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Zhao N, Du L, Lv C, Liang J, He L, Zhou Q. Accuracy analysis of robotic-assisted immediate implant placement: A retrospective case series. J Dent 2024; 146:105035. [PMID: 38734299 DOI: 10.1016/j.jdent.2024.105035] [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: 09/21/2023] [Revised: 04/19/2024] [Accepted: 04/30/2024] [Indexed: 05/13/2024] Open
Abstract
OBJECTIVES This study aimed to investigate the accuracy of a robotic computer-assisted implant surgery (r-CAIS) for immediate implant placement. METHODS Patients requiring immediate implant placement in the maxillary anterior region were enrolled for r-CAIS. Before surgery, the patients underwent a cone beam computed tomography (CBCT) scan with a positioning marker. Virtual implant placement position and drilling sequences were planned. Following spatial registration and calibration, the implants were placed with the robotic system under supervision. A postoperative CBCT was taken to control the actual implant positions. The DICOM data of the virtually planned and the actually placed implant were superimposed and registered through the accuracy verification software of the robotic system. The accuracy was calculated automatically. The deviation at the mesial-distal, labial-palatal, and apico-coronal directions were recorded. RESULTS Fifteen patients with 20 implants were included. No adverse surgical events or postoperative complications were reported. The global platform, apex, and angular deviation were 0.75 ± 0.20 mm (95 % CI: 0.65 to 0.84 mm), 0.70 ± 0.27 mm (95 % CI: 0.57 to 0.82 mm), and 1.17 ± 0.73° (95 % CI: 0.83 to 1.51°), respectively. Moreover, the vertical platform and apex deviation were 0.50 ± 0.31 mm, (95 % CI: 0.35 to 0.64 mm) and 0.48 ± 0.32 mm, (95 % CI: 0.33 to 0.63 mm), respectively. All the placed implant positions were further labial and apical than the planned ones, respectively. CONCLUSIONS High accuracy of immediate implant placement was achieved with the robotic system. CLINICAL SIGNIFICANCE Our study provided evidence to support the potential of the robotic system in implant placement, even in challenging scenarios.
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Affiliation(s)
- Ningbo Zhao
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, PR China; Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Disease, College of Stomatology, Xi'an Jiaotong University, PR China; Department of Implant Dentistry, College of Stomatology, Xi'an Jiaotong University, PR China
| | - Liangzhi Du
- Department of Implant Dentistry, College of Stomatology, Xi'an Jiaotong University, PR China
| | - Chengpeng Lv
- Department of Implant Dentistry, College of Stomatology, Xi'an Jiaotong University, PR China
| | - Jianfei Liang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, PR China; Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Disease, College of Stomatology, Xi'an Jiaotong University, PR China; Department of Implant Dentistry, College of Stomatology, Xi'an Jiaotong University, PR China
| | - Longlong He
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, PR China; Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Disease, College of Stomatology, Xi'an Jiaotong University, PR China; Department of Implant Dentistry, College of Stomatology, Xi'an Jiaotong University, PR China.
| | - Qin Zhou
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, PR China; Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Disease, College of Stomatology, Xi'an Jiaotong University, PR China; Department of Implant Dentistry, College of Stomatology, Xi'an Jiaotong University, PR China.
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Zhu J, Zhao K, Gu X. Research progress on accuracy of intraoral digital impressions for implant-supported full-arch prostheses. Zhejiang Da Xue Xue Bao Yi Xue Ban 2024:1-9. [PMID: 38832462 DOI: 10.3724/zdxbyxb-2024-0079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Abstract
With the rapid development of implant techniques and digital technology, digital impressions have become a commonly used impression method in implant restoration. At present, the accuracy of intraoral digital impressions directly applied to implant-supported full-arch prostheses remains inadequate, which is due to the high accuracy requirement of full-arch implant impressions, while there are still technical challenges in intraoral digital impressions about recognition and stitching. In this regard, scholars have proposed a variety of scanning strategies to improve the accuracy of intraoral scan, including mucosal modifications, auxiliary devices and novel scan bodies. At the same time photogrammetry, as a new digital impression technique, has been developing steadily and exhibits promising accuracy. This article reviews the research progress on the accuracy of edentulous full-arch implant impressions and techniques which can improve the accuracy of intraoral digital impressions, to provide reference for clinical application.
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Affiliation(s)
- Jieying Zhu
- Department of Stomatology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
- Department of Stomatology, Zhejiang University School of Medicine, Hangzhou 310058, China.
| | - Ke Zhao
- Department of Stomatology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
- Department of Stomatology, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Xinhua Gu
- Department of Stomatology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
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Bai X, Wu T, Zhu Y, Yang C, Cheng T, Liu Y, Zhou Y. Cone-wedge anchored surgical templates for stackable metal guide: a novel technique. Int J Implant Dent 2024; 10:27. [PMID: 38819712 PMCID: PMC11143131 DOI: 10.1186/s40729-024-00539-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 04/16/2024] [Indexed: 06/01/2024] Open
Abstract
OBJECTIVE To address the instability in implant surgical guides, this technique proposes an alternative anchoring mechanism in the stackable metal surgical guides utilizing cone-wedge anchors for improved stability. METHODS Postoperative implant position superimposed onto the preoperatively planned design using Mimics Medical 21.0 and Materialise Magics 24.0 to assess 3D coronal implant deviation, 3D apical implant deviation, and implant angular deviation. RESULTS Postoperative cone-beam computed tomography (CBCT) revealed a high level of precision in the implant placement, with an average 0.97 mm deviation at implant coronal region, 1.56 mm at implant apexes, and 2.95° angular deviation. CONCLUSION This technique introduces a novel cone-wedge anchoring mechanism to enhance the stability of stackable metal surgical guide templates, addressing inherent instability issues. The utilization of this approach significantly improves the accuracy of implant placement procedures.
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Affiliation(s)
- Xueying Bai
- 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, PR China
| | - Tao Wu
- Center for Prosthodontics and Implant Dentistry, Optics Valley Branch, School and Hospital of Stomatology; 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 University, Wuhan, PR China
| | - Yuxi 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, PR China
| | - Chengyu Yang
- 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, PR China
| | - Tiange Cheng
- 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, PR China
| | - Yi Liu
- Department of Stomatology, Edong Healthcare Group, Huangshi Central Hospital, Affiliated Hospital of Hubei Polytechnic University, Huangshi, PR China
| | - Yi Zhou
- Center for Prosthodontics and Implant Dentistry, Optics Valley Branch, School and Hospital of Stomatology; 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, 430000, PR China.
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Wu Q, Lou Y, Sun J, Xie C, Wu J, Yu H. Accuracy of the novel digital non-cross-arch surgical guides with integration of tooth undercut retention and screw-bone support for implant placement in mandibular free-end. BMC Oral Health 2024; 24:550. [PMID: 38734597 PMCID: PMC11088151 DOI: 10.1186/s12903-024-04329-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 05/03/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND Large cross-arch free-end surgical guides can obscure the visual field, compromising surgical accuracy due to insufficient stability at the free-end. This in vitro study aims to evaluate the accuracy of novel digital non-cross-arch surgical guides designed for implant placement at the mandibular free-end, incorporating tooth undercut retention and screw-bone support. MATERIALS AND METHODS A mandibular dental model lacking left molars was utilized to fabricate unilateral (cross-arch) tooth-supported surgical guides (GT I, n = 20). Subsequently, two additional types of surgical guides were fabricated: GT II (covering two teeth, n = 20) and GT III (covering three teeth, n = 20). These novel surgical guides were designed to utilize the undercut of the supporting teeth for retention and enhance stability with screw-bone support at the guide's free-end. Furthermore, 60 identical guiding blocks were assembled on the three types of surgical guides to facilitate the implants' insertion. On a phantom head, 120 implant replicas were placed at the Federal Dentaire Internationale (FDI) teeth positions #36 and #37 on the dental model, employing a combination of surgical guides and guiding blocks. To assess accuracy, planned and placed implant positions were compared using intraoral optical scanning. Discrepancies in angulation and linear deviations, including the coronal/apical 3D deviations, lateral deviation as well as depth deviation, were measured. Statistical analysis was performed using two-way ANOVA and Bonferroni test (α = 0.05). RESULTS GT I exhibited significantly largest discrepancies, including angular and linear deviations at the crest and apex at every implant site. Especially in depth, at implant site #36, the mean deviation value of GT I (0.27 ± 0.13 mm) was twice as large as GT III (0.13 ± 0.07 mm), and almost twice as large as GT II (0.14 ± 0.08 mm). However, at implant site #37, this deviation increased to almost a five-fold relationship between GT I (0.63 ± 0.12 mm) and II (0.14 ± 0.09 mm), as well as between GT I and III (0.13 ± 0.09 mm). No significant discrepancies existed between the novel surgical guides at either implant site #36 or #37. CONCLUSION This study provides a practical protocol for enhancing accuracy of implant placement and reducing the size of free-end surgical guides used at mandibular molar sites.
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Affiliation(s)
- Qin Wu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Prosthodontics II, West China Hospital of Stomatology, Sichuan University, 14 Renmin South Road, 3rd Section, Chengdu, Sichuan, 610041, China
| | - Yuxin Lou
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Dental Technology, West China Hospital of Stomatology, Sichuan University, 14 Renmin South Road, 3rd Section, Chengdu, Sichuan, 610041, China
| | - Jikui Sun
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Prosthodontics II, West China Hospital of Stomatology, Sichuan University, 14 Renmin South Road, 3rd Section, Chengdu, Sichuan, 610041, China
| | - Chenyang Xie
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Dental Technology, West China Hospital of Stomatology, Sichuan University, 14 Renmin South Road, 3rd Section, Chengdu, Sichuan, 610041, China
| | - Jiacheng Wu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Dental Technology, West China Hospital of Stomatology, Sichuan University, 14 Renmin South Road, 3rd Section, Chengdu, Sichuan, 610041, China
| | - Haiyang Yu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Prosthodontics II, West China Hospital of Stomatology, Sichuan University, 14 Renmin South Road, 3rd Section, Chengdu, Sichuan, 610041, China.
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Seidel A, Leira Y, Batalla P, Caneiro L, Wichmann M, Blanco J. Three-dimensional imaging analysis of CAD/CAM custom-milled versus prefabricated allogeneic block remodelling at 6 months and long-term follow-up of dental implants: A retrospective cohort study. J Clin Periodontol 2024. [PMID: 38710641 DOI: 10.1111/jcpe.13995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 04/17/2024] [Accepted: 04/20/2024] [Indexed: 05/08/2024]
Abstract
AIM This retrospective cohort study aimed to volumetrically investigate the bone stability rate of prefabricated allogeneic bone blocks (PBB) and computer-aided design (CAD)/computer-aided manufacturing (CAM) custom-milled allogeneic bone blocks (CCBB) for ridge augmentation. MATERIALS AND METHODS Nineteen patients were treated with 20 allografts: 11 CCBB, 9 PBB; 10 in the maxilla and 10 in the mandible. Clinical treatment history and cone beam computed tomography scans before surgery (t0), directly after graft surgery (t1) and after 6 months of healing prior to implant insertion (t2) were evaluated using a three-dimensional evaluation software for absolute bone volume, stability as well as vertical and horizontal bone gain. Furthermore, the inserted implants were analysed for survival, marginal bone loss (MBL) and complications for a mean follow-up period of 43.75 (±33.94) months. RESULTS A mean absolute volume of 2228.1 mm3 (±1205) was grafted at t1. The bone stability rate was 87.6% (±9.9) for CCBB and 83.0% (±14.5) for PBB. The stability was higher in the maxilla (91.6%) than in the mandible (79.53%). Surgery time of PBB was longer than for CCBB (mean Δ = 52 min). The survival rate of the inserted implants was 100% with a mean MBL of 0.41 mm (±0.37). CONCLUSION The clinical performance of both allograft block designs was equally satisfactory for vertical and horizontal bone grafting prior to implant placement. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov: NCT06027710.
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Affiliation(s)
- Anna Seidel
- Department of Prosthodontics, University Hospital Erlangen of Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Yago Leira
- Department of Periodontology and Oral Surgery, Faculty of Odontology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Pilar Batalla
- Department of Periodontology and Oral Surgery, Faculty of Odontology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Leticia Caneiro
- Department of Periodontology and Oral Surgery, Faculty of Odontology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Manfred Wichmann
- Department of Prosthodontics, University Hospital Erlangen of Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Juan Blanco
- Department of Periodontology and Oral Surgery, Faculty of Odontology, University of Santiago de Compostela, Santiago de Compostela, Spain
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Lanis A, Peña-Cardelles JF, Negreiros WM, Hamilton A, Gallucci GO. Impact of digital technologies on implant surgery in fully edentulous patients: A scoping review. Clin Oral Implants Res 2024. [PMID: 38613432 DOI: 10.1111/clr.14268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 03/09/2024] [Accepted: 03/27/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND For over three decades, digital technologies have been used in Implant Dentistry, beginning with the introduction of planning software for Static Computer-Assisted Implant Surgery (S-CAIS). During this time, this field has witnessed the emergence of diverse methodologies and a proliferation of technological advancements. Today, S-CAIS is a widely adopted procedure for the placement of dental implants in both partially and fully edentulous patients, with Dynamic Computer-Assisted Surgery (D-CAIS) and Robotic-Assisted Implant Surgery (RAIS) rapidly gaining attention among dental professionals. The continuous advancements in this arena are not merely indicative of technological progress; they represent a steadfast dedication to refining precision, enhancing efficiency, and fostering innovation with the goal of optimizing patient outcomes in dental implantology. AIMS The purpose of the following review is to meticulously examine the spectrum of digital technologies available and to describe their protocols, advantages, and shortcomings as well as to evaluate their accuracy in implant surgery in patients with complete edentulism. MATERIALS AND METHODS A scoping review was performed following the Joanna Briggs Institute (JBI) protocols, leveraging the population, concept, and context (PCC) framework to construct the research question and determine the inclusion and exclusion criteria. RESULTS Two hundred and sixty-seven records were identified for screening. After applying all the screening criteria, 41 articles were included for review and qualitative data analysis. DISCUSSION S-CAIS, D-CAIS, and RAIS were identified as the main technologies for computer assisted implant surgery. Their applications, characteristics, protocols and levels of accuracy were compared and described. CONCLUSION Taking into consideration the limitations of this study, S-CAIS appears to be the most applied and validated technology in implant surgery for fully edentulous patients followed by D-CAIS and RAIS being these last two promising initiatives in the field. Despite having similar levels of accuracy, the overall comparison showed a slightly higher values in RAIS followed by D-CAIS and S-CAIS.
