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Fu S, Sun W, Zhu J, Huang B, Ji W, Shi B. Accuracy and patient-centered results of static and dynamic computer-assisted implant surgery in edentulous jaws: a retrospective cohort study. Clin Oral Investig 2023; 27:5427-5438. [PMID: 37480368 DOI: 10.1007/s00784-023-05161-5] [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: 12/30/2022] [Accepted: 07/12/2023] [Indexed: 07/24/2023]
Abstract
OBJECTIVES This study aimed to compare implant positioning accuracy and patient-centered results between static and dynamic computer-assisted implant surgery (s-CAIS and d-CAIS) in edentulous jaws. MATERIAL AND METHODS The current study retrospectively evaluated a total of 110 implants placed in 22 fully edentulous patients via s-CAIS or d-CAIS (n = 11). The accuracy of implant positioning was assessed by measuring the implant's angular deviation and deviation at the platform and apex from the preoperative design postoperatively. Patient-centered results, including preoperative and intraoperative patient-reported experiences and postoperative patient-reported outcomes, were extracted from the medical records. The nested t test and chi-square test were used to compare accuracy and patient-centered results between s-CAIS and d-CAIS postoperatively. RESULTS The implants in the s-CAIS group showed significantly smaller angular deviation (2.32 ± 1.23°) than those in the d-CAIS group (3.87 ± 2.75°). In contrast, the platform and apical deviation were significantly larger in s-CAIS (1.56 ± 1.19 mm and 1.70 ± 1.09 mm, respectively) than d-CAIS (1.02 ± 0.45 mm and 1.00 ± 0.51 mm, respectively). Furthermore, the implants in the s-CAIS group deviated significantly (p < 0.001) more toward the coronal direction than those in the d-CAIS group. Notably, all patients in the s-CAIS group reported an obvious foreign body sensation during surgery, representing a significant difference from the d-CAIS group. CONCLUSIONS Compared to s-CAIS, d-CAIS is a reliable technique for the placement of multiple implants in fully edentulous patients with less linear deviation and less foreign body sensation. TRIAL REGISTRATION The retrospective study was registered on the Chinese Clinical Trial Registry on August 8th, 2022, with registration number No. ChiCTR2200062484. CLINICAL RELEVANCE Despite the increasing use of computer- assisted implant surgery in fully edentulous patients, clinical evidence comparing implant positioning accuracy and patient-centered results between static and dynamic CAIS systems is scarce. Our study demonstrated that compared to s-CAIS, d-CAIS is a reliable technique for the placement of multiple implants in fully edentulous patients with less linear deviation.
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Affiliation(s)
- Shuang Fu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Wei Sun
- Department of Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Jingxian Zhu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Bin Huang
- Department of Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Wei Ji
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China.
- Department of Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China.
| | - Bin Shi
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China.
- Department of Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China.
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Lo Russo L, Guida L, Mariani P, Ronsivalle V, Gallo C, Cicciù M, Laino L. Effect of Fabrication Technology on the Accuracy of Surgical Guides for Dental-Implant Surgery. Bioengineering (Basel) 2023; 10:875. [PMID: 37508902 PMCID: PMC10376300 DOI: 10.3390/bioengineering10070875] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/17/2023] [Accepted: 07/21/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND The accuracy of surgical guides is a relevant factor in both surgical safety and prosthetic implications. The impact of widespread fabrication technologies (milling and 3D printing) was investigated. METHODS Surgical guides manufactured by means of two specific milling and 3D-printing systems were digitized and compared in a 3D analysis with the digital file of the designed guides. The surface mean 3D distance (at the surface where the teeth and mucosa made contact) and the axial and linear deviations of the sleeves' housings were measured by means of a metrological software program. Univariate and multivariate statistical analyses were used to investigate the effects of the fabrication technology, type of support, and arch type on the surgical guides' accuracy. RESULTS The median deviations of the intaglio surface in contact with the mucosa were significantly (p < 0.001) lower for the milled surgical guides (0.05 mm) than for the 3D-printed guides (-0.07 mm), in comparison with the reference STL file. The generalized estimated equation models showed that the axial deviations of the sleeves' housings (a median of 0.82 degrees for the milling, and 1.37 degrees for the 3D printing) were significantly affected by the fabrication technology (p = 0.011) (the milling exhibited better results), the type of support (p < 0.001), and the combined effect of the fabrication technology and the sleeve-to-crest angle (p = 0.003). The linear deviation (medians of 0.12 mm for the milling and 0.21 mm for the 3D printing) of their center points was significantly affected by the type of support (p = 0.001), with the milling performing slightly better than the 3D printing. CONCLUSIONS The magnitude of the difference might account for a limited clinical significance.
