4.1 × 10mm) were inserted in FDI positions 15 and 16 per model using two CAIS approaches (10 models per approach). A three-dimensional (3D) reconstruction tool was used for implant planning, surgical guide design, and measuring implant positioning accuracy. In static CAIS, the implants were placed with 3D-printed surgical guides (n=20); in dynamic CAIS, real-time navigation was performed (n=20). Primary outcomes were defined as coronal and apical global deviation as well as angular deviations and deviation comparison between implants placed at positions 15 and 16; the secondary outcome was the bi-directional deviation in mesial-distal, buccal-palatal, and apical-coronal direction. RESULTS The mean±SD 3D-deviation at implant platform and apex levels for static CAIS in position 15 was 0.81±0.31mm, 1.41±0.37mm, and in position 16 was 0.67±0.31mm, 1.07±0.32mm. PRIMARY OUTCOMES buccal-palatal deviation is higher using static CAIS, and mesial-distal deviation is higher in dynamic CAIS. In position 15, mesial-distal deviation at the apex and the platform were lower in static approaches than in dynamic ones. In implant position 16, buccal-palatal deviation at the apex was lower in the dynamic group than with static ones. SECONDARY OUTCOMES for bi-directional analysis, buccal-palatal deviation at the platform (P=0.0028) and mesial-distal deviation at the apex (P=0.0056) were significantly lower in molar sites using static CAIS. Mesial-distal deviation at the apex (P=0.0246) revealed significantly lower values in position 16 following dynamic CAIS. CONCLUSIONS Both static and dynamic CAIS resulted in accurate implant placement. However, dynamic CAIS exhibited higher deviation in the mesial direction in an in-vitro setting. In addition, the implant site affects the accuracy of both CAIS approaches. CLINICAL SIGNIFICANCE Static CAIS demonstrates the highest accuracy for guided implant placement today.
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Affiliation(s)
- Seyedeh Sahar Taheri Otaghsara
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland; Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, Basel, Switzerland; Department of Reconstructive Dentistry, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland
| | - Tim Joda
- Department of Reconstructive Dentistry, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland; Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Florian Markus Thieringer
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland; Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, Basel, Switzerland.
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10
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Rothlauf S, Pieralli S, Wesemann C, Burkhardt F, Vach K, Kernen F, Spies BC. Influence of planning software and surgical template design on the accuracy of static computer assisted implant surgery performed using surgical guides fabricated with material extrusion technology: An in vitro study. J Dent 2023; 132:104482. [PMID: 36931618 DOI: 10.1016/j.jdent.2023.104482] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 03/05/2023] [Accepted: 03/14/2023] [Indexed: 03/17/2023] Open
Abstract
OBJECTIVES This in vitro study aimed to assess the influence of the planning software and design of the surgical template on both trueness and precision of static computer assisted implant surgery (sCAIS) performed using surgical guides fabricated using material extrusion (ME). METHODS Three-dimensional radiographic and surface scans of a typodont were aligned using two planning software (coDiagnostiX, CDX; ImplantStudio, IST) to virtually position the two adjacent oral implants. Thereafter, surgical guides were created with either an original (O) or modified (M) design with reduced occlusal support and were steam sterilized. Forty surgical guides were used to instal 80 implants equally distributed among four groups: CDX-O, CDX-M, IST-O, and IST-M. Thereafter, the scan bodies were adapted to the implants and digitised. Finally, inspection software was used to assess discrepancies between the planned and final positions at the implant shoulder and main axis level. Multilevel mixed-effects generalised linear models were used for statistical analyses (p = 0.05). RESULTS In terms of trueness, the largest average vertical deviations (0.29 ± 0.07 mm) could be assessed for CDX-M. Overall, vertical errors were significantly dependent on the design (O < M; p ≤ 0.001). Furthermore, in horizontal direction, the largest mean discrepancy was 0.32 ± 0.09 mm (IST-O) and 0.31 ± 0.13 mm (CDX-M). CDX-O was superior compared to IST-O (p = 0.003) regarding horizontal trueness. The average deviations regarding the main implant axis ranged between 1.36 ± 0.41 ° (CDX-O) and 2.63 ± 0.87 ° (CDX-M). In terms of precision, mean standard deviation intervals of ≤ 0.12 mm (IST-O and -M) and ≤ 1.09 ° (CDX-M) were calculated. CONCLUSIONS Implant installation with clinically acceptable deviations is possible with ME surgical guides. Both evaluated variables affected trueness and precision with negligible differences. CLINICAL SIGNIFICANCE The planning system and design influenced the accuracy of implant installation using ME-based surgical guides. Nevertheless, discrepancies were ≤ 0.32 mm and ≤ 2.63 °, which may be considered within the range of clinical acceptance. ME should be further investigated as an alternative to the more expensive and time-consuming 3D printing technologies.