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Affiliation(s)
- Alejandro Lanis
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Juan Francisco Peña-Cardelles
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - William Matthew Negreiros
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Adam Hamilton
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
- Oral Health Center of WA, University of Western Australia Dental School, Perth, Australia
| | - German O Gallucci
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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Tommasato G, Piano S, Casentini P, De Stavola L, Chiapasco M. Digital planning and bone regenerative technologies: A narrative review. Clin Oral Implants Res 2024. [PMID: 38591734 DOI: 10.1111/clr.14267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 03/07/2024] [Accepted: 03/27/2024] [Indexed: 04/10/2024]
Abstract
OBJECTIVES The aim of this narrative review was to explore the application of digital technologies (DT) for the simplification and improvement of bone augmentation procedures in advanced implant dentistry. MATERIAL AND METHODS A search on electronic databases was performed to identify systematic reviews, meta-analyses, randomized and non-randomized controlled trials, prospective/retrospective case series, and case reports related to the application of DT in advanced implant dentistry. RESULTS Seventy-nine articles were included. Potential fields of application of DT are the following: 1) the use of intra-oral scanners for the definition of soft tissue profile and the residual dentition; 2) the use of dental lab CAD (computer-aided design) software to create a digital wax-up replicating the ideal ridge and tooth morphology; 3) the matching of STL (Standard Triangulation Language) files with DICOM (DIgital COmmunication in Medicine) files from CBCTs with a dedicated software; 4) the production of stereolithographic 3D models reproducing the jaws and the bone defects; 5) the creation of surgical templates to guide implant placement and augmentation procedures; 6) the production of customized meshes for bone regeneration; and 7) the use of static or dynamic computer-aided implant placement. CONCLUSIONS Results from this narrative review seem to demonstrate that the use of a partially or fully digital workflow can be successfully used also in advanced implant dentistry. However, the number of studies (in particular RCTs) focused on the use of a fully digital workflow in advanced implant dentistry is still limited and more studies are needed to properly evaluate the potentials of DT.
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Affiliation(s)
- Grazia Tommasato
- Unit of Oral Surgery, Department of Biomedical, Surgical, and Dental Sciences, University of Milano, Milan, Italy
| | | | | | - Luca De Stavola
- Unit of Periodontology, Dental Clinic, Department of Neurosciences, University of Padova, Padova, Italy
| | - Matteo Chiapasco
- Unit of Oral Surgery, Department of Biomedical, Surgical, and Dental Sciences, University of Milano, Milan, Italy
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Jia S, Wang G, Zhao Y, Wang X. Autonomous robotic system for the assisted immediate placement of a maxillary anterior implant: A clinical report. J Prosthet Dent 2024:S0022-3913(24)00196-3. [PMID: 38570281 DOI: 10.1016/j.prosdent.2024.02.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 02/17/2024] [Accepted: 02/19/2024] [Indexed: 04/05/2024]
Abstract
Precise reproduction of the preoperatively designed 3-dimensional (3D) implant position is key to seating a prefabricated restoration and restoring esthetics. Static and dynamic computer-aided implant surgery (CAIS) based on the fusion of 3D imaging files have been used to improve implant accuracy. However, both techniques have shortcomings that can be remedied by a robotic system. This clinical report describes the immediate placement of an implant in the anterior esthetic zone by using an autonomous dental implant robotic system (ADIR).
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Affiliation(s)
- Shasha Jia
- Postgraduate student, Department of Oral Implantology, The Affiliated Hospital of Qingdao University, Qingdao, China; School of Stomatology, Qingdao University, Qingdao, PR China
| | - Guowei Wang
- Associate Professor, Department of Stomatology, No. 971 Hospital of the Chinese Navy, Qingdao, Shandong, PR China
| | - Yimin Zhao
- Professor, Department of Prosthodontics, School of Stomatology, Air Force Medical University, Shannxi, PR China
| | - Xiaojing Wang
- Professor, Department of Oral Implantology, The Affiliated Hospital of Qingdao University, Qingdao, PR China; School of Stomatology of Qingdao University. Qingdao, PR China; Department of Stomatology, Lingshui Li Autonomous County People's Hospital, Lingshui, Hainan, China.
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Wang W, Xu H, Mei D, Zhou C, Li X, Han Z, Zhou X, Li X, Zhao B. Accuracy of the Yakebot dental implant robotic system versus fully guided static computer-assisted implant surgery template in edentulous jaw implantation: A preliminary clinical study. Clin Implant Dent Relat Res 2024; 26:309-316. [PMID: 37728030 DOI: 10.1111/cid.13278] [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: 03/06/2023] [Revised: 08/25/2023] [Accepted: 08/29/2023] [Indexed: 09/21/2023]
Abstract
AIMS To compare the accuracy of the Yakebot dental implant robotic system with that of fully guided static computer-assisted implant surgery (CAIS) template in edentulous implantation. MATERIALS AND METHODS Thirteen patients with edentulous were recruited and divided into two groups: the Yake robotic system group (experimental) (n = 5) and the CAIS group (control) (n = 8). Postoperative cone-beam computed tomography (CBCT) was performed immediately, and the 3-dimensional positions of implants were obtained and compared with that in the preoperative design. The comparison showed platform, apical, depth, and angular deviations. A value of p < 0.05 was considered statistically significant. RESULTS A total of 84 implants (36 in the robotic group and 48 in the CAIS group) were placed. The mean deviation at the implant platform, apex, depth, and angle in the CAIS group was 1.37 ± 0.72 mm, 1.28 ± 0.68 mm, 0.88 ± 0.47 mm, and 3.47 ± 2.02°, respectively. However, the mean deviation at the implant platform, apex, depth, and angle in the robotic group was 0.65 ± 0.25 mm, 0.65 ± 0.22 mm, 0.49 ± 0.24 mm, and 1.43 ± 1.18°, respectively. Significant differences in the four types of deviation (p < 0.05) between the two groups were observed. CONCLUSION The accuracy of robotic system in edentulous implant placement was superior to that of the CAIS template, suggesting that robotic system is more accurate, safe, and flexible, can be considered a promising treatment in clinical practice.
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Affiliation(s)
- Wenxue Wang
- Department of Oral Implantology, The Affiliated Hospital of Qingdao University, Qingdao, China
- School of Stomatology of Qingdao University, Qingdao, China
| | - Hao Xu
- Department of Oral Implantology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Dongmei Mei
- Department of Oral Implantology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Chen Zhou
- Department of Oral Implantology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xiaojing Li
- Department of Oral Implantology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Ze'yu Han
- Department of Oral Implantology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xiaobin Zhou
- Department of Epidemiology and Health Statistics, School of Public Health of Qingdao University, Qingdao, China
| | - Xin Li
- Department of Oral Implantology, The Affiliated Hospital of Qingdao University, Qingdao, China
- School of Stomatology of Qingdao University, Qingdao, China
| | - Baodong Zhao
- Department of Oral Implantology, The Affiliated Hospital of Qingdao University, Qingdao, China
- School of Stomatology of Qingdao University, Qingdao, China
- Qingdao Dental Digital Medicine & 3D Printing Engineering Laboratory of Qingdao University, Qingdao, China
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Khaohoen A, Powcharoen W, Sornsuwan T, Chaijareenont P, Rungsiyakull C, Rungsiyakull P. Accuracy of implant placement with computer-aided static, dynamic, and robot-assisted surgery: a systematic review and meta-analysis of clinical trials. BMC Oral Health 2024; 24:359. [PMID: 38509530 PMCID: PMC10956322 DOI: 10.1186/s12903-024-04033-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 02/14/2024] [Indexed: 03/22/2024] Open
Abstract
This systematic review explores the accuracy of computerized guided implant placement including computer-aided static, dynamic, and robot-assisted surgery. An electronic search up to February 28, 2023, was conducted using the PubMed, Embase, and Scopus databases using the search terms "surgery", "computer-assisted", "dynamic computer-assisted", "robotic surgical procedures", and "dental implants". The outcome variables were discrepancies including the implant's 3D-coronal, -apical and -angular deviations. Articles were selectively retrieved according to the inclusion and exclusion criteria, and the data were quantitatively meta-analysed to verify the study outcomes. Sixty-seven articles were finally identified and included for analysis. The accuracy comparison revealed an overall mean deviation at the entry point of 1.11 mm (95% CI: 1.02-1.19), and 1.40 mm (95% CI: 1.31-1.49) at the apex, and the angulation was 3.51˚ (95% CI: 3.27-3.75). Amongst computerized guided implant placements, the robotic system tended to show the lowest deviation (0.81 mm in coronal deviation, 0.77 mm in apical deviation, and 1.71˚ in angular deviation). No significant differences were found between the arch type and flap operation in cases of dynamic navigation. The fully-guided protocol demonstrated a significantly higher level of accuracy compared to the pilot-guided protocol, but did not show any significant difference when compared to the partially guided protocol. The use of computerized technology clinically affirms that operators can accurately place implants in three directions. Several studies agree that a fully guided protocol is the gold standard in clinical practice.
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Affiliation(s)
- Angkoon Khaohoen
- Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Warit Powcharoen
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Tanapon Sornsuwan
- Department of Restorative Dentistry, Faculty of Dentistry, Naresuan University, Phitsanulok, 65000, Thailand
| | - Pisaisit Chaijareenont
- Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Chaiy Rungsiyakull
- Department of Mechanical Engineering, Faculty of Engineering, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Pimduen Rungsiyakull
- Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai, 50200, Thailand.
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11
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Strauss FJ, Gil A, Smirani R, Rodriguez A, Jung R, Thoma D. The use of digital technologies in peri-implant soft tissue augmentation - A narrative review on planning, measurements, monitoring and aesthetics. Clin Oral Implants Res 2024. [PMID: 38308466 DOI: 10.1111/clr.14238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 11/21/2023] [Accepted: 01/11/2024] [Indexed: 02/04/2024]
Abstract
OBJECTIVE To identify the different uses and modalities of digital technologies to diagnose, plan and monitor peri-implant soft tissue conditions and aesthetics. METHODS A comprehensive narrative review of pertinent literature was conducted, critically appraising key digital technologies that may assist peri-implant soft tissue augmentation and assessment. An electronic search on four databases including studies published prior to 1st July 2023 was performed and supplemented by a manual search. RESULTS Predominantly, tools such as cone beam computed tomography (CBCT), intraoral scanning (iOS), intraoral ultrasonography and digital spectrophotometry were commonly to assess and monitor peri-implant soft tissues. The main clinical and research applications included: (i) initial assessment of mucosal thickness, supra-crestal tissue height and keratinized mucosa width, (ii) evaluation of peri-implant soft tissue health and inflammation, (iii) monitoring profilometric changes and midfacial mucosal margin stability over time and (iv) aesthetic evaluation through colour assessment. While evidence for some digital tools may be limited, the integration of digital technologies into peri-implant soft tissue management holds great promise. These technologies offer improved precision, comfort and speed in assessment, benefiting both patients and clinicians. CONCLUSION As digital technologies progress, their full potential in peri-implant soft tissue augmentation and their value will become more evident with ongoing research. Embracing these innovations and their potential benefits is recommended to ensure that during progress in implant dentistry, patient care is not hindered.
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Affiliation(s)
- Franz Josef Strauss
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Alfonso Gil
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Rawen Smirani
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Univ. Bordeaux, INSERM, BioTis, U1026, Bordeaux, France
- CHU de Bordeaux, Service de Médecine Bucco-Dentaire, Bordeaux, France
| | - Amanda Rodriguez
- Department of Periodontics and Oral Medicine, Dental School, University of Michigan, Ann Arbor, Michigan, USA
| | - Ronald Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Daniel Thoma
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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12
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Vavrickova L, Kapitan M, Schmidt J. Patient-reported outcome measures (PROMs) of digital and conventional impression methods for fixed dentures. Technol Health Care 2024; 32:885-896. [PMID: 37661898 DOI: 10.3233/thc-230277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
BACKGROUND Digital impression technique or computer-aided impression (CAI) has been recently concluded as a clinically acceptable alternative to conventional impression method (CIM) in the fabrication of crowns, short fixed partial dentures (FPDs), and implant-supported crowns. OBJECTIVE The purpose of this study was to investigate the patients' opinion and subjective perception of two different ways of impression - digital and conventional. METHODS A total of 45 patients were treated with CAI and CIM for the fabrication of tooth or implant-supported crowns. They fulfilled a questionnaire including 11 questions regarding the treatment time, gag reflex, discomfort related to manipulation, and other aspects of treatment. RESULTS CAI was considered the preferential method for future treatment in 53% of patients, whereas 28.9% of the respondents preferred CIM. The preference for the impression method was influenced by the total time spent with the procedure, discomfort during manipulation with the tray or scanning head, size of the tray or scanning head, maximal opening discomfort, and (the tendency towards) gag reflex. CONCLUSION CAI was considered a more comfortable and preferential method. Discomfort or difficulties during CAI negatively affected the patients' attitude to CAI, whereas the difficulties associated with CIM did not have any influence on the preferred method.