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Affiliation(s)
- Lucio Lo Russo
- Department of Clinical and Experimental Medicine, School of Dentistry, University of Foggia, 71122 Foggia, Italy
| | | | - Pierluigi Mariani
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania, "Luigi Vanvitelli", 81055 Naples, Italy
| | - Vincenzo Ronsivalle
- Department of General Surgery and Medical-Surgical Specialties, School of Dentistry, Unit of Oral Surgery and Prosthodontics, University of Catania, 95124 Catania, Italy
| | - Crescenzio Gallo
- Department of Clinical and Experimental Medicine, School of Dentistry, University of Foggia, 71122 Foggia, Italy
| | - Marco Cicciù
- Department of General Surgery and Medical-Surgical Specialties, School of Dentistry, Unit of Oral Surgery and Prosthodontics, University of Catania, 95124 Catania, Italy
| | - Luigi Laino
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania, "Luigi Vanvitelli", 81055 Naples, Italy
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Pimkhaokham A, Jiaranuchart S, Kaboosaya B, Arunjaroensuk S, Subbalekha K, Mattheos N. Can computer-assisted implant surgery improve clinical outcomes and reduce the frequency and intensity of complications in implant dentistry? A critical review. Periodontol 2000 2022; 90:197-223. [PMID: 35924457 PMCID: PMC9805105 DOI: 10.1111/prd.12458] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Computer-assisted implant surgery (CAIS), either static or dynamic, is well documented to significantly improve the accuracy of implant placement. Whether the increased accuracy leads to a corresponding improvement in clinical outcomes has not yet been systematically investigated. The aim of this critical review was to investigate whether the use of CAIS can lead to reduction of complications as well as improved clinical and patient-reported outcomes (PROs) when compared with conventional freehand implant surgery. A comprehensive online search was conducted to identify studies where implants were installed with static computer-assisted implant surgery (s-CAIS)or dynamic computer-assisted implant surgery(d-CAIS) or combinations of the two, either compared with conventional free-hand implant placement or not. Seventy-seven studies were finally included in qualitative analysis, while data from three studies assessing postsurgical pain were suitable for a meta-analysis. Only a small number of the available studies were comparative. The current evidence does not suggest any difference with regard to intraoperative complications, immediate postsurgical healing, osseointegration success, and survival of implants placed with CAIS or freehand protocols. Intraoperative and early healing events as reported by patients in randomized clinical trials (RCTs) did not differ significantly between CAIS used with flap elevation and conventional implant placement. There is limited evidence that increased accuracy of placement with CAIS is correlated with superior esthetic outcomes. Use of CAIS does not significantly reduce the length of surgeries in cases of single implants and partially edentulous patients, although there appears to be a more favorable impact in fully edentulous patients. Although CAIS alone does not seem to improve healing and the clinical and PRO, to the extent that it can increase the utilization of flapless surgery and predictability of immediacy protocols, its use may indirectly lead to substantial improvements in all of the above parameters.