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Affiliation(s)
- Severin Rothlauf
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine - University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany.
| | - Stefano Pieralli
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt - Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.
| | - Christian Wesemann
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine - University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany.
| | - Felix Burkhardt
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine - University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany.
| | - Kirstin Vach
- Medical Center - University of Freiburg, Institute for Medical Biometry and Statistics, Faculty of Medicine, University of Freiburg, Zinkmattenstr. 6A, 79108, Freiburg, Germany.
| | - Florian Kernen
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany.
| | - Benedikt Christopher Spies
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine - University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany.
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11
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Pepelnjak T, Stojšić J, Sevšek L, Movrin D, Milutinović M. Influence of Process Parameters on the Characteristics of Additively Manufactured Parts Made from Advanced Biopolymers. Polymers (Basel) 2023; 15:polym15030716. [PMID: 36772018 PMCID: PMC9922018 DOI: 10.3390/polym15030716] [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: 12/19/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 02/04/2023] Open
Abstract
Over the past few decades, additive manufacturing (AM) has become a reliable tool for prototyping and low-volume production. In recent years, the market share of such products has increased rapidly as these manufacturing concepts allow for greater part complexity compared to conventional manufacturing technologies. Furthermore, as recyclability and biocompatibility have become more important in material selection, biopolymers have also become widely used in AM. This article provides an overview of AM with advanced biopolymers in fields from medicine to food packaging. Various AM technologies are presented, focusing on the biopolymers used, selected part fabrication strategies, and influential parameters of the technologies presented. It should be emphasized that inkjet bioprinting, stereolithography, selective laser sintering, fused deposition modeling, extrusion-based bioprinting, and scaffold-free printing are the most commonly used AM technologies for the production of parts from advanced biopolymers. Achievable part complexity will be discussed with emphasis on manufacturable features, layer thickness, production accuracy, materials applied, and part strength in correlation with key AM technologies and their parameters crucial for producing representative examples, anatomical models, specialized medical instruments, medical implants, time-dependent prosthetic features, etc. Future trends of advanced biopolymers focused on establishing target-time-dependent part properties through 4D additive manufacturing are also discussed.
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Affiliation(s)
- Tomaž Pepelnjak
- Faculty of Mechanical Engineering, University of Ljubljana, Aškerčeva 6, 1000 Ljubljana, Slovenia
- Correspondence: ; Tel.: +386-1-47-71-734
| | - Josip Stojšić
- Mechanical Engineering Faculty in Slavonski Brod, University of Slavonski Brod, Trg Ivane Brlić Mažuranić 2, 35000 Slavonski Brod, Croatia
| | - Luka Sevšek
- Faculty of Mechanical Engineering, University of Ljubljana, Aškerčeva 6, 1000 Ljubljana, Slovenia
| | - Dejan Movrin
- Department for Production Engineering, Faculty of Technical Sciences, University of Novi Sad, Trg Dositeja Obradovića 6, 21000 Novi Sad, Serbia
| | - Mladomir Milutinović
- Department for Production Engineering, Faculty of Technical Sciences, University of Novi Sad, Trg Dositeja Obradovića 6, 21000 Novi Sad, Serbia
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Huang S, Wei H, Li D. Additive manufacturing technologies in the oral implant clinic: A review of current applications and progress. Front Bioeng Biotechnol 2023; 11:1100155. [PMID: 36741746 PMCID: PMC9895117 DOI: 10.3389/fbioe.2023.1100155] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 01/11/2023] [Indexed: 01/21/2023] Open
Abstract
Additive manufacturing (AM) technologies can enable the direct fabrication of customized physical objects with complex shapes, based on computer-aided design models. This technology is changing the digital manufacturing industry and has become a subject of considerable interest in digital implant dentistry. Personalized dentistry implant treatments for individual patients can be achieved through Additive manufacturing. Herein, we review the applications of Additive manufacturing technologies in oral implantology, including implant surgery, and implant and restoration products, such as surgical guides for implantation, custom titanium meshes for bone augmentation, personalized or non-personalized dental implants, custom trays, implant casts, and implant-support frameworks, among others. In addition, this review also focuses on Additive manufacturing technologies commonly used in oral implantology. Stereolithography, digital light processing, and fused deposition modeling are often used to construct surgical guides and implant casts, whereas direct metal laser sintering, selective laser melting, and electron beam melting can be applied to fabricate dental implants, personalized titanium meshes, and denture frameworks. Moreover, it is sometimes required to combine Additive manufacturing technology with milling and other cutting and finishing techniques to ensure that the product is suitable for its final application.