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Wang B, Yang J, Siow L, Wang Y, Zhang X, Zhou Y, Yu M, Wang H. Clinical accuracy of partially guided implant placement in edentulous patients: A computed tomography-based retrospective study. Clin Oral Implants Res 2024; 35:31-39. [PMID: 37814971 DOI: 10.1111/clr.14191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 09/14/2023] [Accepted: 09/19/2023] [Indexed: 10/11/2023]
Abstract
OBJECTIVES This retrospective study was intended to evaluate the clinical accuracy of partially guided template in guiding implant placement in edentulous patients. METHODS A total of 120 implants were placed in 24 patients with at least one completely edentulous arch with a partially guided system. Based on CBCT data, a repeatable method was used to measure linear and angular deviations of implants at 3D level in Mimics medical software. The influence of supporting tissue and implant region on the accuracy was assessed, followed by the evaluation of direction of linear deviations in biologically vital areas. RESULTS Linear deviations of all implants were 1.91 ± 0.68 mm, 1.47 ± 0.68 mm, and 1.02 ± 0.69 mm at apical, apical lateral, and apical vertical levels. When at the cervical, cervical lateral, and cervical vertical levels, the linear deviations were 1.53 ± 0.65 mm, 0.98 ± 0.53 mm, and 1.01 ± 0.69 mm, respectively. Angular deviation of all implants was 7.14 ± 3.41°. Implants guided by mucosa + tooth-supported templates showed higher linear deviations at apical vertical level (1.21 ± 0.72 mm vs. 0.86 ± 0.63 mm, p < .05) and cervical vertical level (1.18 ± 0.72 mm vs. 0.87 ± 0.63 mm, p < .05) than mucosa-supported templates, and implants in maxilla were found higher angular deviation than mandible (7.89 ± 3.61° vs. 6.29 ± 2.97°, p < .05). CONCLUSIONS The partially guided template served as clinically viable surgical assistance in implant placement in edentulous patients. When using mucosa + tooth-supported template or placing implants in maxilla, more caution was required, especially in biologically vital areas.
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Affiliation(s)
- Baixiang Wang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Jiakang Yang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Lixuen Siow
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Yu Wang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Xinyue Zhang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Yiqun Zhou
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Mengfei Yu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Huiming Wang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
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Ma J, Zhang B, Song H, Wu D, Song T. Accuracy of digital implant impressions obtained using intraoral scanners: a systematic review and meta-analysis of in vivo studies. Int J Implant Dent 2023; 9:48. [PMID: 38055096 DOI: 10.1186/s40729-023-00517-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 11/28/2023] [Indexed: 12/07/2023] Open
Abstract
PURPOSE This systematic review aimed to investigate the accuracy of intraoral scan (IOS) impressions of implant-supported restorations in in vivo studies. METHODS A systematic electronic search and review of studies on the accuracy of IOS implant impressions were conducted to analyze the peer-reviewed literature published between 1989 and August 2023. The bias analysis was performed by two reviewers. Data on the study characteristics, accuracy outcomes, and related variables were extracted. A meta-analysis of randomized control trials was performed to investigate the impact of IOS on peri-implant crestal bone loss and the time involved in the impression procedure. RESULTS Ten in vivo studies were included in this systematic review for final analysis. Six studies investigated the trueness of IOS impressions, but did not reach the same conclusions. One study assessed the precision of IOS impressions for a single implant. Four clinical studies examined the accuracy of IOS implant impressions with a follow-up of 1-2 years. In full arches, IOS impression procedure needed significantly less time than conventional one (mean difference for procedure time was 8.59 min [6.78, 10.40 min], P < 0.001), prosthetic survival rate was 100%, and marginal bone levels of all participants could be stably maintained (mean difference in marginal bone loss at 12 months was 0.03 mm [-0.08, 0.14 mm], P = 0.55). CONCLUSIONS The accuracy of IOS impressions of implant-supported restorations varied greatly depending on the scanning strategy. The trueness and precision of IOS in the partial and complete arches remain unclear and require further assessment. Based on follow-up clinical studies, IOS impressions were accurate in clinical practice. However, these results should be interpreted with caution, as some evidences are obtained from the same research group.
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Affiliation(s)
- Jie Ma
- Department of Implant Dentistry, Shanghai Xuhui District Dental Center, No.500 Fenglin Road, Shanghai, 200032, China
| | - Binghua Zhang
- Department of Implant Dentistry, Shanghai Xuhui District Dental Center, No.500 Fenglin Road, Shanghai, 200032, China
| | - Hao Song
- Department of Oral Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Dongle Wu
- Department of Implant Dentistry, Shanghai Xuhui District Dental Center, No.500 Fenglin Road, Shanghai, 200032, China
| | - Tao Song
- Department of Implant Dentistry, Shanghai Xuhui District Dental Center, No.500 Fenglin Road, Shanghai, 200032, China.
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Li P, Chen J, Li A, Luo K, Xu S, Yang S. Accuracy of autonomous robotic surgery for dental implant placement in fully edentulous patients: A retrospective case series study. Clin Oral Implants Res 2023; 34:1428-1437. [PMID: 37855331 DOI: 10.1111/clr.14188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 09/17/2023] [Accepted: 09/19/2023] [Indexed: 10/20/2023]
Abstract
OBJECTIVES This study evaluated the accuracy of dental implant placement using the robotic computer-assisted implant surgery (r-CAIS) technology in fully edentulous patients. MATERIALS AND METHODS Fully edentulous and terminal dentition patients were enrolled for r-CAIS technology. Based on the cone-beam computed tomography (CBCT) examination, a customized positioning marker and a preoperative surgical plan were created before surgery. During the implant surgery, the implant osteotomy and placement were automatically performed using an autonomous robotic surgery system under the surgeon's supervision. A postoperative CBCT scan was used to determine the discrepancies between the planned and placed implants. RESULTS Ten patients with 59 implants underwent autonomous robotic surgery. No adverse surgical events occurred. The deviations of global coronal, global apical, and angular were 0.67 ± 0.37 mm (95% CI: 0.58-0.77 mm), 0.69 ± 0.37 mm (95% CI: 0.59-0.78 mm), and 1.27° ± 0.59° (95% CI: 1.42°-1.11°), respectively. CONCLUSIONS The autonomous r-CAIS technology proved an accurate surgical approach for implant placement in fully edentulous patients due to the control of the angular deviation. Autonomous robotic surgery seems promising as an accurate technology for treating fully edentulous patients. However, further trials are required to provide more hard clinical evidence.
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Affiliation(s)
- Ping Li
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
- Department of Prosthodontics, School and Hospital of Stomatology, Guangzhou Medical University, Guangzhou, Guangdong, China
- School and Hospital of Stomatology, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Jiahao Chen
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
- Department of Stomatology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - An Li
- Department of Periodontology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Ke Luo
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Shulan Xu
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Shuo Yang
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
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Ashraf Y, Abo El Fadl A, Hamdy A, Ebeid K. Effect of different intraoral scanners and scanbody splinting on accuracy of scanning implant-supported full arch fixed prosthesis. J ESTHET RESTOR DENT 2023; 35:1257-1263. [PMID: 37310208 DOI: 10.1111/jerd.13070] [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: 01/31/2023] [Revised: 05/30/2023] [Accepted: 05/31/2023] [Indexed: 06/14/2023]
Abstract
OBJECTIVE This study evaluated the accuracy of different intraoral scanners (IOS) for scanning of implant-supported full arch fixed prosthesis with different implant angulations with and without scanbodies splinting. MATERIALS AND METHODS Two maxillary models were designed and fabricated to receive an all-on-four implant retained. The models were divided into two groups according to the angulation of the posterior implant (Group 1; 30 and Group 2; 45). Each group was then divided into three subgroups according to the type of IOS used: Subgroup C; Primescan, subgroup T; Trios4, and subgroup M; Medit i600. Then each subgroup was divided into two divisions according to scanning technique; division S: splinted and division N: nonsplinted. Ten scans were made by each scanner for every division. Trueness and precision were analyzed using Geomagic controlX analysis software. RESULTS Angulation had no significant effect on both the trueness (p = 0.854) and precision (p = 0.347). Splinting had a significant effect on trueness and precision (p < 0.001). Scanner type had a significant effect on trueness (p < 0.001) and precision (p < 0.001). There was no significant difference between trueness of Trios 4 (112.15 ± 12.85) and Primescan (106.75 ± 22.58). However, there was a significant difference when compared to trueness of Medit i600 (158.50 ± 27.65). For the precision results Cerec Primescan showed the highest precision (95.45 ± 33.21). There was a significant difference between the three scanners, precision of Trios4 (109.72 ± 19.24) and Medit i600 (121.21 ± 17.26). CONCLUSION Cerec Primescan has higher trueness and precision than Trios 4 and Medit i600 in full arch implants scanning. Splinting the scanbodies improve the accuracy of full arch implants scanning. CLINICAL SIGNIFICANCE Cerec Primescan and 3Shape Trios 4 can be used for scanning of All-on-four implant supported prosthesis when scanbodies are splinted using a modular chain device.
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Affiliation(s)
- Yasmine Ashraf
- Department of Fixed Prosthodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Ahmad Abo El Fadl
- Department of Fixed Prosthodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Amina Hamdy
- Department of Fixed Prosthodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Kamal Ebeid
- Department of Fixed Prosthodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
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17
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Abdelrehim A, Sulaiman E, Sofian H, Salleh NM. Effect of geometric heterogeneity using an auxiliary device on the accuracy of complete arch implant scanning: An in vitro study of different clinical simulations. J Prosthet Dent 2023:S0022-3913(23)00692-3. [PMID: 37980225 DOI: 10.1016/j.prosdent.2023.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 10/15/2023] [Accepted: 10/16/2023] [Indexed: 11/20/2023]
Abstract
STATEMENT OF PROBLEM Intraoral scanning of implants supporting complete arch prostheses is limited because of the lack of geometric heterogeneity and unique reference points, creating inherent errors in the image stitching process by the scanner software program. PURPOSE The purpose of this in vitro study was to evaluate the significance of geometric heterogeneity on complete arch implant scanning by using a novel auxiliary geometric device. Three different clinical simulations were tested to assess its significance. The study also assessed whether scans produced using the auxiliary device would meet a clinically acceptable threshold. MATERIAL AND METHODS A total of 60 scans (n=20) were performed using an intraoral scanner in 3 different clinical simulations: 2 parallel implants, 4 parallel implants, and 4 implants with a 30-degree posterior angulation of the distal implants. Scanning alternated between using the auxiliary geometric scanning device (test groups; 4IP+, 4IA+, 2IP+) and not using the device (control groups; 4IP-, 4IA-, 2IP-). A reference scan for each model was prepared from a high precision laboratory scanner. The scans were analyzed for accuracy in 3-dimensional deviation, interimplant distance deviation, and angular deviation by using an inspection software program. The effect of the auxiliary device was statistically analyzed by comparing scans of the same group using the paired t test for normally distributed data and the Wilcoxon Signed Rank test when data were not normally distributed (α=.05). RESULTS Significant effects of the auxiliary geometric device were found in 3-dimensional, distance and angular deviations (P<.05). Scans performed using the device were significantly more accurate in most implant positions (P<.05). Linear and angular deviations were clinically acceptable for all test groups. However, the deviations were above the clinically acceptable threshold for the control groups. CONCLUSIONS Using an auxiliary geometric device significantly improved scanning accuracy and produced scans with clinically acceptable deviations, while standard digital scans exceeded the accepted clinical threshold.
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Affiliation(s)
- Aly Abdelrehim
- Graduate student, Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya (UM), Kuala Lumpur, Malaysia
| | - Eshamsul Sulaiman
- Associate Professor, Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya (UM), Kuala Lumpur, Malaysia
| | - Hazrina Sofian
- Senior Lecturer, Department of Software Engineering, Faculty of Computer Science & Information Technology, Universiti Malaya (UM), Kuala Lumpur, Malaysia
| | - Nosizana Mohd Salleh
- Associate Professor, Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya (UM), Kuala Lumpur, Malaysia.
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Happe A, Blender SM, Luthardt RG, Rudolph H, Kuhn K. Digital Evaluation of Vertical Ridge Augmentation with the Modified Shell Technique Using a Xenogeneic Bone Lamina: A Case Series. J Clin Med 2023; 12:7013. [PMID: 38002627 PMCID: PMC10671913 DOI: 10.3390/jcm12227013] [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: 10/02/2023] [Revised: 10/18/2023] [Accepted: 11/06/2023] [Indexed: 11/26/2023] Open
Abstract
Vertical ridge augmentation is a demanding and technique-sensitive surgical procedure. In the present case series, cone beam CT (CBCT) scans from the clinical routine of patients treated using a novel approach for vertical bone augmentation were assessed. All patients showed a single-tooth class 5 defect and were treated using a modification of the original shell technique. Cortical bone plates were replaced with a lamina composed of a partially demineralized porcine xenograft. CBCT scans of six consecutive patients were treated with the lamina and particulate bone from the mandibular ramus prior to a single tooth implant in the anterior maxilla were included. Pre- and postsurgical CBCT data sets were superimposed and analyzed digitally using surface matching and Boolean subtraction. The volume of the grafted area was calculated with and without the xenograft. The vertical gain of the ridge height measured in this case series varied from 7 to 11.3 mm. The mean vertical gain was 8.97 mm. The mean volume including the xenograft was 382.59 mm3 (SD 73.39) and 250.84 mm3 (SD 53.67) without the lamina. The modified shell technique used in this case series for the vertical augmentation of single-tooth class 5 defects provided sufficient bone for single implant restorations.
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Affiliation(s)
- Arndt Happe
- Department of Prosthetic Dentistry, Center of Dentistry University of Ulm, 89081 Ulm, Germany; (S.M.B.); (R.G.L.); (H.R.); (K.K.)
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Tarce M, Becker K, Lahoud P, Shujaat S, Jacobs R, Quirynen M. Non-invasive oral implant position assessment: An ex vivo study using a 3D industrial scan as the reference model to mimic the clinical situation. Clin Oral Implants Res 2023. [PMID: 37927146 DOI: 10.1111/clr.14206] [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: 07/31/2023] [Revised: 10/17/2023] [Accepted: 11/01/2023] [Indexed: 11/07/2023]
Abstract
AIM To introduce an objective method to evaluate the accuracy of implant position assessment in partially edentulous patients by comparing different techniques (conventional impression, intraoral scan, CBCT) to a reference 3D model obtained with an industrial scanner, the latter mimicking the clinical situation. MATERIALS AND METHODS Twenty-nine implants were placed in four human cadaver heads using a fully guided flapless protocol. Implant position was assessed using (a) a conventional impression, (b) an intraoral scan, and (c) CBCT and compared to an industrial scan. Three-dimensional models of intraoral scan body and implant were registered to the arch models and the deviation at implant shoulder, apex, and the angle of deviation were compared to each other as well as to the reference model. RESULTS The three assessment techniques showed statistically significant deviations (p < .01) from the industrial scan, for all measurements, with no difference between the techniques. The maximum deviation at the implant shoulder was 0.16 mm. At the implant apex this increased to 0.38 mm. The intraoral scan deviated significantly more than the CBCT (0.12 mm, p < .01) and the conventional impression (0.10 mm, p = .02). The maximum implant angle deviation was 1.0°. The intraoral scan deviated more than the conventional impression (0.3°, p = .02). CONCLUSION All assessment techniques deviated from the reference industrial scan, but the differences were relatively small. Intraoral scans were slightly less accurate than both conventional impressions and CBCT. Depending on the application, however, this inaccuracy may not be clinically relevant.