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Affiliation(s)
- Atiphan Pimkhaokham
- Department of Oral and Maxillofacial Surgery, Faculty of DentistryChulalongkorn UniversityBangkokThailand
| | - Sirimanas Jiaranuchart
- Department of Oral and Maxillofacial Surgery, Faculty of DentistryChulalongkorn UniversityBangkokThailand
| | - Boosana Kaboosaya
- Department of Oral and Maxillofacial Surgery, Faculty of DentistryChulalongkorn UniversityBangkokThailand
| | - Sirida Arunjaroensuk
- Department of Oral and Maxillofacial Surgery, Faculty of DentistryChulalongkorn UniversityBangkokThailand
| | - Keskanya Subbalekha
- Department of Oral and Maxillofacial Surgery, Faculty of DentistryChulalongkorn UniversityBangkokThailand
| | - Nikos Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of DentistryChulalongkorn UniversityBangkokThailand,Department of Dental MedicineKarolinska InstituteStockholmSweden
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Aesthetic Outcomes of Early Occlusal Loaded SLA Dental Implants with Hydroxyl Ion Modified Surface-A 12 Months Prospective Study. MATERIALS 2021; 14:ma14216353. [PMID: 34771884 PMCID: PMC8585409 DOI: 10.3390/ma14216353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 10/19/2021] [Accepted: 10/21/2021] [Indexed: 11/17/2022]
Abstract
Background: Many efforts have been made recently to arrange a newer, more hydrophilic and more osteoconductive implant surface. One of the possible options in this matter is modification with hydroxyl ion. Materials and Methods: Forty implants with the diameters 3.5 and 4.0 mm were inserted as a single missing tooth restoration protocol in the frontal aspect of the maxilla. All implants were loaded early in a 4 week period. Prior to and during the surgery, the following indices were considered: height of keratinized tissue, the thickness of soft tissue, and the initial level of bone tissue. After 12 months, the implant and the tissues in its direct vicinity were evaluated once more with the following indices: marginal bone loss (MBL), height of keratinized tissue (HKT), probing pocket depth (PPD), pink and white aesthetics scores (PES, WES), as well as pain sensations combined with the procedure (VAS). All results were related to the diameter of the implant and thickness of periodontal biotype. Results: High aesthetic outcomes were reported regardless of soft tissue thickness and implant diameter. The VAS score was higher for the 4.0 implant group, and the thickness of soft tissue had no influence on VAS. In case of implantation in thin or soft tissue, higher MBL levels were reported (0.26 mm), while in case of a thick phenotype, MBL was 0.06 mm. Conclusions: Hydrophilic surface implants can be used for a protocol of early functional occlusal loading. The initial thickness of soft tissue does not influence aesthetic outcomes and does not raise pain perception, although it may elevate crestal bone resorption.
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Bishti S, Tuna T, Rittich A, Wolfart S. Patient-reported outcome measures (PROMs) of implant-supported reconstructions using digital workflows: A systematic review and meta-analysis. Clin Oral Implants Res 2021; 32 Suppl 21:318-335. [PMID: 34642981 DOI: 10.1111/clr.13846] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 07/09/2021] [Accepted: 07/20/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To summarize the existing evidence on patient-reported outcome measures (PROMs) of implant-supported restorations fabricated using a digital workflow in comparison to conventional manufacturing procedures. METHODS A PICO strategy was executed using an electronic and manual search focusing on clinical studies evaluating PROMs of implant-supported restorations. Only clinical trials assessing conventional versus digital workflows for implant-supported restorations were included. PROMS on implant impression procedures and fabrication of final restorations were evaluated using random and fixed effects meta-analyses, while implant planning/placement was reported descriptively. RESULTS Among 1062 titles identified, 14 studies were finally included, and only seven studies were eligible for meta-analysis. For implant planning and placement, only a qualitative analysis was possible due to heterogeneity between the studies. For impression procedures, the random effects model revealed statistically significant differences in taste, anxiety, nausea, pain, shortness of breath, and discomfort in favor of optical impressions. No significant difference in the subjective perception of the duration of an impression could be reported. For the final fabrication of restorations, no significant difference between veneered and monolithic posterior restorations was found in terms of esthetic, function, and general satisfaction. CONCLUSION Most of the studies reporting about PROMs were published during the last ten years and limited to implant-supported single crowns in the posterior region. Based on PROMs, no scientifically proven recommendation for guided implant placement could be given at this time. Patients showed high preference for optical impressions, whereas no differences between veneered and monolithic restorations could be reported.