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Affiliation(s)
| | - Hongbo Wei
- *Correspondence: Hongbo Wei, ; Dehua Li,
| | - Dehua Li
- *Correspondence: Hongbo Wei, ; Dehua Li,
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13
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Tailoring the composition of biocopolyester blends for dimensionally accurate extrusion-based printing, annealing and steam sterilization. Sci Rep 2022; 12:20341. [PMID: 36434090 PMCID: PMC9700831 DOI: 10.1038/s41598-022-24991-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 11/23/2022] [Indexed: 11/27/2022] Open
Abstract
Fused filament fabrication (FFF) represents a straightforward additive manufacturing technique applied in the medical sector for personalized patient treatment. However, frequently processed biopolymers lack sufficient thermal stability to be used as auxiliary devices such as surgical guides. The aim of this study was to evaluate the dimensional accuracy of experimental biocopolyester blends with improved thermal characteristics after printing, annealing and sterilization. A total of 160 square specimens and 40 surgical guides for oral implant placement were printed. One subgroup of each material (n = 10) underwent thermal annealing before both subgroups were subjected to steam sterilization (134 °C; 5 min). Specimens were digitized and the deviation from the original file was calculated. The thermal behavior was analyzed using differential scanning calorimetry and thermogravimetric analysis. A one-way ANOVA and t-tests were applied for statistical analyses (p < 0.05). All biocopolyester blends showed warpage during steam sterilization. However, the material modification with mineral fillers (21-32 wt%) and nucleating agents in combination with thermal annealing showed a significantly reduced warpage of printed square specimens. Geometry of the printing object seemed to affect dimensional accuracy, as printed surgical guides showed less distortion between the groups. In summary, biocopolyesters did benefit from fillers and annealing to improve their dimensional stability.
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Böse MWH, Beuer F, Schwitalla A, Bruhnke M, Herklotz I. Dynamic navigation for dental implant placement in single-tooth gaps: A preclinical pilot investigation. J Dent 2022; 125:104265. [PMID: 35995082 DOI: 10.1016/j.jdent.2022.104265] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 07/26/2022] [Accepted: 08/18/2022] [Indexed: 10/15/2022] Open
Abstract
OBJECTIVES To compare the planned (PIP) and transferred implant position (TIP) after dental implant placement in single-tooth gaps utilizing dynamic computer-assisted implant surgery (dCAIS). METHODS Five pairs of artificial jaws (n = 5) with four single tooth gaps in FDI (Fédération Dentaire Internationale) regions 16, 25, 36 and 44 were manufactured via injection molding technique. Cone beam computed tomographies (CBCTs) were made and digital implant planning of twenty implants (n = 20) was performed with a dynamic navigation system (DNS, Navident, ClaroNav, Toronto, Canada). After guided drilling and manual implant placement, post-operative CBCTs were made. Global deviations at entry point (two-dimensional, 2D), apex (three-dimensional, 3D), apex (vertical, V) and angulation (in degrees, °) were calculated by DNS software. For statistical analysis, level of significance was set to p < 0.05. RESULTS Mean deviation at the implants entry point (2D) was 0.78 ± 0.45 mm (range: 0.10-1.63 mm). For the implants apex (3D) and the implants apex (V) deviations were 1.08 ± 0.50 mm (range: 0.33-2.10 mm) and 0.32 ± 0.22 mm (range: 0.02-0.90 mm), respectively. The median angular deviation (°) was 2.81 ± 2.29° (range: 0.56-9.58°). Statistically significant differences (p < 0.05) were found regarding apex (3D), apex (V), and angulation (°) comparing I.-IV. quadrants. CONCLUSIONS Using the investigated dCAIS seems to provide satisfactory results regarding TIP in single-tooth gaps in vitro. Due to documented deviations, a safety distance of more than 2 mm should be respected while implant planning in DNS software. CLINICAL SIGNIFICANCE The investigated DNS seems to be reliant in transferring PIP with acceptable deviations in vitro.