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Affiliation(s)
- Mihai Tarce
- Division of Periodontology & Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
- Periodontology and Oral Microbiology, Department of Oral Health Sciences, Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - Kathrin Becker
- Charité- Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Orthodontics and Dentofacial Orthopedics, Berlin, Germany
| | - Pierre Lahoud
- Periodontology and Oral Microbiology, Department of Oral Health Sciences, Faculty of Medicine, KU Leuven, Leuven, Belgium
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium
- Department of Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Sohaib Shujaat
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium
- Department of Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- King Abdullah International Medical Research Center, Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
| | - Reinhilde Jacobs
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium
- Department of Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Marc Quirynen
- Periodontology and Oral Microbiology, Department of Oral Health Sciences, Faculty of Medicine, KU Leuven, Leuven, Belgium
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Manfredini M, Poli PP, Maiorana C, Salina FE, Tandurella M, Beretta M. Computer Aided Full Arch Restoration by Means of One-Piece Implants and Stackable Guide: A Technical Note. Dent J (Basel) 2023; 11:256. [PMID: 37999020 PMCID: PMC10670089 DOI: 10.3390/dj11110256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 10/22/2023] [Accepted: 10/30/2023] [Indexed: 11/25/2023] Open
Abstract
This technical note aims to present a recently developed computer-guided protocol characterized by titanium-reinforced stackable surgical guides during post-extractive implant placement and subsequent immediate loading. A full maxillary edentulism was rehabilitated with one-piece implants, starting from a pre-existing removable denture. 3D digital scans of the removable denture and upper and lower arches were performed. On this basis, a prototype with ideal esthetic and functional outcomes was realized and replicated into a custom-made radiological stent with markers. The superimposition of STL and DICOM files allowed virtual planning of one-piece implants in the ideal prosthetically driven position. The stackable guides, composed of a fixed base template and additional removable components, were then realized. The fixed template, initially secured with anchor pins to the bone, was no longer removed. The removable components, which were screwed to the base template, were used to perform implant surgery and immediate prosthetic loading. No surgical complications occurred, the implants achieved a minimum insertion torque of 35 Ncm, and immediate prosthetic loading was performed. The base template allowed for the maintenance of a fixed reference during the entire workflow, improving the transition between the digital project, the surgical procedure, and the prosthetic rehabilitation.
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Affiliation(s)
- Mattia Manfredini
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy; (M.M.); (C.M.); (F.E.S.); (M.T.); (M.B.)
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Pier Paolo Poli
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy; (M.M.); (C.M.); (F.E.S.); (M.T.); (M.B.)
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Carlo Maiorana
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy; (M.M.); (C.M.); (F.E.S.); (M.T.); (M.B.)
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Federica Eugenia Salina
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy; (M.M.); (C.M.); (F.E.S.); (M.T.); (M.B.)
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Marco Tandurella
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy; (M.M.); (C.M.); (F.E.S.); (M.T.); (M.B.)
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Mario Beretta
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy; (M.M.); (C.M.); (F.E.S.); (M.T.); (M.B.)
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
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21
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Ma L, Ye M, Wu M, Chen X, Shen S. A retrospective study of dynamic navigation system-assisted implant placement. BMC Oral Health 2023; 23:759. [PMID: 37838655 PMCID: PMC10576318 DOI: 10.1186/s12903-023-03481-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 10/03/2023] [Indexed: 10/16/2023] Open
Abstract
BACKGROUND To evaluate the accuracy of implant placement assisted by a dynamic navigation system, as well as its influencing factors and learning curve. METHODS At Macao We Care Dental Center, 55 cases of implant placement using dynamic navigation were retrospectively evaluated. To evaluate their accuracy, the apex, tip, and angle deviations of preoperatively planned and postoperatively placed implants were measured. The effects of the upper and lower jaws, different sites or lateral locations of dental implants, and the length and diameter of the implants on accuracy were analyzed, as well as the variation in accuracy with the increase in the number of surgical procedures performed by dentists. RESULTS The implant had an apex deviation of 1.60 ± 0.94 mm, a tip deviation of 1.83 ± 1.03 mm, and an angle deviation of 3.80 ± 2.09 mm. Statistical differences were observed in the tip deviation of implants at different positions based on three factors: jaw position, lateral location, and tooth position (P < 0.05). The tip deviation of the anterior teeth area was significantly greater than those of the premolar and molar areas. There were no statistically significant differences in apex deviation, tip deviation, or angle deviation between the implants of different diameters and lengths (P > 0.05). There were significant differences in the angle deviation between the final 27 implants and the first 28 implants. Learning curve analysis revealed that angle deviation was negatively correlated with the number of surgical procedures, whereas the regression of apex deviation and tip deviation did not differ statistically. CONCLUSIONS The accuracy of dynamic navigation-assisted dental implants meets the clinical needs and is higher than that of traditional implants. Different jaw positions, lateral locations, and implant diameters and lengths had no effect on the accuracy of the dental implants guided by the dynamic navigation system. The anterior teeth area had a larger tip deviation than the posterior teeth area did. As the number of dynamic implantation procedures performed by the same implant doctor increased, the angle deviation gradually decreased.
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Affiliation(s)
- Lijuan Ma
- Department of Stomatology, Affiliated Stomatological Hospital of Jinan University (Daliang Hospital Shunde District Foshan City), Foshan City, 528399, Guangdong Province, China
| | - Mingjun Ye
- School of Stomatology, Jinan University, Guangzhou City, 510620, Guangdong Province, China
| | - Mingle Wu
- Department of Stomatology, Affiliated Stomatological Hospital of Jinan University (Daliang Hospital Shunde District Foshan City), Foshan City, 528399, Guangdong Province, China
| | - Xiaolei Chen
- School of Stomatology, Jinan University, Guangzhou City, 510620, Guangdong Province, China
| | - Shan Shen
- Department of Stomatology, The First Affiliated Hospital of Jinan University, No. 613, Huangpu Avenue West, Tianhe District, Guangzhou, 510632, Guangdong Province, China.
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Mäntynen P, Laurila M, Strausz T, Mauno J, Leikola J, Suojanen J. Use of Individually Designed CAD/CAM Suprastructures for Dental Reconstruction in Patients with Cleft Lip and Palate. Dent J (Basel) 2023; 11:212. [PMID: 37754332 PMCID: PMC10528161 DOI: 10.3390/dj11090212] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/01/2023] [Accepted: 09/07/2023] [Indexed: 09/28/2023] Open
Abstract
This patient series reports the outcomes of CAD/CAM prosthetic reconstructions in patients with cleft lip and palate (n = 9, aged 27 to 76) who have experienced significant failure with conventional restorative and fixed prosthodontic treatments. The objective of the protocol is to establish a functional and patient-friendly prosthetic structure for individuals with unilateral/bilateral cleft lip and palate (UCLP/BCLP) while minimising the requirement for specialised follow-up care in the cleft unit. The study data were obtained from a retrospective cohort at Helsinki University Hospital. Prosthetic reconstructions were performed using CAD/CAM bar structures by the Atlantis 2in1 system or Createch removable telescope structures, supported by four to eight maxillary dental implants. Out of the nine patients, seven experienced no complications. One prosthesis fracture occurred after 16 months due to a design error in the original framework, and one patient experienced failure of osseointegration in a dental fixture (specifically, one fixture out of the eight maxillary implants in this patient). In total, 56 implants were successfully placed. The maxillary dentition of elderly patients with cleft lip and palate often poses challenges due to periodontal and reconstructive issues. An implant-supported CAD/CAM bar with a removable telescope suprastructure offers an easily maintained and functional solution for dental rehabilitation.
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Affiliation(s)
- Pilvi Mäntynen
- Päijät-Häme Joint Authority for Health and Wellbeing, Department of Oral and Maxillofacial Surgery, Lahti Central Hospital, 15850 Lahti, Finland; (M.L.); (J.S.)
- Clinicum, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland
| | - Marisa Laurila
- Päijät-Häme Joint Authority for Health and Wellbeing, Department of Oral and Maxillofacial Surgery, Lahti Central Hospital, 15850 Lahti, Finland; (M.L.); (J.S.)
| | - Tommi Strausz
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, 00014 Helsinki, Finland
| | - Jari Mauno
- Cleft Palate and Craniofacial Centre, Department of Plastic Surgery, HUS Helsinki University Hospital and University of Helsinki, 00029 Helsinki, Finland; (J.M.); (J.L.)
| | - Junnu Leikola
- Cleft Palate and Craniofacial Centre, Department of Plastic Surgery, HUS Helsinki University Hospital and University of Helsinki, 00029 Helsinki, Finland; (J.M.); (J.L.)
| | - Juho Suojanen
- Päijät-Häme Joint Authority for Health and Wellbeing, Department of Oral and Maxillofacial Surgery, Lahti Central Hospital, 15850 Lahti, Finland; (M.L.); (J.S.)
- Clinicum, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland
- Cleft Palate and Craniofacial Centre, Department of Plastic Surgery, HUS Helsinki University Hospital and University of Helsinki, 00029 Helsinki, Finland; (J.M.); (J.L.)
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23
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Takács A, Marada G, Turzó K, Nagy Á, Németh O, Mijiritsky E, Kivovics M, Mühl A. Does implant drill design influence the accuracy of dental implant placement using static computer-assisted implant surgery? An in vitro study. BMC Oral Health 2023; 23:575. [PMID: 37596610 PMCID: PMC10439617 DOI: 10.1186/s12903-023-03297-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 08/09/2023] [Indexed: 08/20/2023] Open
Abstract
BACKGROUND The purpose of this in vitro study was to compare the accuracy of implant placement in model surgeries according to the design of the drills (straight drills or step drills) used to finalize the implant bed during pilot-guided static computer-assisted implant surgery (sCAIS). METHODS Model surgeries were carried out on resin models randomly assigned to three study groups. Virtual planning software (coDiagnostiX 10.6, Dental Wings, Montreal, Canada) was used to plan the implant positions. In Groups 1 and 2, pilot-guided sCAIS was performed. Straight drills were used in Group 1, and step drills were used in Group 2 to finalize the implant beds. In Group 3, fully guided sCAIS was performed using a universal fully guided kit (RealGUIDE Full Surgical Kit 3DIEMME, RealGUIDE, Cantù, Como, Italy). A total of 90 dental implants (Callus Pro, Callus Implant Solutions GmbH, Nuremberg, Germany) were placed (six implants per model, five models per study group). The primary outcome variables (angular deviation, coronal global deviation, and apical global deviation) were calculated for all implants based on the comparison of the preoperative surgical plan with the postoperative scans. RESULTS Group 2 (coronal global deviation, 0.78 ± 0.29 mm; apical global deviation, 1.02 ± 0.56 mm) showed significantly lower values of both global deviation variables than Group 1 (coronal global deviation, 0.95 ± 0.20 mm; apical global deviation, 1.42 ± 0.49 mm). However, there was no significant difference in angular deviation between Groups 1 and 2 (7.56 ± 2.92° and 6.44 ± 2.84°). Group 3 produced significantly lower values of all three primary outcome variables (angular deviation, 2.36 ± 0.90°; coronal global deviation, 0.59 ± 0.28 mm; apical global deviation, 0.90 ± 0.29 mm) than Group 1 and significantly lower angular deviation and coronal global deviation values than Group 2. CONCLUSIONS The design of the drills used to finalize implant osteotomies during pilot-guided sCAIS influences dental implant placement accuracy. Using step drills instead of straight drills for final osteotomies decreases deviation from the surgical plan. The fully guided approach performed better than the pilot-guided sCAIS.