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Affiliation(s)
- Shaza Bishti
- Department of Prosthodontics and Biomaterials, RWTH University, Aachen, Germany
| | - Taskin Tuna
- Department of Prosthodontics and Biomaterials, RWTH University, Aachen, Germany
| | - Anne Rittich
- Department of Prosthodontics and Biomaterials, RWTH University, Aachen, Germany
| | - Stefan Wolfart
- Department of Prosthodontics and Biomaterials, RWTH University, Aachen, Germany
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Papazoglou E, Charalambous C. Analog-digital hybrid impression technique in an elderly patient: A case report. Clin Case Rep 2021; 9:2179-2184. [PMID: 33936659 PMCID: PMC8077252 DOI: 10.1002/ccr3.3975] [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: 01/03/2021] [Revised: 02/05/2021] [Accepted: 02/11/2021] [Indexed: 11/24/2022] Open
Abstract
The hybrid impression technique consists of an initial alginate impression that provides a preoperative cast upon which a diagnostic wax-up and a silicone index are made. The wax-up is digitized; thus, the final altered digital impression is limited to absolute minimum time, effort and ensures comfort for the patient.
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Affiliation(s)
- Efstratios Papazoglou
- Department of Operative DentistrySchool of DentistryNational and Kapodistrian University of AthensAthensGreece
| | - Constantinos Charalambous
- Postgraduate program in Restorative DentistrySchool of DentistryNational and Kapodistrian University of AthensAthensGreece
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7
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Analysis of Digital Workflow in Implantology. Case Rep Dent 2021; 2021:6655908. [PMID: 33628525 PMCID: PMC7899756 DOI: 10.1155/2021/6655908] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 02/09/2021] [Indexed: 01/21/2023] Open
Abstract
Digital workflow is increasingly accessible in daily dental practice. It has several benefits in implantology, such as the possibility of precise planning, which results in faster and safer surgery and, consequently, reduced prosthetic complications. There are also disadvantages that must be taken into consideration for successful treatment, such as deviations between the planned and placed implant position and intraoral scanning inaccuracies. We report a clinical case in implantology in which digital workflow was used throughout the process, pointing out its facilities and complications in the daily practice of dental surgeons. The patient had grade II mobility and external root resorption of tooth 11. After virtual planning, a surgical guide was fabricated by a CAD/CAM system, with immediate placement of a dental implant using the guided surgery technique. At the end of the osseointegration period, intraoral scanning was performed for fabrication of the final prosthesis also by a CAD/CAM system. After placement, the patient approved the aesthetic and functional results of the implant. We observed advantages such as simplification of clinical steps and safety of the proposed planning, but there were also disadvantages such as the complexity of digital tools, deviations of the placed implant, and inaccuracy in color selection. It was concluded that digital workflow is a reality that can be integrated into daily dental practice, resulting in greater safety, predictability of results, and ease of use in all clinical stages. However, it should be noted that there are still inaccuracies in digital tools and that a steep learning curve is needed in this area, which, if neglected, may lead to unsatisfactory results.