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Affiliation(s)
- Mats Wernfried Heinrich Böse
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Aßmannshauser Str. 4-6, Berlin 14197, Germany.
| | - Florian Beuer
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Aßmannshauser Str. 4-6, Berlin 14197, Germany
| | - Andreas Schwitalla
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Aßmannshauser Str. 4-6, Berlin 14197, Germany
| | - Maria Bruhnke
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Aßmannshauser Str. 4-6, Berlin 14197, Germany
| | - Insa Herklotz
- Dental Office Amalienpark - Dr. Herklotz & Dr. Thiele, Amalienpark 1, Berlin 13187, Germany
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15
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Recent advances in 3D-printed polylactide and polycaprolactone-based biomaterials for tissue engineering applications. Int J Biol Macromol 2022; 218:930-968. [PMID: 35896130 DOI: 10.1016/j.ijbiomac.2022.07.140] [Citation(s) in RCA: 87] [Impact Index Per Article: 43.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 07/13/2022] [Accepted: 07/18/2022] [Indexed: 01/10/2023]
Abstract
The three-dimensional printing (3DP) also known as the additive manufacturing (AM), a novel and futuristic technology that facilitates the printing of multiscale, biomimetic, intricate cytoarchitecture, function-structure hierarchy, multi-cellular tissues in the complicated micro-environment, patient-specific scaffolds, and medical devices. There is an increasing demand for developing 3D-printed products that can be utilized for organ transplantations due to the organ shortage. Nowadays, the 3DP has gained considerable interest in the tissue engineering (TE) field. Polylactide (PLA) and polycaprolactone (PCL) are exemplary biomaterials with excellent physicochemical properties and biocompatibility, which have drawn notable attraction in tissue regeneration. Herein, the recent advancements in the PLA and PCL biodegradable polymer-based composites as well as their reinforcement with hydrogels and bio-ceramics scaffolds manufactured through 3DP are systematically summarized and the applications of bone, cardiac, neural, vascularized and skin tissue regeneration are thoroughly elucidated. The interaction between implanted biodegradable polymers, in-vivo and in-vitro testing models for possible evaluation of degradation and biological properties are also illustrated. The final section of this review incorporates the current challenges and future opportunities in the 3DP of PCL- and PLA-based composites that will prove helpful for biomedical engineers to fulfill the demands of the clinical field.
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16
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Sun Y, Ding Q, Yuan F, Zhang L, Sun Y, Xie Q. Accuracy of a chairside, fused deposition modeling three‐dimensional‐printed, single tooth surgical guide for implant placement: A randomized controlled clinical trial. Clin Oral Implants Res 2022; 33:1000-1009. [PMID: 35852859 DOI: 10.1111/clr.13981] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/15/2022] [Accepted: 06/24/2022] [Indexed: 12/01/2022]
Affiliation(s)
- Yao Sun
- Department of Prosthodontics Peking University School and Hospital of Stomatology Beijing China
- Department of Prosthodontics The Third Clinic of Peking University School and Hospital of Stomatology Beijing China
| | - Qian Ding
- Department of Prosthodontics Peking University School and Hospital of Stomatology Beijing China
| | - Fusong Yuan
- Center of Digital Dentistry, Faculty of Prosthodontics Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Research Center of Engineering and Technology for Digital Dentistry of Ministry of Health Beijing China
| | - Lei Zhang
- Department of Prosthodontics Peking University School and Hospital of Stomatology Beijing China
| | - Yuchun Sun
- Center of Digital Dentistry, Faculty of Prosthodontics Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Research Center of Engineering and Technology for Digital Dentistry of Ministry of Health Beijing China
| | - Qiufei Xie
- Department of Prosthodontics Peking University School and Hospital of Stomatology Beijing China
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Burkhardt F, Spies BC, Wesemann C, Schirmeister CG, Licht EH, Beuer F, Steinberg T, Pieralli S. Cytotoxicity of polymers intended for the extrusion-based additive manufacturing of surgical guides. Sci Rep 2022; 12:7391. [PMID: 35513701 PMCID: PMC9072356 DOI: 10.1038/s41598-022-11426-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 04/19/2022] [Indexed: 11/09/2022] Open
Abstract
Extrusion-based printing enables simplified and economic manufacturing of surgical guides for oral implant placement. Therefore, the cytotoxicity of a biocopolyester (BE) and a polypropylene (PP), intended for the fused filament fabrication of surgical guides was evaluated. For comparison, a medically certified resin based on methacrylic esters (ME) was printed by stereolithography (n = 18 each group). Human gingival keratinocytes (HGK) were exposed to eluates of the tested materials and an impedance measurement and a tetrazolium assay (MTT) were performed. Modulations in gene expression were analyzed by quantitative PCR. One-way ANOVA with post-hoc Tukey tests were applied. None of the materials exceeded the threshold for cytotoxicity (< 70% viability in MTT) according to ISO 10993-5:2009. The impedance-based cell indices for PP and BE, reflecting cell proliferation, showed little deviations from the control, while ME caused a reduction of up to 45% after 72 h. PCR analysis after 72 h revealed only marginal modulations caused by BE while PP induced a down-regulation of genes encoding for inflammation and apoptosis (p < 0.05). In contrast, the 72 h ME eluate caused an up-regulation of these genes (p < 0.01). All evaluated materials can be considered biocompatible in vitro for short-term application. However, long-term contact to ME might induce (pro-)apoptotic/(pro-)inflammatory responses in HGK.