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Affiliation(s)
- Anna Takács
- Department of Community Dentistry, Semmelweis University, Szentkirályi utca 40, Budapest, 1088, Hungary
| | - Gyula Marada
- Dental School, Medical Faculty, University of Pécs, Tüzér utca 1, Pécs, 7623, Hungary
| | - Kinga Turzó
- Dental School, Medical Faculty, University of Pécs, Tüzér utca 1, Pécs, 7623, Hungary
| | - Ákos Nagy
- Dental School, Medical Faculty, University of Pécs, Tüzér utca 1, Pécs, 7623, Hungary
| | - Orsolya Németh
- Department of Community Dentistry, Semmelweis University, Szentkirályi utca 40, Budapest, 1088, Hungary
| | - Eitan Mijiritsky
- Department of Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, School of Medicine, Tel-Aviv University, Tel Aviv, 64239, Israel
- Goldschleger School of Dental Medicine, Faculty of Medicine, Tel-Aviv University, Tel Aviv, 39040, Israel
| | - Márton Kivovics
- Department of Community Dentistry, Semmelweis University, Szentkirályi utca 40, Budapest, 1088, Hungary.
| | - Attila Mühl
- Dental School, Medical Faculty, University of Pécs, Tüzér utca 1, Pécs, 7623, Hungary
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24
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Zhang YJ, Qian SJ, Lai HC, Shi JY. Accuracy of photogrammetric imaging versus conventional impressions for complete arch implant-supported fixed dental prostheses: A comparative clinical study. J Prosthet Dent 2023; 130:212-218. [PMID: 34776266 DOI: 10.1016/j.prosdent.2021.09.035] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 09/29/2021] [Accepted: 09/29/2021] [Indexed: 11/18/2022]
Abstract
STATEMENT OF PROBLEM Clinical studies on the accuracy of the photogrammetric imaging technique for complete arch implant-supported fixed dental prostheses are lacking. PURPOSE The purpose of this clinical study was to evaluate the accuracy (trueness) of photogrammetric imaging for complete arch implant-supported prostheses by comparing photogrammetric imaging with verified conventional splinted impressions. MATERIAL AND METHODS Completely edentulous arches with at least 4 implants were included. Both photogrammetric imaging and conventional splinted impressions were performed in each jaw. The conventional casts were verified and scanned by using a laboratory scanner as the control. The distances and angulations between different implants (interimplant distances and interimplant angulations) were measured in all photogrammetric and conventional standard tessellation language (STL) files by using a reverse-engineering software program. The distance deviations between the photogrammetric and conventional impressions of the same participant were calculated as the primary outcome, and the angular deviations were obtained as the secondary outcome with descriptive analyses. The comparison between distance deviations and the clinically acceptable level of deviations (150 μm) was conducted by using the 1-sample t test. The effect of interimplant distances, interimplant angulations, and jaw (maxilla or mandible) on deviations was analyzed by using the Spearman correlation analysis, Kruskal-Wallis test, or Student t test, depending on the type of data (α=0.05 for all tests). RESULTS Fourteen edentulous jaws were included. The overall distance deviation of photogrammetric imaging was 70 ±57 μm, significantly lower than the clinically acceptable level of misfit (150 μm; P<.001). The overall angular deviation was 0.432 ±0.348 degrees. The distance deviations were correlated with interimplant distances with a correlation coefficient (r) of 0.371 (P=.002). Interimplant angulation was not correlated with distance or angular deviations (P=.914, P=.914). Jaw was not correlated with distance or angular deviations either (P=.190, P=.209). CONCLUSIONS The accuracy (trueness) of photogrammetric imaging of complete arch implant-supported prostheses was within a clinically acceptable range of errors. Distance deviations increased with greater interimplant distances. Interimplant angulations and jaw (maxilla or mandible) had no significant effect on the accuracy of photogrammetric imaging.
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Affiliation(s)
- Yi-Jie Zhang
- Resident, Department of Implant Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai, PR China
| | - Shu-Jiao Qian
- Attending, Department of Implant Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai, PR China
| | - Hong-Chang Lai
- Professor, Department of Implant Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai, PR China
| | - Jun-Yu Shi
- Attending, Department of Implant Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai, PR China.
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25
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Maoxia W, Anchun M. A digital workflow for the inferior alveolar nerve block in the edentulous mandible. J Prosthet Dent 2023; 130:141-145. [PMID: 34862084 DOI: 10.1016/j.prosdent.2021.10.024] [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: 09/29/2021] [Revised: 10/27/2021] [Accepted: 10/27/2021] [Indexed: 02/05/2023]
Abstract
The inferior alveolar nerve block is the most frequently used anesthetic method for implant placement in the completely edentulous mandible. However, achieving a successful inferior alveolar nerve block in edentulous mandibles is challenging. The present clinical report describes a novel digital workflow for precise local anesthetic injections at the mandibular foramen.
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Affiliation(s)
- Wang Maoxia
- Doctoral student, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
| | - Mo Anchun
- Professor, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China.
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26
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Vieira SNV, Lourenço MF, Pereira RC, França EC, Vilaça ÊL, Silveira RR, Silva GC. Conventional and Digital Impressions for Fabrication of Complete Implant-Supported Bars: A Comparative In Vitro Study. MATERIALS (BASEL, SWITZERLAND) 2023; 16:ma16114176. [PMID: 37297310 DOI: 10.3390/ma16114176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 05/31/2023] [Accepted: 06/02/2023] [Indexed: 06/12/2023]
Abstract
Obtaining accurate models and well-fitting prostheses during the fabrication of complete implant-supported prostheses has been a significant challenge. Conventional impression methods involve multiple clinical and laboratory steps that can lead to distortions, potentially resulting in inaccurate prostheses. In contrast, digital impressions may eliminate some of these steps, leading to better-fitting prostheses. Therefore, it is important to compare conventional and digital impressions for producing implant-supported prostheses. This study aimed to compare the quality of digital intraoral and conventional impressions by measuring the vertical misfit of implant-supported complete bars obtained using both types of techniques. Five digital impressions using an intraoral scanner and five impressions using elastomer were made in a four-implant master model. The plaster models produced with conventional impressions were scanned in a laboratory scanner to obtain virtual models. Screw-retained bars (n = five) were designed on the models and milled in zirconia. The bars fabricated using digital (DI) and conventional (CI) impressions were screwed to the master model, initially with one screw (DI1 and CI1) and later with four screws (DI4 and CI4), and were analyzed under a SEM to measure the misfit. ANOVA was used to compare the results (p < 0.05). There were no statistically significant differences in the misfit between the bars fabricated using digital and conventional impressions when screwed with one (DI1 = 94.45 µm vs. CI1 = 101.90 µm: F = 0.096; p = 0.761) or four screws (DI4 = 59.43 µm vs. CI4 = 75.62 µm: F = 2.655; p = 0.139). Further, there were no differences when the bars were compared within the same group screwed with one or four screws (DI1 = 94.45 µm vs. DI4 = 59.43 µm: F = 2.926; p = 0.123; CI1 = 101.90 µm vs. CI4 = 75.62 µm: F = 0.013; p = 0.907). It was concluded that both impression techniques produced bars with a satisfactory fit, regardless of whether they were screwed with one or four screws.
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Affiliation(s)
- Samanta N V Vieira
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | | | | | - Esdras C França
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Ênio L Vilaça
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Rodrigo R Silveira
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Guilherme C Silva
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
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27
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Troncoso-Pazos J, Matamala P, Jusari MF, Risco K, Aguilera FR, Aravena PC. Position of digitally guided implants in completely edentulous maxillae by using a modified double-scan and overlap of three digital surface protocol. J Prosthet Dent 2023:S0022-3913(23)00224-X. [PMID: 37188614 DOI: 10.1016/j.prosdent.2023.03.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 02/28/2023] [Accepted: 03/01/2023] [Indexed: 05/17/2023]
Abstract
STATEMENT OF PROBLEM In patients with a completely edentulous maxilla, the variability in resilience and mucosal thickness and the lack of teeth and rigid supporting structures may lead to poor adaptation of the surgical guide and significant variation in the definitive implant position. Whether a modified double-scan technique with overlap of surfaces will improve implant placement is unclear. PURPOSE The purpose of this prospective clinical study was to evaluate the 3-dimensional position and the correlation of 6 dental implants in participants with a completely edentulous maxilla using a mucosa-supported flapless surgical guide designed with 3 matched digital surfaces obtained with a modified double-scan protocol. MATERIAL AND METHODS Dental implants were installed with an all-on-6 protocol in the edentulous maxilla of participants at the Santa Cruz Public Hospital, Chile. A stereolithographic mucosa-supported template was fabricated from a cone beam computed tomography (CBCT) scan made with a prosthesis with 8 radiopaque ceramic spheres inserted and by scanning the same prosthesis with an intraoral scanner. The mucosa was obtained by digitally casting the relining of the removable complete denture in the design software program. After 4 months, a second CBCT scan was obtained to evaluate the position of the installed implants measured at 3 locations: apical, coronal, platform depth, and angulation. Differences in position between the 6 implants in the completely edentulous maxilla and their linear correlation at the measured points were compared with the Kruskal-Wallis and Spearman correlation tests (α=.05). RESULTS Sixty implants were installed in 10 participants (age 54.3 ±8.2 years; 7 women). The average deviation in the apical axis was 1.02 ±0.9 mm, coronal 0.76 ±0.74 mm, platform depth 0.92 ±0.8 mm, and the major axis angulation of the 6 implants was 2.92 ±3.65 degrees. The implant in the maxillary left lateral incisor region had the most significant deviation in apical and angular points (P<.05). A linear correlation between apical-to-coronal deviations and apical-to-angular deviations was observed for all implants (P<.05). CONCLUSIONS A stereolithographic mucosa-supported guide designed with the overlap of 3 digital surfaces had average dental implant position values similar to those reported by systematic reviews and meta-analyses. In addition, implant position varied based on the location of the implant installation in the edentulous maxilla.
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Affiliation(s)
- Jorge Troncoso-Pazos
- Founder and Director, Make Solid Digital Dental Implant Study Group, Santiago, Chile; and Director, Department of Dental Services, Santa Cruz Hospital, O'Higgins Health Service, Ministry of Health, Government of Chile, Santa Cruz, Chile
| | - Pablo Matamala
- Founder and Director, Make Solid Digital Dental Implant Study Group. Santiago, Chile; and Researcher, El Salvador Hospital, Eastern Metropolitan Health Service, Government of Chile Santiago, Chile
| | - María Francisca Jusari
- Dental Surgeon and Researcher, School of Dentistry, Faculty of Medicine, Austral University of Chile, Valdivia, Chile
| | - Keila Risco
- Dental Surgeon and Researcher, School of Dentistry, Faculty of Medicine, Austral University of Chile, Valdivia, Chile
| | - Felipe-Rodrigo Aguilera
- PhD student, Lab, Molecular Microbiology & Antimicrobials, Department of Pathology & Experimental Therapeutics, Faculty of Medicine, University of Barcelona, Barcelona, Spain; and Assistant Professor, School of Dentistry, Faculty of Medicine, Austral University of Chile, Valdivia, Chile
| | - Pedro Christian Aravena
- Director, Institute of Odontostomatology, Faculty of Medicine, Austral University of Chile, Valdivia, Chile; and Assistant Professor, School of Dentistry, Faculty of Medicine, Austral University of Chile, Valdivia, Chile.
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Chen W, Al-Taezi KA, Chu CH, Shen Y, Wu J, Cai K, Chen P, Tang C. Accuracy of dental implant placement with a robotic system in partially edentulous patients: A prospective, single-arm clinical trial. Clin Oral Implants Res 2023. [PMID: 37167364 DOI: 10.1111/clr.14083] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 04/05/2023] [Accepted: 04/21/2023] [Indexed: 05/13/2023]
Abstract
OBJECTIVES This clinical study aimed to assess the accuracy of implant positions using a robotic system in partially edentulous patients. MATERIALS AND METHODS Twenty-eight partially edentulous patients received 31 implants using the robotic system. Deviations between the planned and placed implants were calculated after surgery. The deviations were compared with objective performance goals (OPGs) from reported studies of fully guided static computer-assisted implant surgery (CAIS) and dynamic CAIS. A multiple linear regression analysis was performed to investigate the possible effects of the type and side of the arch, implant location, and implant dimensions on the deviations. RESULTS The evaluation of 31 implants resulted in a mean angle deviation of 2.81 ± 1.13° (95% confidence interval (CI): 2.40-3.23°), while the 3D deviations at the implant shoulder and apex were 0.53 ± 0.23 mm (95% CI 0.45-0.62 mm) and 0.53 ± 0.24 mm (95% CI 0.44-0.61 mm), respectively. The upper limits of the 95% CI of 3D deviations were lower than those of the corresponding OPGs; however, the angle deviation was similar to that of the OPG. No statistically significant differences were found for the type and side of the arch, implant location, and implant dimensions to the deviations (p > .05). CONCLUSIONS The robotic system appears to achieve higher accuracy in implant positions than static and dynamic CAIS in partially edentulous patients (Chinese Clinical Trial Registry ChiCTR2300067587).
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Affiliation(s)
- Wei Chen
- Department of Oral Implantology, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, China
| | - Khulood Ali Al-Taezi
- Department of Oral Implantology, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China
| | - Catherine Huihan Chu
- Department of Orthodontic, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Yue Shen
- Department of Oral Implantology, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, China
| | - Jin Wu
- Department of Oral Implantology, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, China
| | - Kunzhan Cai
- Department of Oral Implantology, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, China
| | - Peng Chen
- Hangzhou Lancet Robotics Company Ltd, Hangzhou, China
| | - Chunbo Tang
- Department of Oral Implantology, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
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29
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Yang S, Chen J, Li A, Deng K, Li P, Xu S. Accuracy of autonomous robotic surgery for single-tooth implant placement: A case series. J Dent 2023; 132:104451. [PMID: 36781099 DOI: 10.1016/j.jdent.2023.104451] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 02/02/2023] [Accepted: 02/08/2023] [Indexed: 02/13/2023] Open
Abstract
OBJECTIVES This study aimed to investigate the accuracy of the autonomous robotic computer-assisted implant surgery (r-CAIS) for single-tooth implant placement. METHODS Patients with a single missing tooth were enrolled for the autonomous robotic implant surgery. The patients underwent a cone-beam computed tomography (CBCT) scan with a positioning marker. Virtual preoperative implant placement and a drilling plan were created before surgery. The robotic system automatically performed the implant osteotomy and placement intraoperatively under the surgeon's supervision. A postoperative CBCT scan was performed to evaluate the deviations between the planned and placed implants. RESULTS Ten patients with single dental implant placement were enrolled. No adverse surgical events and postoperative complications (i.e., infection and early implant failure) were reported. The autonomous robotic implant surgery exhibited a mean overall coronal deviation of 0.74 mm (95% CI: 0.53 to 0.94 mm), a mean overall apical deviation of 0.73 mm (95% CI: 0.53 to 0.93 mm), and an angular deviation of 1.11° (95% CI: 0.78 to 1.44°), respectively. CONCLUSIONS The high accuracy of autonomous r-CAIS technology in single-tooth implant placement was attributed to the control of the angular deviation and axial errors. CLINICAL SIGNIFICANCE The main findings of this study provide significant evidence to support the autonomous robotic implant surgery system as a potential alternative in dental implant surgery.
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Affiliation(s)
- Shuo Yang
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, China
| | - Jiahao Chen
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, China
| | - An Li
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, China
| | - Ke Deng
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, Prince Philip Dental Hospital, The University of Hong Kong, 34 Hospital Road, Hong Kong SAR 999077, China
| | - Ping Li
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, China.
| | - Shulan Xu
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, China.