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8
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Zulkarnaen F, Indrasari M, Dewi RS. Evaluation of Masticatory Performance and Patient Satisfaction Before and After Posterior Implant Restoration. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2021. [DOI: 10.1590/pboci.2021.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Effects of supporting conditions and anchor microscrew on the stabilization of the implant guide template during the drilling process: An in vitro study. J Prosthet Dent 2020; 124:727.e1-727.e8. [PMID: 33160620 DOI: 10.1016/j.prosdent.2020.06.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 06/19/2020] [Accepted: 06/22/2020] [Indexed: 11/23/2022]
Abstract
STATEMENT OF PROBLEM Implant placement errors have been reported in guided surgeries because of movement of the guide template during implant placement. With a completely limiting guide design with high restrictions, guide template stabilization is essential to minimize mobility during the drilling process. PURPOSE The purpose of this in vitro study was to evaluate the effects of supporting conditions and the use of an anchor microscrew on the seating and functional stabilization of a computer-aided design and computer-aided manufacturing (CAD-CAM) implant surgical guide with a completely limiting design. MATERIAL AND METHODS Twelve implant surgical guide templates were fabricated under different supporting conditions: tooth-mucosa, tooth-tooth, tooth-screw, and screw-screw (n=3 per group). In the tooth-screw and screw-screw groups, anchor microscrews and anchor caps were used to fix the guide templates. The seating stability of the templates was evaluated by using a micromovement assessment. The functional stability of the templates was analyzed during the drilling process by using a motion tracking method. One-way analysis of variance and the Tukey HSD post hoc test were conducted to compare the differences among the groups (α=.05). RESULTS The tooth-tooth, tooth-screw, and screw-screw groups exhibited similar seating stability, which was significantly more stable than that of the tooth-mucosa group (P<.001). In terms of functional stability, the tooth-mucosa group reported the highest positional deviation and motion magnitude, whereas low values were found in the tooth-screw and screw-screw groups (P<.001). CONCLUSIONS The use of anchor microscrews can increase the seating and functional stability of CAD-CAM guide templates during the drilling process for implant placement.
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Choi YD, Mai HN, Mai HY, Ha JH, Li LJ, Lee DH. The Effects of Distribution of Image Matched Fiducial Markers on Accuracy of Computer-Guided Implant Surgery. J Prosthodont 2020; 29:409-414. [PMID: 32237001 DOI: 10.1111/jopr.13171] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 01/17/2020] [Accepted: 03/24/2020] [Indexed: 11/27/2022] Open
Abstract
PURPOSE Image registration of the optical intraoral scan to computed tomography image is essential for computer-guided implant surgery. The remaining teeth, which are considered to be congruent structures observed in the scan and radiographic images, are used to perform the image registration. The purpose of this study was to evaluate the effects of the distribution of matching fiducial points on the accuracy of the image registration. MATERIALS AND METHODS A partially edentulous model with three anterior remaining teeth was prepared. Two mini dental implants were inserted in the posterior edentulous areas on both sides, and computed tomography and surface scan data were obtained. Three groups were set according to the distribution of the image matching points used: localized distribution, unilateral distribution, and bilateral distribution. Fifteen graduate students performed the registration process in each group using the same image matching method. The accuracy of image registration was evaluated by measuring the geometric discrepancies between the radiographic and registered scan images in the anterior, middle, and posterior regions. One-way and two-way analysis of variance with the Tukey HSD post hoc test were used for statistical analysis (α = 0.05) RESULTS: In general, the registration discrepancy was lowest in the bilateral distribution group, followed by the unilateral distribution and localized distribution groups (p< 0.001). In the regional analysis, the registration error tended to increase as the measurement region moved farther from the matching points. The distribution of the matching points and measurement regions had a statistical interaction in the accuracy of image registration. CONCLUSION The accuracy of image registration of the surface scan to the computed tomography is affected by the matching point distribution that can be improved by placing artificial markers in the edentulous areas.