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Affiliation(s)
- Felix Burkhardt
- Department of Prosthetic Dentistry, Faculty of Medicine, Medical Center, Center for Dental Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany.
| | - Benedikt C Spies
- Department of Prosthetic Dentistry, Faculty of Medicine, Medical Center, Center for Dental Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany
| | - Christian Wesemann
- Department of Prosthetic Dentistry, Faculty of Medicine, Medical Center, Center for Dental Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany.,Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité -Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin and Berlin Institute of Health, Assmanshauser Str. 4-6, 14197, Berlin, Germany
| | - Carl G Schirmeister
- Freiburg Materials Research Center FMF and Institute for Macromolecular Chemistry, Albert-Ludwigs-University Freiburg, Stefan-Meier-Str. 21, 79104, Freiburg, Germany.,Basell Sales & Marketing B.V., LyondellBasell Industries, Industriepark Höchst, 65926, Frankfurt, Germany
| | - Erik H Licht
- Basell Sales & Marketing B.V., LyondellBasell Industries, Industriepark Höchst, 65926, Frankfurt, Germany
| | - Florian Beuer
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité -Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin and Berlin Institute of Health, Assmanshauser Str. 4-6, 14197, Berlin, Germany
| | - Thorsten Steinberg
- Division of Oral Biotechnology, Faculty of Medicine, Medical Center, Center for Dental Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany
| | - Stefano Pieralli
- Department of Prosthetic Dentistry, Faculty of Medicine, Medical Center, Center for Dental Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany
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Nica DF, Gabor AG, Duma VF, Tudericiu VG, Tudor A, Sinescu C. Sinus Lift and Implant Insertion on 3D-Printed Polymeric Maxillary Models: Ex Vivo Training for In Vivo Surgical Procedures. J Clin Med 2021; 10:jcm10204718. [PMID: 34682841 PMCID: PMC8538196 DOI: 10.3390/jcm10204718] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 10/11/2021] [Accepted: 10/12/2021] [Indexed: 12/14/2022] Open
Abstract
Background and Objectives: The aim of this study is to demonstrate the increased efficiency achieved by dental practitioners when carrying out an ex vivo training process on 3D-printed maxillaries before performing in vivo surgery. Materials and Methods: This developed ex vivo procedure comprises the following phases: (i) scanning the area of interest for surgery; (ii) obtaining a 3D virtual model of this area using Cone Beam Computed Tomography (CBCT); (iii) obtaining a 3D-printed model (based on the virtual one), on which (iv) the dental practitioner simulates/rehearses ex vivo (most of) the surgery protocol; (v) assess with a new CBCT the 3D model after simulation. The technical steps of sinus augmentation and implant insertion could be performed on the corresponding 3D-printed hemi-maxillaries prior to the real in vivo surgery. Two study groups were considered, with forty patients divided as follows: Group 1 comprises twenty patients on which the developed simulation and rehearsal procedure was applied; Group 2 is a control one which comprises twenty patients on which similar surgery was performed without this procedure (considered in order to compare operative times without and with rehearsals). Results: Following the ex vivo training/rehearsal, an optimal surgery protocol was developed for each considered case. The results of the surgery on patients were compared with the results obtained after rehearsals on 3D-printed models. The performed quantitative assessment proved that, using the proposed training procedure, the results of the in vivo surgery are not significantly different (p = 0.089) with regard to the ex vivo simulation for both the mezio-distal position of the implant and the distance from the ridge margin to sinus window. On the contrary, the operative time of Group 1 was reduced significantly (p = 0.001), with an average of 20% with regard to in vivo procedures performed without rehearsals (on the control Group 2). Conclusions: The study demonstrated that the use of 3D-printed models can be beneficial to dental surgeon practitioners, as well as to students who must be trained before performing clinical treatments.