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Bathija A, Papaspyridakos P, Finkelman M, Kim Y, Kang K, De Souza AB. Accuracy of static computer-aided implant surgery (S-CAIS) using CAD-CAM surgical templates fabricated from different additive manufacturing technologies. J Prosthet Dent 2023:S0022-3913(23)00191-9. [PMID: 37121851 DOI: 10.1016/j.prosdent.2023.03.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 03/26/2023] [Accepted: 03/28/2023] [Indexed: 05/02/2023]
Abstract
STATEMENT OF PROBLEM Different 3D printers are available for guided implant surgery, but studies that evaluate their source of errors and their cost-effectiveness are lacking. PURPOSE The purpose of this in vitro study was to compare the accuracy of different 3-dimensional (3D) printed surgical templates made using different additive manufacturing technologies and to evaluate the effect of implant location on the accuracy of fully guided implant placement. MATERIAL AND METHODS Fifty partially edentulous maxillary typodonts with edentulous sites in the right second premolar (SP), right lateral incisor (LI), left central incisor (CI), and left first molar (FM) locations were scanned and printed from the standard tessellation language (STL) datasets. The study compared 5 groups for the fabrication of implant surgical templates: Varseo S-Bego (Bego), Polyjet-Stratasys (Poly), Low Force Stereolithography-FormLabs (LFS), P30+-Straumann (P30), and M2-Carbon (M2). After fully guided implant placement, the typodont was scanned, and the 3D implant positions were compared with the master model by superimposing the STL files. Descriptive statistics were calculated for groups and subgroups, and comparisons among the groups and subgroups were conducted via 2-way mixed analysis of variance, Tukey honest significant difference, and post hoc Bonferroni tests (α=.05). RESULTS The results were site specific and not consistent within each group. For angle deviation, the within-group analysis for P30 demonstrated significantly lower values for implants positioned at site SP (1.4 ±0.8 degrees) than for sites LI (2.3 ±0.7 degrees; P=.001) and CI (2.3 ±0.8 degrees; P=.007). For 3D offset at base for implant CI, LFS was significantly higher than Bego (P=.002), Poly (P=.035), or M2 (P=.001); P30 was also significantly higher than Bego (P=.014) and M2 (P=.006). LFS had a significantly higher 3D offset at the tip than Bego (P=.001) and M2 (P=.022) for implant CI. CONCLUSIONS The choice of 3D printer seemed to influence fully guided implant surgery in terms of the final implant position compared with initial implant planning. However, although statistically significant differences were present across groups, all additive manufacturing technologies were within clinically acceptable values.
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Affiliation(s)
- Anshu Bathija
- Assistant Professor, Department of Prosthodontics, University of New England, Portland, Maine
| | - Panos Papaspyridakos
- Associate Professor, Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass Adjunct Associate Professor, University of Rochester Eastman Institute for Oral Health, Rochester, NY
| | - Matthew Finkelman
- Associate Professor, Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston, Mass
| | - Yongjeong Kim
- Associate Professor, Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass
| | - Kiho Kang
- Professor, Loma Linda University School of Dentistry, Loma Linda, CA
| | - Andre B De Souza
- Adjunct Professor, Department of Periodontology, Nova Southeastern University College of Dental Medicine, Davie, Fla.
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Struwe M, Leontiev W, Connert T, Kühl S, Filippi A, Herber V, Dagassan-Berndt D. Accuracy of a dynamic navigation system for dental implantation with two different workflows and intraoral markers compared to static-guided implant surgery: An in-vitro study. Clin Oral Implants Res 2023; 34:196-208. [PMID: 36626272 DOI: 10.1111/clr.14030] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 11/14/2022] [Accepted: 12/20/2022] [Indexed: 01/11/2023]
Abstract
PURPOSE To investigate the accuracy of a miniaturized dynamic navigation system with intraoral markers and two different workflows for dental implantation and to compare with static computer-assisted implant surgery (sCAIS) surgery. MATERIALS AND METHODS Two operators performed a total of 270 implant insertions in polyurethane mandibular models under simulated clinical conditions. Implants were placed after CBCT-based virtual planning in three different groups: two workflows utilizing dynamic computer-assisted implant surgery (dCAIS; DG1: marker in CBCT; DG2: 3D-printed marker) and the others with sCAIS (TG: template guided). Postoperative surface scans were matched to the planning data and allowed an evaluation of the angular and spatial deviation between the planned and the actually achieved implant position. Descriptive statistics were followed by a Mixed Model Analysis to determine the influence of the operator, the method, and operating area on different accuracy parameters and the random effect of the model number. RESULTS The mean angular deviation ranged from 2.26° (DG1) to 2.96° (TG). The mean 3D deviation at the implant's tip ranged from 1.08 mm (TG) to 1.51 mm (DG2) and at the implant's base from 0.69 mm (TG) to 1.49 mm (DG2). The operator showed no significant influence on the accuracy. The method showed significant influence on singular parameters and the operating area on all spatial accuracy parameters. CONCLUSIONS Dynamic navigation systems with intraoral markers enable accurate implant positioning, which is comparable to the static-guided implant surgery. 3D-printed markers provide less accurate results compared to prefabricated markers, attached before CBCT scan.
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Affiliation(s)
- Maximilian Struwe
- Department of Oral Surgery, University Center for Dental Medicine, University of Basel, Basel, Switzerland
| | - Wadim Leontiev
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
| | - Thomas Connert
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
| | - Sebastian Kühl
- Department of Oral Surgery, University Center for Dental Medicine, University of Basel, Basel, Switzerland
| | - Andreas Filippi
- Department of Oral Surgery, University Center for Dental Medicine, University of Basel, Basel, Switzerland
| | - Valentin Herber
- Department of Oral Surgery, University Center for Dental Medicine, University of Basel, Basel, Switzerland
| | - Dorothea Dagassan-Berndt
- Center for Dental Imaging, University Center for Dental Medicine, University of Basel, Basel, Switzerland
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Jorba-García A, Bara-Casaus JJ, Camps-Font O, Sánchez-Garcés MÁ, Figueiredo R, Valmaseda-Castellón E. Accuracy of dental implant placement with or without the use of a dynamic navigation assisted system: A randomized clinical trial. Clin Oral Implants Res 2023; 34:438-449. [PMID: 36794798 DOI: 10.1111/clr.14050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 01/29/2023] [Accepted: 01/30/2023] [Indexed: 02/17/2023]
Abstract
OBJECTIVES To assess dental implant placement accuracy with a dynamic computer-assisted implant surgery (dCAIS) system and a freehand approach. Secondarily, to compare the patients' perception and quality of life (QoL) with the two approaches. METHODS A double-arm randomized clinical trial was conducted. Consecutive partially edentulous patients were randomly allocated to the dCAIS or standard freehand approach groups. Implant placement accuracy was evaluated by overlapping the preoperative and postoperative Cone Beam Computer Tomographs (CBCT) and recording linear deviations at the implant apex and platform (in mm) and angular deviations (in degrees). Questionnaires recorded self-reported satisfaction, pain and QoL during surgery and postoperatively. RESULTS Thirty patients (22 implants) were enrolled in each group. One patient was lost to follow-up. A significant difference (p < .001) in mean angular deviation was found between the dCAIS (4.02°; 95% CI: 2.85 to 5.19) and the FH (7.97°; 95% CI: 5.36 to 10.58) groups. Linear deviations were significantly lower in the dCAIS group, except for the apex vertical deviation, where no differences were found. Although dCAIS took 14 min longer (95% CI: 6.43 to 21.24; p < .001), patients in both groups considered the surgical time acceptable. Postoperative pain and analgesic consumption during the first postoperative week were similar between groups and self-reported satisfaction was very high. CONCLUSION dCAIS systems significantly increase the accuracy of implant placement in partially edentulous patients in comparison with the conventional freehand approach. However, they increase the surgical time significantly and do not seem to improve patient satisfaction or reduce postoperative pain.
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Affiliation(s)
- Adrià Jorba-García
- Master of Oral Surgery and Implantology, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | | | - Octavi Camps-Font
- Oral Surgery, Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain.,IDIBELL Institute (Bellvitge Biomedical Research Institute), Barcelona, Spain
| | - Maria Ángeles Sánchez-Garcés
- Oral Surgery, Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain.,IDIBELL Institute (Bellvitge Biomedical Research Institute), Barcelona, Spain
| | - Rui Figueiredo
- Oral Surgery, Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain.,IDIBELL Institute (Bellvitge Biomedical Research Institute), Barcelona, Spain
| | - Eduard Valmaseda-Castellón
- Oral Surgery, Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain.,IDIBELL Institute (Bellvitge Biomedical Research Institute), Barcelona, Spain
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Tao B, Feng Y, Fan X, Lan K, Zhuang M, Wang S, Wang F, Chen X, Wu Y. The accuracy of a novel image-guided hybrid robotic system for dental implant placement: An in vitro study. Int J Med Robot 2023; 19:e2452. [PMID: 35946497 DOI: 10.1002/rcs.2452] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 05/31/2022] [Accepted: 08/08/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND This in vitro study aims to evaluate the accuracy of dental implant placement by a novel image-guided hybrid robotic system for dental implant surgery (HRS-DIS). METHODS The HRS-DIS with a 5 degree of freedom (DOF) serial manipulator and a 6 DOF Stewart platform was developed. To evaluate the accuracy of repeated drilling, the holes were prepared twice with a 2.2 mm drill. To evaluate the accuracy of dental implant placement, the entry, exit and angle deviations of dental implants were measured. RESULTS Twenty-four holes were prepared twice, and mean (±SD) of diameters were measured as 2.2 ± 0.02 mm. A total of 160 dental implants were placed in 32 phantoms by HRS-DIS. The mean (±SD) of the entry, exit and angle deviation were 0.8 ± 0.54 mm, 0.87 ± 0.54 mm and 1.0 1 ± 0.44°, respectively. CONCLUSIONS The results of the in vitro study preliminarily validated that the HRS-DIS could provide a high accuracy for dental implant surgery.
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Affiliation(s)
- Baoxin Tao
- Department of Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,College of Stomatology, Shanghai Jiao Tong University, Shanghai, China.,National Center for Stomatology, Shanghai, China.,National Clinical Research Center for Oral Diseases, Shanghai, China.,Shanghai Key Laboratory of Stomatology, Shanghai, China.,Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
| | - Yuan Feng
- School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Xingqi Fan
- Institute of Biomedical Manufacturing and Life Quality Engineering, State Key Laboratory of Mechanical System and Vibration, School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Kengliang Lan
- Department of Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,College of Stomatology, Shanghai Jiao Tong University, Shanghai, China.,National Center for Stomatology, Shanghai, China.,National Clinical Research Center for Oral Diseases, Shanghai, China.,Shanghai Key Laboratory of Stomatology, Shanghai, China.,Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
| | - Minjie Zhuang
- Department of Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,College of Stomatology, Shanghai Jiao Tong University, Shanghai, China.,National Center for Stomatology, Shanghai, China.,National Clinical Research Center for Oral Diseases, Shanghai, China.,Shanghai Key Laboratory of Stomatology, Shanghai, China.,Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
| | - Shigang Wang
- School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Feng Wang
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China.,National Center for Stomatology, Shanghai, China.,National Clinical Research Center for Oral Diseases, Shanghai, China.,Shanghai Key Laboratory of Stomatology, Shanghai, China.,Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China.,Department of Oral Implantology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaojun Chen
- Institute of Biomedical Manufacturing and Life Quality Engineering, State Key Laboratory of Mechanical System and Vibration, School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Yiqun Wu
- Department of Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,College of Stomatology, Shanghai Jiao Tong University, Shanghai, China.,National Center for Stomatology, Shanghai, China.,National Clinical Research Center for Oral Diseases, Shanghai, China.,Shanghai Key Laboratory of Stomatology, Shanghai, China.,Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
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Lanis A, Gallucci G, Pedrinaci I. Full mouth oral rehabilitation of a severely worn dentition based on a fully digital workflow. J ESTHET RESTOR DENT 2023; 35:596-608. [PMID: 36715027 DOI: 10.1111/jerd.13020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 01/09/2023] [Accepted: 01/12/2023] [Indexed: 01/31/2023]
Abstract
OBJECTIVE To demonstrate the use of a complete digital workflow for a full mouth rehabilitation in a severely worn dentition. CLINICAL CONSIDERATIONS The present case report successfully rehabilitated a full-mouth case of a severely worn dentition based on the use of digital technologies, making the diagnosis and treatment process faster, accurate and less expensive. A long-lasting esthetic and functional result are showed after 30-months follow up. CONCLUSIONS An appropriate knowledge on dental erosion and oral rehabilitation, combined with a digital dentistry approach could lead the clinician to deliver a fast, accurate and predictable noninvasive restorative treatment in cases like the one described. CLINICAL SIGNIFICANCE Bruxism-based severely worn dentition is being found more often in population. In this situation, a detailed diagnosis and tailored treatment are mandatory to obtain a predictable treatment outcome. In this sense, the development of adhesive dentistry, new restorative materials and the incorporation of digital technologies can create a predictable synergy to rehabilitate these types of patients with a modern and less invasive approach.