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Affiliation(s)
- Yong-Do Choi
- Department of Prosthodontics, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
| | - Hang-Nga Mai
- Institute for Translational Research in Dentistry, Kyungpook National University, Daegu, Republic of Korea
| | - Hai Yen Mai
- Department of Prosthodontics, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
| | - Jung-Hong Ha
- Department of Conservative Dentistry, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
| | | | - Du-Hyeong Lee
- Department of Prosthodontics, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea.,Institute for Translational Research in Dentistry, Kyungpook National University, Daegu, Republic of Korea
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11
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Tatakis DN, Chien HH, Parashis AO. Guided implant surgery risks and their prevention. Periodontol 2000 2019; 81:194-208. [PMID: 31407433 DOI: 10.1111/prd.12292] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Ideal implant placement may reduce surgical complications, such as nerve injury and lingual cortical plate perforation, and minimize the likelihood of functional and prosthetic compromises. Guided implant surgery (GIS) has been used as the means to achieve ideal implant placement. GIS refers to the process of digital planning, custom-guide fabrication, and implant placement using the custom guide and an implant system-specific guided surgery kit. GIS includes numerous additional steps beyond the initial prosthetic diagnosis, treatment planning, and fabrication of surgical guide. Substantial errors can occur at each of these individual steps and can accumulate, significantly impacting the final accuracy of the process with potentially disastrous deviations from proper implant placement. Pertinent overall strategies to reduce or eliminate these risks can be summarized as follows: complete understanding of the possible risks is fundamental; knowledge of the systems and tools used is essential; consistent verification of both diagnostic and surgical procedures after each step is crucial; proper training and surgical experience are critical. This review article summarizes information on the accuracy and efficacy of GIS, provides insight on the potential risks and problems associated with each procedural step, and offers clinically relevant recommendations to minimize or eliminate these risks.
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Affiliation(s)
- Dimitris N Tatakis
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, Ohio, USA
| | - Hua-Hong Chien
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, Ohio, USA
| | - Andreas O Parashis
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, Ohio, USA.,Private Practice Limited to Periodontology and Implant Surgery, Athens, Greece
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12
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Joda T, Derksen W, Wittneben JG, Kuehl S. Static computer‐aided implant surgery (
s‐CAIS
) analysing patient‐reported outcome measures (PROMs), economics and surgical complications: A systematic review. Clin Oral Implants Res 2018; 29 Suppl 16:359-373. [DOI: 10.1111/clr.13136] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Tim Joda
- Section for Digital Reconstructive Technology + Implant Dentistry [DiRecT+ID]Department of Reconstructive Dentistry & GerodontologySchool of Dental MedicineUniversity of Bern Bern Switzerland
- Department of Reconstructive DentistryUniversity Center for Dental Medicine BaselUniversity of Basel Basel Switzerland
| | - Wiebe Derksen
- Division of ImplantologyACTAAcademic Centre for Dentistry Amsterdam Amsterdam the Netherlands
| | - Julia Gabriela Wittneben
- Department of Reconstructive Dentistry & GerodontologySchool of Dental MedicineUniversity of Bern Bern Switzerland
| | - Sebastian Kuehl
- Department of Oral Surgery, Oral Radiology & Oral MedicineUniversity Center for Dental Medicine BaselUniversity of Basel Basel Switzerland
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13
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Flapless dental implant surgery and use of cone beam computer tomography guided surgery. Br Dent J 2018; 224:601-11. [PMID: 29622801 DOI: 10.1038/sj.bdj.2018.268] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2018] [Indexed: 01/11/2023]
Abstract
Flapless implant surgery is increasing in popularity, particularly due to advances and increased usage of cone beam computed tomography (CBCT) and dental implant treatment planning software allowing three-dimensional assessment of the implant site. It is the aim of the article to provide an overview of flapless implant surgery and CBCT guided flapless implant surgery and summarise the literature with regard to the effectiveness of this surgical technique.