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Affiliation(s)
- Diana Florina Nica
- School of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy of Timisoara, 2A Eftimie Murgu Place, 300070 Timisoara, Romania;
| | - Alin Gabriel Gabor
- Research Center in Dental Medicine Using Conventional and Alternative Technologies, School of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy of Timisoara, 9 Revolutiei 1989 Ave., 300070 Timisoara, Romania; (A.G.G.); (A.T.); (C.S.)
| | - Virgil-Florin Duma
- 3OM Optomechatronics Group, Faculty of Engineering, “Aurel Vlaicu” University of Arad, 2 Elena Dragoi, 310177 Arad, Romania
- Doctoral School, Polytechnic University of Timisoara, 1 Mihai Viteazu Ave., 300222 Timisoara, Romania
- Correspondence: ; Tel.: +40-751-511451
| | | | - Anca Tudor
- Research Center in Dental Medicine Using Conventional and Alternative Technologies, School of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy of Timisoara, 9 Revolutiei 1989 Ave., 300070 Timisoara, Romania; (A.G.G.); (A.T.); (C.S.)
| | - Cosmin Sinescu
- Research Center in Dental Medicine Using Conventional and Alternative Technologies, School of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy of Timisoara, 9 Revolutiei 1989 Ave., 300070 Timisoara, Romania; (A.G.G.); (A.T.); (C.S.)
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Peroz S, Spies BC, Adali U, Beuer F, Wesemann C. Measured accuracy of intraoral scanners is highly dependent on methodical factors. J Prosthodont Res 2021; 66:318-325. [PMID: 34456211 DOI: 10.2186/jpr.jpr_d_21_00023] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Simon Peroz
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Benedikt Christopher Spies
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Ufuk Adali
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Florian Beuer
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Christian Wesemann
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.,Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Abstract
Additive manufacturing is becoming an increasingly important technique for the production of dental restorations and assistive devices. The most commonly used systems are based on vat polymerization, e.g., stereolithography (SLA) and digital light processing (DLP). In contrast, fused filament fabrication (FFF), also known under the brand name fused deposition modeling (FDM), is rarely applied in the dental field. This might be due to the reduced accuracy and resolution of FFF compared to vat polymerization. However, the use of FFF in the dental sector seems very promising for in-house production since it presents a cost-effective and straight forward method. The manufacturing of nearly ready-to-use parts with only minimal post-processing can be considered highly advantageous. Therefore, the objective was to implement FFF in a digital dental workflow. The present report demonstrates the production of surgical guides for implant insertion by FFF. Furthermore, a novel approach using a temperature-sensitive filament for bite registration plates holds great promise for a simplified workflow. In combination with a medical-grade filament, a multi-material impression tray was printed for optimized impression taking of edentulous patients. Compared to the conventional way, the printed thermoplastic material is pleasant to model and can allow clean and fast work on the patient.
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Schnutenhaus S, Edelmann C, Rudolph H. Does the macro design of an implant affect the accuracy of template-guided implantation? A prospective clinical study. Int J Implant Dent 2021; 7:42. [PMID: 33899126 PMCID: PMC8071785 DOI: 10.1186/s40729-021-00320-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 03/17/2021] [Indexed: 11/10/2022] Open
Abstract
Background An implant prosthesis aims to ensure the best possible rehabilitation of function and esthetics following tooth loss. Template-guided insertion is used to achieve an optimal position of the implant with regard to prosthetic restorability, bone availability, and condition of the surrounding soft tissues. The accuracy of template-guided implant placement is subject to various influencing factors. The clinically achievable accuracy depending on the macro design of the implant body was investigated in this prospective clinical study. Material and methods In this prospective clinical study, 20 implants were placed in 20 patients. The implant had a pronounced conical outer geometry (Conelog ProgressiveLine, Camlog Wimsheim, Germany). Data from a study using an implant with a distinct cylindrical outer geometry were used as a comparison group (Conelog ScrewLine, Camlog, Wimsheim, Germany). The clinically achieved implant position was compared with the planned position. Results The evaluation of the two-dimensional deviations in direction resulted in the following mean values (standard deviation) at the shoulder: 0.42 mm (0.33) in the buccolingual direction, 0.27 mm (0.25) in the mesiodistal direction, and 0.68 mm (0.55) in the apicocoronal direction. The mean angular deviation was 4.1° (2.3). The three-dimensional (3D) deviation was 0.94 mm (0.53) at the shoulder and 1.36 mm (0.62) at the apex of the implant. Significant differences between implants with different macro designs were found in the apicocoronal direction. In connection to this, a significant 3D deviation was found at the implant shoulder. Conclusions Significant differences in height were found between the groups. The study had shown that the macro design of an implant has no influence on accuracy in all other directions. Overall, the implants showed a high level of accuracy and a low variation in values. The values were in the range determined by the template-guided insertion system in numerous other investigations. This provides good predictability of prosthetic rehabilitation. Trial registration German Register for Clinical Studies (DRKS-ID: DRKS000018939). Date of registration: November 11, 2019.