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Affiliation(s)
- Alejandro Lanis
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - German Gallucci
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Ignacio Pedrinaci
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA.,Section of Graduate Periodontology, School of Dentistry, Complutense University of Madrid, Madrid, Spain
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35
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Retentive design of a small surgical guide for implant surgery: An in-vitro study. J Dent 2023; 128:104384. [PMID: 36470471 DOI: 10.1016/j.jdent.2022.104384] [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: 03/21/2022] [Revised: 10/17/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES Instability of the surgical guide is an overlooked factor that can result in a difference between the planned and the actual positions of an implant. Our aim was to compare the stability of the retentive surgical guide (RSG) with a conventional surgical guide (CSG) in an in-vitro experiment. METHODS A platform to evaluate the stability of the surgical guide was designed using 3D-modelling software (Meshmixer 3.5, Autodesk). Imaging data from 15 patients with a single missing tooth were used to plan the virtual implant. Two surgical guides were designed (Blue Sky Plan 4.8, Blue Sky Bio) and 3D printed (Form2, Dental SG resin, Formlabs) for each case: the CSG with the default, predetermined software settings, and the RSG, designed on a dental model with a 0.1-mm undercut and altered production parameters (reduced guide-to-teeth offset of 0.07 mm, reduced guide thickness of 2.3 mm and a retentive clasp in a marginal area). The dental models were reproducibly secured on the testing platform using a digital force gauge, and the surgical guides were positioned. An increasing force of 0.1 N, 1 N, 2.5 N, and 5 N was sequentially applied from the buccal and the oral directions to the surgical guide via a drill handle. For each force, either the magnitude of the guide's displacement was captured with an intra-oral scanner (CEREC Omnicam AC, Dentsply Sirona; software version: SW 4.5.2) or the dislodgement of the guide was recorded. Scans were imported for analysis (GOM Inspect 2018, GOM GmbH), and library files of the surgical guides and implants were superimposed as a joined complex. The deviation of the implant's position was calculated from the displacement of the guide's position RESULTS: Three-way repeated measures using ANOVA revealed a more significant guide displacement and virtually projected implant deviation in the CSG group than the RSG group and with increasing force in all the deviation parameters. Both groups showed greater resistance to the displacement with the force applied from the oral direction than the buccal direction. The application of the force in the buccal direction resulted in guide dislodgements of 13% and 0% for the CSG and RSG, respectively. In the oral direction, the dislodgement rates were 33% and 7% for the CSG and RSG, respectively. CONCLUSIONS Within the limitations of this study, the retentive design increased the stability of the surgical guide and, consequently, the accuracy of the virtually projected implants in comparison to the conventional surgical guide designed using the default settings. Clinical trials are needed to confirm its advantages in clinical use. CLINICAL SIGNIFICANCE With a simple modification to the design, the surgical guide retention provided greater stability, with smaller deviations under loading; this resulted in improved implant precision parameters without requiring additional materials or software. Further studies are needed to assess the clinical feasibility of this surgical guide with improved retention and function.
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Sequeira V, Harper MT, Lilly CL, Bryington MS. Accuracy of Digital Impressions at Varying Implant Depths: An In Vitro Study. J Prosthodont 2023; 32:54-61. [PMID: 35191128 DOI: 10.1111/jopr.13496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 02/08/2022] [Indexed: 01/25/2023] Open
Abstract
PURPOSE Implants placed at variable depths may vary the amount of visible scannable surface of a scan body. Intraoral scanner technology uses advanced optical principles to record the surface of the scan body to accurately capture the implant position. The purpose of this study is to investigate the effect implant placement depth has on the accuracy of digital implant impressions using an intraoral scanner. MATERIALS AND METHODS A partially edentulous gypsum master model was fabricated to allow the positioning of a single implant analog at different depths. Four groups were created based on the planned implant depths of 7, 6, 3, and 0 mm and corresponding visibility of the scan body at 2, 3, 6, and 9 mm. The model was digitized with a laboratory scanner for the reference scan and with an intraoral scanner to generate 15 test scans per group, with a total of 60 scans. The test scans were superimposed onto the reference scan using the best fit algorithm to analyze and measure the positional (dXYZ) and angular deviation (d⍬) of the scan body using three-dimensional metrology software. Statistical analysis was performed using a one-way ANOVA and pairwise comparison was done with a Tukey-Kramer HSD test (α = 0.05). RESULTS The one-way ANOVA of the groups for the dXYZ and dθ parameters was statistically significant (F3,56 = 11.45, p < 0.001, F3,56 = 24.04, p < 0.001). Group D (9 mm) showed the least positional deviation at 38.41 μm (95% CI 30.26; 46.56) and the least angular deviation of 0.17° (95% CI 0.12; 0.21). Group A (2 mm) showed the greatest positional deviation of 77.17 μm (95% CI 65.23; 89.11) and greatest angular deviation of 0.84° (95% CI 0.65; 1.03). The positional and angular deviation increased with increased implant depth. CONCLUSIONS The accuracy of digital impressions is influenced by the implant depth and the amount of visibility of the scan body. The trueness and precision are highest when the implant is placed at 0 mm depth with complete visibility of the scan body and decreases with subgingival implant placement.
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Affiliation(s)
- Vivia Sequeira
- Department of Restorative Dentistry, School of Dentistry, West Virginia University, Morgantown, WA
| | - Matthew T Harper
- Department of Restorative Dentistry, School of Dentistry, West Virginia University, Morgantown, WA
| | - Christa L Lilly
- Department of Epidemiology and Biostatistics, School of Public Health, West Virginia University, Morgantown, WA
| | - Matthew S Bryington
- Department of Restorative Dentistry, School of Dentistry, West Virginia University, Morgantown, WA
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In vitro scan accuracy and time efficiency in various implant-supported fixed partial denture situations. J Dent 2022; 127:104358. [PMID: 36356837 DOI: 10.1016/j.jdent.2022.104358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 11/03/2022] [Accepted: 11/05/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES To compare the accuracy and time efficiency of different digital workflows in 3 implant-supported fixed partial denture situations. METHODS Three partially edentulous maxillary models with 2 implants (Model 1: implants at lateral incisor sites; Model 2: implants at right canine and first molar sites; Model 3: implants at right first premolar and first molar sites) were digitized (ATOS Capsule 200MV120, n=1) for reference scans. Test scans were performed for direct (Primescan (DDW-P) and Trios 3 (DDW-T)) and indirect (IDW) digital workflows (n=14). For IDW, stone casts (type IV) were obtained from vinylsiloxanether impressions and digitized (S600 Arti). The scan/impression and post processing times were recorded. Reference and test scans were superimposed (GOM Inspect) to calculate 3D point, inter-implant distance, and angular deviations. Kruskal-Wallis and Mann-Whitney tests were used for trueness and precision analyses (α=.05). RESULTS Tested workflows affected trueness (P≤.030) and precision (P<.001) of scans (3D point, inter-implant distance, and angular deviations) within models. DDW-P had the highest accuracy (3D point deviations) for models 1 and 3 (P≤.046). IDW had the lowest accuracy for model 2 (P<.01). DDW-P had the highest accuracy (inter-implant distance deviations) for model 3 (P≤.048). Direct digital workflow mostly led to lower angular deviations (P≤.040), and higher precision for models 2 (mesiodistal direction) and 3 (P<.001). The time for direct digital workflow was shorter (P<.001), DDW-P being more efficient than DDW-T (P=.008). CONCLUSION Direct digital workflow was more accurate and efficient than indirect digital workflow in tested partial edentulism situations with 2 implants. CLINICAL SIGNIFICANCE Tested intraoral scanners can be recommended for accurate and efficient impressions of anterior and posterior 3- or 4-unit implant-supported fixed partial dentures.
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38
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Clinical study of precision analysis and deviation control of a domestic guide plate-assisted edentulous implant surgery. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 124:101328. [PMID: 36343903 DOI: 10.1016/j.jormas.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 11/03/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE To evaluate the accuracy of a domestic digital implant guide plate to assist edentulous implant surgery, analyze the sources of deviation, and reduce the deviation of the guide plate. METHODS In total, 14 edentulous patients were selected, and 100 implant sites were measured. The preoperative cone beam computerized tomography (CBCT) data were imported into the software to design and fabricate the guide plate. After implant surgery,the data were imported for 3D reconstruction and alignment model was exported into the Geomagic Studio software for deviation measurement. RESULTS Analysis of the overall accuracy of the domestic guide plate showed deviation of the implant neck center, horizontal direction, implant base center, depth, and angle of 0.83 ± 0.27 mm, 0.39 ± 0.17 mm, 1.11 ± 0.35 mm, 0.45 ± 0.19 mm, and 3.16 ± 1.73°. There were not statistically significant difference (p>0.05) between the tooth/mucosa-supported guide plate and the mucosa-supported, mandibular guide plate and maxillary, vertical implantation and inclined, anterior implant sites and posterior teeth. There was a statistically significant difference (p<0.05) between the use of the modified non-pressure plate tool box and the pressure plate tool box. CONCLUSION First, the domestic implant guide plate can significantly improve the accuracy and efficiency in edentulous implant surgery. Second, the accuracy of the tooth/mucosa-supported guide plate is higher than mucosa-supported guide plate. Third, the accuracy of the new tool box without pressure plate is improved.
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39
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Wei SM, Li Y, Deng K, Lai HC, Tonetti MS, Shi JY. Does machine-vision-assisted dynamic navigation improve the accuracy of digitally planned prosthetically guided immediate implant placement? A randomized controlled trial. Clin Oral Implants Res 2022; 33:804-815. [PMID: 35652362 DOI: 10.1111/clr.13961] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/19/2022] [Accepted: 05/29/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES This randomized controlled clinical trial was designed to compare the accuracy of machine-vision (MV)-based dynamic navigation (DN)-assisted immediate implant placement with the conventional freehand technique. MATERIAL AND METHODS A total of 24 subjects requiring immediate implant placement in maxillary anterior teeth were randomly assigned to either the control (freehand by an experienced surgeon, n = 12) or the test group (MV-DN, n = 12). Implant platform, implant apex, angular, and depth deviations with respect to prosthetically guided digital planning and differences in implant insertion torque (ITV) and implant stability quotient (ISQ) were compared between the groups. RESULTS MV-DN resulted in more accurate immediate implant position: significantly smaller global platform deviation (1.01 ± 0.41 mm vs. 1.51 ± 0.67 mm, p = .038), platform depth deviation (0.44 ± 0.46 mm vs. 0.95 ± 0.68 mm, p = .045), global apex deviation (0.88 ± 0.43 mm vs. 1.94 ± 0.86 mm, p = .001), and lateral apex deviation (0.68 ± 0.30 mm vs. 1.61 ± 0.88 mm, p = .004) were found in MV-DN compared to controls. No significant intergroup differences were observed for ITV and ISQ. CONCLUSIONS MV-DN achieved more precise immediate implant position and comparable primary stability. Further trials are necessary to assess the benefits in terms of esthetics and tissue health/stability.
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Affiliation(s)
- Shi-Min Wei
- Shanghai PerioImplant Innovation Center and Department of Oral and Maxillo-Facial Implantology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Yuan Li
- Shanghai PerioImplant Innovation Center and Department of Oral and Maxillo-Facial Implantology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Ke Deng
- Shanghai PerioImplant Innovation Center and Department of Oral and Maxillo-Facial Implantology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Hong-Chang Lai
- Shanghai PerioImplant Innovation Center and Department of Oral and Maxillo-Facial Implantology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Maurizio S Tonetti
- Shanghai PerioImplant Innovation Center and Department of Oral and Maxillo-Facial Implantology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China.,European Research Group on Periodontology, Genova, Italy
| | - Jun-Yu Shi
- Shanghai PerioImplant Innovation Center and Department of Oral and Maxillo-Facial Implantology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
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40
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Accuracy of DICOM-DICOM vs. DICOM-STL Protocols in Computer-Guided Surgery: A Human Clinical Study. J Clin Med 2022; 11:jcm11092336. [PMID: 35566462 PMCID: PMC9101796 DOI: 10.3390/jcm11092336] [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: 02/25/2022] [Revised: 04/19/2022] [Accepted: 04/20/2022] [Indexed: 02/04/2023] Open
Abstract
Guided implant surgery can enhance implant placement positioning, increasing predictability and decreasing postoperative complications., To date, the best protocol to be used for template realization is still unknown. Thus, the aim herein was to clinically compare the accuracy of two different protocols. A total of 48 implants were divided into Group A (24 implants), in which a stereolithographic template was realized using the digital imaging and communications in medicine (DICOM) data arrived from cone beam computer tomographies (CBCTs) (patients and prothesis alone), and Group B (24 implant), in which a standard intraoral stent with a standardized extraoral support was used for patients’ intraoral impressions and CBCT. The preimplant virtual planning and postsurgery CBCT images of both groups were superimposed, and differences were registered in terms of average deviations at the platform (a) and implant apex (b), mean depth change (c), and angular deviation (d). The results demonstrated that there were no statistically significant differences between groups (p = 0.76) for the parameters measured. However, statistically significant differences (p < 0.05) were found between maxillary and mandible implant surgery, as the latter showed greater accuracy. Additional studies are necessary to further reduce discrepancies between planning and surgical procedures.
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41
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Elliott T, Hamilton A, Griseto N, Gallucci GO. Additively Manufactured Surgical Implant Guides: A Review. J Prosthodont 2022; 31:38-46. [PMID: 35313020 DOI: 10.1111/jopr.13476] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/25/2021] [Indexed: 01/21/2023] Open
Abstract
Static computer assisted implant surgery (s-CAIS) is an integral part of the digital workflow in implant dentistry and provides the link between the virtual planning environment and surgical field. The accuracy of s-CAIS is influenced by many cumulative factors including the fit of the template which is related to the manufacturing process. This critical review provides an overview of the current research on additively manufactured surgical implant guides.
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Affiliation(s)
- Tom Elliott
- Division of Oral Restorative and Rehabilitative Sciences, University of Western Australia, Perth, Western Australia
| | - Adam Hamilton
- Division of Oral Restorative and Rehabilitative Sciences, University of Western Australia, Perth, Western Australia.,Division of Regenerative and Implant Sciences, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA
| | - Neil Griseto
- Division of Regenerative and Implant Sciences, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA
| | - German O Gallucci
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA
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42
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Xiong J, Sun W, Huang B, Ji W, Shi B. Effect of the implant-supported provisional restoration on the accuracy of digital peri-implant mucosa replication - a clinical study. Clin Oral Implants Res 2022; 33:598-606. [PMID: 35290685 DOI: 10.1111/clr.13921] [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: 06/02/2021] [Revised: 03/03/2022] [Accepted: 03/07/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study aimed to quantitatively evaluate the effect of implant-supported provisional restorations (ISPRs) on the accuracy of the intraoral scanned peri-implant soft-tissue profile in the esthetic area. MATERIALS AND METHODS Sixteen patients with a single ISPR in the maxillary central incisor's region were recruited for this study. Three impression methods were sequentially used in each patient: (1) an intraoral scanning (IOS) with the ISPR, (2) a conventional impression using the ISPR as impression coping, and (3) a routine IOS without the ISPR. The stereolithography files of the three impression methods obtained from the same patient were superimposed, and the conventional impression method was used as the reference model. Two-dimensional (2D) and three-dimensional (3D) analyses were performed to measure the peri-implant soft-tissue deviation between the reference models and IOS from the groups with or without the ISPR, respectively. Data were presented as the means ± standard deviations. Two-way analyses of variance with post hoc Sidak's multiple comparisons and paired t-tests were performed for 2D and 3D analyses, respectively. The significance level was set at p<0.05. RESULTS The peri-implant mucosa without the ISPR immediately collapsed (<20 s), particularly on the palatine side of the labial mucosa and labial side of the palatine mucosa. Consequently, the IOS without the ISPR led to 414.7±116.0 μm of overall dimensional deformation in the cuff-like submucosal region, which was significantly larger (p<0.0001) than that in the IOS with the ISPR (230.6±85.5 μm). CONCLUSION ISPRs are important for accurate replication of the intraorally scanned peri-implant soft-tissue profile.