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14
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Lee DH, An SY, Hong MH, Jeon KB, Lee KB. Accuracy of a direct drill-guiding system with minimal tolerance of surgical instruments used for implant surgery: a prospective clinical study. J Adv Prosthodont 2016; 8:207-13. [PMID: 27350855 PMCID: PMC4919491 DOI: 10.4047/jap.2016.8.3.207] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 01/26/2016] [Accepted: 04/26/2016] [Indexed: 11/08/2022] Open
Abstract
PURPOSE A recently introduced direct drill-guiding implant surgery system features minimal tolerance of surgical instruments in the metal sleeve by using shank-modified drills and a sleeve-incorporated stereolithographic guide template. The purpose of this study was to evaluate the accuracy of this new guided surgery system in partially edentulous patients using geometric analyses. MATERIALS AND METHODS For the study, 21 implants were placed in 11 consecutive patients using the direct drill-guiding implant surgery system. The stereolithographic surgical guide was fabricated using cone-beam computed tomography, digital scanning, computer-aided design and computer-assisted manufacturing, and additive manufacturing processes. After surgery, the positional and angular deviations between planned and placed implants were measured at the abutment level using implant-planning software. The Kruskal-Wallis test and Mann-Whitney U test were used to compare the deviations (α=.05). RESULTS The mean horizontal deviations were 0.593 mm (SD 0.238) mesiodistally and 0.691 mm (SD 0.344) buccolingually. The mean vertical deviation was 0.925 mm (SD 0.376) occlusogingivally. The vertical deviation was significantly larger than the horizontal deviation (P=.018). The mean angular deviation was 2.024 degrees (SD 0.942) mesiodistally and 2.390 degrees (SD 1.142) buccolingually. CONCLUSION The direct drill-guiding implant surgery system demonstrates high accuracy in placing implants. Use of the drill shank as the guiding component is an effective way for reducing tolerance.
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Affiliation(s)
- Du-Hyeong Lee
- Department of Prosthodontics, School of Dentistry, A3DI, Kyungpook National University, Daegu, Republic of Korea
| | - Seo-Young An
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
| | - Min-Ho Hong
- Department of Bio-medical Research Institute, A3DI, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Kyoung-Bae Jeon
- Department of Prosthodontics, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
| | - Kyu-Bok Lee
- Department of Prosthodontics, School of Dentistry, A3DI, Kyungpook National University, Daegu, Republic of Korea
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Baruffaldi A, Poli PP, Baruffaldi A, Giberti L, Pigozzo M, Maiorana C. Computer-aided flapless implant surgery and immediate loading. A technical note. Oral Maxillofac Surg 2016; 20:313-9. [PMID: 27044419 DOI: 10.1007/s10006-016-0554-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Accepted: 03/21/2016] [Indexed: 10/22/2022]
Abstract
PURPOSE The aim of the present technical note was to describe a prosthetic technique developed to increase the predictability of immediately loaded implants supporting a fixed prosthesis after computer-aided template-guided flapless implant placement. METHODS During a 2-year period, eight patients presenting partial edentulism underwent computer-aided template-guided implant placement. The presented technique was used during the prosthetic procedures to directly transfer the data obtained with the facebow to the surgical environment, allowing for accurate repositioning of the temporary prosthesis on the implants as previously planned with the digital software. RESULTS A total of 78 dental implants were immediately loaded with an implant-supported fixed prosthesis after flapless template-guided implant placement. A survival and success rate of 100 % was reported after a mean follow-up of 1 year from the prosthetic loading. Neither major complications nor dropouts were observed during the healing time. From both clinical and radiological evaluations, implants appeared stable with no signs of soft tissue inflammation or infection and no evidence of pathological peri-implant bone resorption. CONCLUSIONS The proposed technique associated with computer-aided implant placement and immediate loading protocol provided a high implant and prosthetic survival and success rate. No complications were reported during the recalls, suggesting predictability and reliability of the present technique over a short-term period.
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Affiliation(s)
- Alfonso Baruffaldi
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, Fondazione IRCSS Cà Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Pier Paolo Poli
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, Fondazione IRCSS Cà Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.
| | | | | | | | - Carlo Maiorana
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, Fondazione IRCSS Cà Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
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