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Affiliation(s)
- Sigmar Schnutenhaus
- Zentrum für Zahnmedizin Dr. Schnutenhaus MVZ GmbH [Center for Dentistry, Dr. Schnutenhaus Community Health Center (CHC) GmbH], Breiter Wasmen 10, 78247, Hilzingen, Germany. .,Clinic for Dental Prosthetics, Center for Dental, Oral and Maxillofacial, Ulm University, Albert-Einstein-Allee 11, 89081, Ulm, Germany.
| | - Cornelia Edelmann
- Zentrum für Zahnmedizin Dr. Schnutenhaus MVZ GmbH [Center for Dentistry, Dr. Schnutenhaus Community Health Center (CHC) GmbH], Breiter Wasmen 10, 78247, Hilzingen, Germany
| | - Heike Rudolph
- Clinic for Dental Prosthetics, Center for Dental, Oral and Maxillofacial, Ulm University, Albert-Einstein-Allee 11, 89081, Ulm, Germany
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22
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Edelmann C, Wetzel M, Knipper A, Luthardt RG, Schnutenhaus S. Accuracy of Computer-Assisted Dynamic Navigation in Implant Placement with a Fully Digital Approach: A Prospective Clinical Trial. J Clin Med 2021; 10:jcm10091808. [PMID: 33919257 PMCID: PMC8122675 DOI: 10.3390/jcm10091808] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/20/2021] [Accepted: 04/20/2021] [Indexed: 02/06/2023] Open
Abstract
Background: This prospective clinical study aimed to investigate a possible deviation between the digitally planned implant position and the position achieved using dynamic navigation. The aim of the study was to establish clinical effectiveness and precision of implantation using dynamic navigation. Methods: Twenty consecutive patients received an implant (iSy-Implantat, Camlog, Wimsheim, Germany). One screw implant was placed in one jaw with remaining dentition of at least six teeth. The workflow was fully digital. Digital implant planning was conducted using cone-beam computed tomography (CBCT) and an intraoral scan of the actual condition. Twenty implants were subsequently placed using a dynamic computer-assisted procedure. The clinical situation of the implant position was recorded using an intraoral scan. Using these data, models were produced via 3D printing, and CBCTs of these models were made using laboratory analogs. Deviations of the achieved implant position from the planned position were determined using evaluation software. Results: The evaluation of 20 implants resulted in a mean angle deviation of 2.7° (95% CI 2.2–3.3°). The 3D deviation at the implant shoulder was 1.83 mm (95% CI 1.34–2.33 mm). No significant differences were found for any of the parameters between the implantation in the upper or lower jaw and an open or flapless procedure (p-value < 0.05). Conclusion: The clinical trial showed that sufficiently precise implantation was possible with the dynamic navigation system used here. Dynamic navigation can improve the quality of implant positioning. In particular, the procedure allows safe positioning of the implants in minimally invasive procedures, which usually cannot be performed freehand in this form. A clinical benefit and effectiveness can be determined from the results.
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Affiliation(s)
- Cornelia Edelmann
- Centre for Dentistry, Dr Schnutenhaus Community Health Centre (CHC) GmbH, 78247 Hilzingen, Germany; (C.E.); (M.W.); (A.K.)
| | - Martin Wetzel
- Centre for Dentistry, Dr Schnutenhaus Community Health Centre (CHC) GmbH, 78247 Hilzingen, Germany; (C.E.); (M.W.); (A.K.)
| | - Anne Knipper
- Centre for Dentistry, Dr Schnutenhaus Community Health Centre (CHC) GmbH, 78247 Hilzingen, Germany; (C.E.); (M.W.); (A.K.)
| | - Ralph G. Luthardt
- Department of Dentistry, Clinic for Prosthodontics, Ulm University, 89081 Ulm, Germany;
| | - Sigmar Schnutenhaus
- Centre for Dentistry, Dr Schnutenhaus Community Health Centre (CHC) GmbH, 78247 Hilzingen, Germany; (C.E.); (M.W.); (A.K.)