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Affiliation(s)
- Jiabi Xiong
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University.,Department of Implantology, School & Hospital of Stomatology, Wuhan University
| | - Wei Sun
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University.,Department of Implantology, School & Hospital of Stomatology, Wuhan University
| | - Bin Huang
- Department of Implantology, School & Hospital of Stomatology, Wuhan University
| | - Wei Ji
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University.,Department of Implantology, School & Hospital of Stomatology, Wuhan University
| | - Bin Shi
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University.,Department of Implantology, School & Hospital of Stomatology, Wuhan University
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43
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Accuracy of dental implant placement using augmented reality-based navigation, static computer assisted implant surgery, and the free-hand method: An in vitro study In vitro evaluation of accuracy of dental implant placement guided by three distinct navigational methods. J Dent 2022; 119:104070. [DOI: 10.1016/j.jdent.2022.104070] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 02/03/2022] [Accepted: 02/16/2022] [Indexed: 12/17/2022] Open
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44
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Pozzi A, Arcuri L, Lio F, Papa A, Nardi A, Londono J. Accuracy of complete-arch digital implant impression with or without scanbody splinting: an in vitro study. J Dent 2022; 119:104072. [DOI: 10.1016/j.jdent.2022.104072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 02/01/2022] [Accepted: 02/17/2022] [Indexed: 10/19/2022] Open
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45
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Özal Ç, Ulusoy M. In-vitro evaluation of marginal and internal fit of 3-unit monolithic zirconia restorations fabricated using digital scanning technologies. J Adv Prosthodont 2022; 13:373-384. [PMID: 35003553 PMCID: PMC8712113 DOI: 10.4047/jap.2021.13.6.373] [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: 08/11/2021] [Revised: 09/30/2021] [Accepted: 11/15/2021] [Indexed: 11/08/2022] Open
Abstract
PURPOSE This study aimed to compare the marginal and internal fit of 3-unit monolithic zirconia restorations that were designed by using the data obtained with the aid of intraoral and laboratory scanners. MATERIALS AND METHODS For the fabrication of 3-unit monolithic zirconia restorations using impressions taken from the maxillary master cast, plaster cast was created and scanned in laboratory scanners (InEos X5 and D900L). The main cast was also scanned with different intraoral scanners (Omnicam [OMNI], Primescan [PS], Trios 3 [T3], Trios 4 [T4]) (n = 12 per group). Zirconia fixed partial dentures were virtually designed, produced from presintered block, and subsequently sintered. Marginal and internal discrepancy values (in µm) were measured by using silicone replica method under stereomicroscope. Data were statistically analyzed by using 1-way ANOVA and Kruskal Wallis tests (P<.05). RESULTS In terms of marginal adaptation, the measurements on the canine tooth indicated better performance with intraoral scanners than those in laboratory scanners, but there was no difference among intraoral scanners (P<.05). In the premolar tooth, PS had the lowest marginal (86.9 ± 19.2 µm) and axial (92.4 ± 14.8 µm), and T4 had the lowest axio-occlusal (89.4 ± 15.6 µm) and occlusal (89.1 ± 13.9 µm) discrepancy value. In both canine and premolar teeth, the D900L was found to be the most marginally and internally inconsistent scanner. CONCLUSION Within the limits of the study, marginal and internal discrepancy values were generally lower in intraoral scanners than in laboratory scanners. Marginal discrepancy values of scanners were clinically acceptable (< 120 µm), except D900L.
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Affiliation(s)
- Çise Özal
- Department of Prosthodontics, Faculty of Dentistry, Near East University, Nicosia, Turkey
| | - Mutahhar Ulusoy
- Department of Prosthodontics, Faculty of Dentistry, Near East University, Nicosia, Turkey
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46
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Alsharif SB, Bahanan L, Almutairi M, Alshammry S, Khalifa H. Retrospective Assessment of Dental Implant-Related Anatomical Structure Perforations Using Cone Beam Computed Tomography. ANNALS OF DENTAL SPECIALTY 2022. [DOI: 10.51847/jeyoudif94] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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47
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Kunavisarut C, Santivitoonvong A, Chaikantha S, Pornprasertsuk-Damrongsri S, Joda T. Patient-reported outcome measures comparing static computer-aided implant surgery and conventional implant surgery for single-tooth replacement: A randomized controlled trial. Clin Oral Implants Res 2021; 33:278-290. [PMID: 34921690 DOI: 10.1111/clr.13886] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 11/03/2021] [Accepted: 11/29/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare static computer-aided implant surgery (s-CAIS) and conventional implant surgery (CIS) for single-tooth replacement in posterior sites in terms of patient-reported outcome measures (PROMs). METHODS Forty patients were divided into two groups for treatment with s-CAIS (Test) and CIS (Control). Patients' anxiety level was measured using the modified dental anxiety score before implant surgery. After surgery, patients completed two questionnaires for 7 days. The first questionnaire assessed pain level using a visual analog scale (VAS) and the incident rate of pain using a 5-point Likert scale; analgesic intake was also recorded. The second questionnaire investigated patients' oral health-related quality of life (OHRQoL) including postoperative symptoms, oral function, and daily activity. The difference between data was compared at significance level (α = 0.05). RESULTS There was no statistically significant difference in pretreatment dental anxiety level, postoperative pain scores, and OHRQoL between treatment groups. Overall, mild or moderate dental anxiety was reported by 70% and 20% of patients, respectively. Pain score was significantly reduced by postoperative Day 3 in the test group and Day 4 in the control group, compared with baseline. Both groups significant reduced analgesic intake by postoperative Day 5. Most OHRQoL-related complaints subsided approximately 3 days after surgery. CONCLUSIONS Overall, PROMs between s-CAIS and CIS were not significantly different for the single-tooth implant surgery in the posterior area. Postoperative symptoms after implant surgery still inevitably occurred, reflecting the normal process of oral wound healing.
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Affiliation(s)
| | | | - Sarunya Chaikantha
- Department of Oral and Maxillofacial Radiology, Mahidol University, Bangkok, Thailand
| | | | - Tim Joda
- Department of Reconstructive Dentistry, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland
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48
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Huang R, Liu Y, Huang B, Zhou F, Chen Z, Li Z. Improved accuracy of digital implant impressions with newly designed scan bodies: an in vivo evaluation in beagle dogs. BMC Oral Health 2021; 21:623. [PMID: 34876122 PMCID: PMC8650335 DOI: 10.1186/s12903-021-01986-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 11/24/2021] [Indexed: 11/26/2022] Open
Abstract
Background The accuracy of digital impressions for fully edentulous cases is currently insufficient for routinely clinical application. To overcome the challenge, a modified scan body was introduced, which demonstrated satisfactory accuracy in vitro. The aim of this study was to evaluate the accuracy of digital impressions using the modified scan bodies with extensional structure versus scan bodies without extensional structure in mandible with two implants in beagle dogs. Methods The unilateral mandibular second premolar to second molar were extracted in four beagle dogs. Twelve weeks later, two implants were placed. Five repeated digital impressions were performed with an intraoral scanner on each dog using each of the two different scan bodies: Group I—scan body without extensional structure (SB); Group II—scan body with extensional structure (SBE). The scans were exported to Standard Tessellation Language (STL) files to serve as test data. The dogs were sacrificed and the dissected mandibles were digitalized with a lab scanner to provide reference data. Linear and angular deviations were calculated in an inspection software for accuracy assessment. Statistical analysis was performed with two-way ANOVA. The level of significance was set at α = 0.05. Results For trueness assessment, the mean of absolute linear/angular deviations were 119.53 μm/0.75 degrees in Group I and 68.89 μm/0.36 degrees in Group II. SBE was more accurate than SB regarding both linear (p = 0.008) and angular (p = 0.049) deviations. For precision assessment, the mean of absolute linear/angular deviations were 63.01 μm/0.47 degrees in Group I and 38.38 μm/0.24 degrees in Group II. No significant difference was found. Conclusions The application of SBE significantly improved the trueness of digital impressions in mandible with two implants compared to SB. No significant difference was found in terms of precision.
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Affiliation(s)
- Ruoxuan Huang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Stomatology, No. 56, Lingyuan west road, Guangzhou, 510060, China
| | - Yuanxiang Liu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Stomatology, No. 56, Lingyuan west road, Guangzhou, 510060, China
| | - Baoxin Huang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Stomatology, No. 56, Lingyuan west road, Guangzhou, 510060, China
| | | | - Zhuofan Chen
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Stomatology, No. 56, Lingyuan west road, Guangzhou, 510060, China.
| | - Zhipeng Li
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Stomatology, No. 56, Lingyuan west road, Guangzhou, 510060, China.
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Geometric Reproducibility of Three-Dimensional Oral Implant Planning Based on Magnetic Resonance Imaging and Cone-Beam Computed Tomography. J Clin Med 2021; 10:jcm10235546. [PMID: 34884244 PMCID: PMC8658654 DOI: 10.3390/jcm10235546] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 11/22/2021] [Accepted: 11/24/2021] [Indexed: 12/04/2022] Open
Abstract
This study aimed to investigate the geometric reproducibility of three-dimensional (3D) implant planning based on magnetic resonance imaging (MRI) and cone-beam computed tomography (CBCT). Four raters used a backward-planning approach based on CBCT imaging and standard software to position 41 implants in 27 patients. Implant planning was repeated, and the first and second plans were analyzed for geometric differences regarding implant tip, entry-level, and axis. The procedure was then repeated for MRI data of the same patients. Thus, 656 implant plans were available for analysis of intra-rater reproducibility. For both imaging modalities, the second-round 3D implant plans were re-evaluated regarding inter-rater reproducibility. Differences between the modalities were analyzed using paired t-tests. Intra- and inter-rater reproducibility were higher for CBCT than for MRI. Regarding intra-rater deviations, mean values for MRI were 1.7 ± 1.1 mm/1.5 ± 1.1 mm/5.5 ± 4.2° at implant tip/entry-level/axis. For CBCT, corresponding values were 1.3 ± 0.8 mm/1 ± 0.6 mm/4.5 ± 3.1°. Inter-rater comparisons revealed mean values of 2.2 ± 1.3 mm/1.7 ± 1 mm/7.5 ± 4.9° for MRI, and 1.7 ± 1 mm/1.2 ± 0.7 mm/6 ± 3.7° for CBCT. CBCT-based implant planning was more reproducible than MRI. Nevertheless, more research is needed to increase planning reproducibility—for both modalities—thereby standardizing 3D implant planning.
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50
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Kunavisarut C, Jarangkul W, Pornprasertsuk-Damrongsri S, Joda T. Patient-reported outcome measures (PROMs) comparing digital and conventional workflows for treatment with posterior single-unit implant restorations: A randomized controlled trial: PROMs comparing digital & conventional workflows. J Dent 2021; 117:103875. [PMID: 34728252 DOI: 10.1016/j.jdent.2021.103875] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 10/22/2021] [Accepted: 10/26/2021] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVES The aim of this randomized controlled trial (RCT) was to analyze patient-reported outcome measures (PROMs) of prosthetic therapy with monolithic implant crowns in completely digital workflows (test) with intraoral optical scanning (IOS) and conventional workflows (control) with conventional impressions. Secondary, an objective evaluation of the final implant restorations was performed using the Functional Implant Prosthodontic Score (FIPS). MATERIALS AND METHODS Forty patients who required an implant-supported single crown on posterior regions were randomly divided into test (n=20) and control (n=20) groups for impression taking. Each group was then equally separated into two subgroups according to the restorative material used: lithium disilicate (LS2, N!CE®, Straumann AG, Basel, Switzerland) or polymer-infiltrated ceramic networks (PICN, Enamic®, Vita, Bad Säckingen, Germany). Patient satisfaction was evaluated using PROM questionnaires with visual analog scales (VAS) after impression-taking and 1 week after prosthetic delivery. Patient satisfaction with the impression technique was assessed in six domains: length, comfort, anxiety, taste, nausea, and pain, whereas patient satisfaction with the final restoration was assessed in four domains: overall treatment outcome, functionality, esthetics, and cleanability. In addition, the final implant restorations were objectively assessed by an independent prosthodontist using the FIPS. Mann-Whitney U test was used to analyze the defined outcomes. Statistical analysis was completed with a level of significance set at α=0.05. RESULTS PROMs focusing on the impression technique demonstrated higher levels of patient satisfaction for IOS compared to conventional impressions, especially in terms of "taste irritation" (p=0.036); whereas no significant differences were found between both restorative CAD/CAM-materials. Mean FIPS values demonstrated similar results among subgroups. CONCLUSIONS Within the limitation of this study, both completely digital and conventional protocols provided great levels of patient satisfaction in implant rehabilitation of single-tooth gaps in posterior sites with monolithic implant crowns. The restorative material, LS2 versus PICN, does not impact patient satisfaction with their treatment. However, long-term followed up is required to ensure patient' satisfaction with the restorations.
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Affiliation(s)
- Chatchai Kunavisarut
- Department of Advanced General Dentistry, Mahidol University, Bangkok, Thailand.
| | - Worapat Jarangkul
- Education Program in Implant Dentistry, Mahidol University, Bangkok, Thailand
| | | | - Tim Joda
- Department of Reconstructive Dentistry, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland
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