Computer-assisted bone reduction and static computer-guided implant surgery in a fully edentulous patient: a technique report

Computer-assisted implant surgery is one of the techniques that has gained much popularity over the past years. The amount of information that can be managed in a virtual environment allows for a faster, safer, and more precise implant placement. In certain cases, an appropriate implant-supported rehabilitation is accompanied by the need for complementary surgical procedures. The present technique report describes a clinical situation in which a bone reduction template and a stackable implant placement guide were digitally designed and 3D printed for a simultaneous ridge ostectomy and computer-assisted implant placement.

Patient-specific titanium onlay eminoplasty: A novel protocol for treatment of recurrent temporomandibular joint dislocation

PURPOSE

The present study aimed to introduce an accurate, less morbid and less time-consuming approach that secures the stability of the condylar movement's range for treating recurrent TMJ dislocations.

METHODS

Five patients were treated by surgical implantation of bilateral patient-specific titanium onlay eminoplasties; each implant was virtually designed using specific software and milled from grade V titanium blocks. Intraoperatively, each implant was fixed with three mini-screws along the lateral aspect of the zygomatic arch.

RESULTS

The follow-up period ranged from 6 months to 1 year, which targeted the assessment of the maximal incisal mouth opening (MIO). The mean preoperative maximal incisal mouth opening figured (47.8 mm) vs (33.2 mm) for that recorded postoperatively. One patient reported postoperative slight unilateral pain that was gradually diminished through the first postoperative month.

CONCLUSION

The innovated patient-specific titanium eminoplasty represents an accurate alternative for treatment of chronic recurrent TMJ dislocation.

Comparing Accuracy of Implant Installation with a Navigation System (NS), a Laboratory Guide (LG), NS with LG, and Freehand Drilling

The aim of this study was to compare the accuracy of implant placement by using the conventional freehand method, the surgical guide alone, the dental navigation system alone, and the dental navigation system with a surgical guide. The participants were aged 20 years or older and were requiring dental implant surgery according to an assessment made by a dentist between July 2014 and December 2017. A total of 128 dental implants were inserted, 32 dental implants in each group, and participants with similar or identical age (i.e., 20–50 years or 50 years or above) and missing tooth locations were paired for comparison. Accuracy was measured by overlaying the real position in the postoperative Cone Beam Computerized Tomography (CBCT) on the virtual presurgical placement of the implant in a CBCT image. Using the dental navigation system with a surgical guide could help dentists to position implants more accurately. Total, longitudinal, and angular error deviation were significantly different (p < 0.0001). The same level of accuracy could be obtained for the different jaws and tooth positions. The one-way analysis of variance (ANOVA) showed that the total, longitudinal, and angular errors differed significantly (p < 0.0001). A comparison of the four dental implant surgical methods indicated that the combination of a dental implant navigation system and a surgical guide kit achieved the highest accuracy in terms of the different tooth positions and jaws.

Computerized implant-dentistry: Advances toward automation

Advancements in the field of implantology such as three-dimensional imaging, implant-planning software, computer-aided-design/computer-aided-manufacturing (CAD/CAM) technology, computer-guided, and navigated implant surgery have led to the computerization of implant-dentistry. This three-dimensional computer-generated implant-planning and surgery has not only enabled accurate preoperative evaluation of the anatomic limitations but has also facilitated preoperative planning of implant positions along with virtual implant placement and subsequently transferring the virtual treatment plans onto the surgical phase via static (guided) or dynamic (navigated) systems aided by CAD/CAM technology. Computerized-implant-dentistry being highly predictable and minimally invasive in nature has also allowed implant placement in patients with medical comorbidities (e.g. radiation therapy, blood dyscrasias), in patients with complex problems following a significant alteration of the bony anatomy as a result of benign or malignant pathology of the jaws or trauma and in patients with other physical and emotional problems. With significant achievements accomplished in the field of computerized implant-dentistry, attempts are now been made toward complete automation of implant-dentistry.