- Department of Dentistry, Clinic for Prosthodontics, Ulm University, 89081 Ulm, Germany;
- Correspondence:
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Schnutenhaus S, Knipper A, Wetzel M, Edelmann C, Luthardt R. Accuracy of Computer-Assisted Dynamic Navigation as a Function of Different Intraoral Reference Systems: An In Vitro Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18063244. [PMID: 33801039 PMCID: PMC8003934 DOI: 10.3390/ijerph18063244] [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: 02/06/2021] [Revised: 03/12/2021] [Accepted: 03/18/2021] [Indexed: 11/16/2022]
Abstract
The aim of this in vitro study was to determine whether the process chain influences the accuracy of a computer-assisted dynamic navigation procedure. Four different data integration workflows using cone-beam computed tomography (CBCT), conventional impressions, and intraoral digitization with and without reference markers were analyzed. Digital implant planning was conducted using data from the CBCT scans and 3D data of the oral models. The restoration of the free end of the lower jaw was simulated. Fifteen models were each implanted with two new teeth for each process chain. The models were then scanned with scan bodies screwed onto the implants. The deviations between the planned and achieved implant positions were determined. The evaluation of all 120 implants resulted in a mean angular deviation of 2.88 ± 2.03°. The mean 3D deviation at the implant shoulder was 1.53 ± 0.70 mm. No significant differences were found between the implant regions. In contrast, the workflow showed significant differences in various parameters. The position of the reference marker affected the accuracy of the implant position. The in vitro examination showed that precise implantation is possible with the dynamic navigation system used in this study. The results are of the same order of magnitude that can be achieved using static navigation methods. Clinical studies are yet to confirm the results of this study.
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Affiliation(s)
- Sigmar Schnutenhaus
- Centre for Dentistry, Dr Schnutenhaus Community Health Centre (CHC) GmbH, 78247 Hilzingen, Germany; (A.K.); (M.W.); (C.E.)
- Department for Dentistry, Clinic for Prosthodontics, Ulm University, 89081 Ulm, Germany;
- Correspondence:
| | - Anne Knipper
- Centre for Dentistry, Dr Schnutenhaus Community Health Centre (CHC) GmbH, 78247 Hilzingen, Germany; (A.K.); (M.W.); (C.E.)
| | - Martin Wetzel
- Centre for Dentistry, Dr Schnutenhaus Community Health Centre (CHC) GmbH, 78247 Hilzingen, Germany; (A.K.); (M.W.); (C.E.)
| | - Cornelia Edelmann
- Centre for Dentistry, Dr Schnutenhaus Community Health Centre (CHC) GmbH, 78247 Hilzingen, Germany; (A.K.); (M.W.); (C.E.)
| | - Ralph Luthardt
- Department for Dentistry, Clinic for Prosthodontics, Ulm University, 89081 Ulm, Germany;
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Pandemic-Driven Development of a Medical-Grade, Economic and Decentralized Applicable Polyolefin Filament for Additive Fused Filament Fabrication. Molecules 2020; 25:molecules25245929. [PMID: 33333753 PMCID: PMC7765172 DOI: 10.3390/molecules25245929] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/04/2020] [Accepted: 12/13/2020] [Indexed: 12/21/2022] Open
Abstract
A polyolefin with certified biocompatibility according to USP class VI was used by our group as feedstock for filament-based 3D printing to meet the highest medical standards in order to print personal protective equipment for our university hospital during the ongoing pandemic. Besides the chemical resistance and durability, as well as the ability to withstand steam sterilization, this polypropylene (PP) copolymer is characterized by its high purity, as achieved by highly efficient and selective catalytic polymerization. As the PP copolymer is suited to be printed with all common printers in fused filament fabrication (FFF), it offers an eco-friendly cost–benefit ratio, even for large-scale production. In addition, a digital workflow was established focusing on common desktop FFF printers in the medical sector. It comprises the simulation-based optimization of personalized print objects, considering the inherent material properties such as warping tendency, through to validation of the process chain by 3D scanning, sterilization, and biocompatibility analysis of the printed part. This combination of digital data processing and 3D printing with a sustainable and medically certified material showed great promise in establishing decentralized additive manufacturing in everyday hospital life to meet peaks in demand, supply bottlenecks, and enhanced personalized patient treatment.
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