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Chen Z, Li J, Wei CX, Mendonca G, Wang HL. Accuracy of open-sleeved vs. closed-sleeved static computer-assisted implant systems in immediate maxillary molar implant placement: An in vitro study. Clin Oral Implants Res 2024. [PMID: 38587183 DOI: 10.1111/clr.14265] [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: 09/17/2023] [Revised: 03/14/2024] [Accepted: 03/27/2024] [Indexed: 04/09/2024]
Abstract
OBJECTIVES The objective of this study is (1) to compare the accuracy of an open-sleeved static computer-assisted implant system (sCAIS) with a closed-sleeve sCAIS and free-hand approach in immediate implant placement (IIP) of maxillary molar sites and (2) to investigate the influence of socket morphology on these approaches. MATERIALS AND METHODS Ninety partially edentulous duplicated maxillary models simulating three different molar sockets (type A, B, and C based on Smith and Tarnow's classification) were investigated. Three modalities, including sCAIS with open-sleeves, sCAIS with closed-sleeves, and free-hand approach, were applied separately to 30 models with 120 sockets. A customized Python script automatically measured the deviations between the virtual and actual implant positions for all 360 implants. RESULTS The 3D deviations of sCAIS were significantly influenced by the socket and sleeve types. Both guided groups exhibited significantly less deviation than the free-hand approach. Type A and C sockets resulted in better implant positions than type B socket sites. In type B sockets, the open-sleeve group achieved significantly less deviation compared to the closed-sleeve group, with respect to apical global (1.34 ± 0.53 vs. 1.84 ± 0.59 mm), coronal horizontal (0.68 ± 0.36 vs. 0.93 ± 0.34 mm), apical horizontal (1.21 ± 0.59 vs. 1.74 ± 0.63 mm), and angular (3.30 ± 1.41 vs. 4.41 ± 1.96°) deviations. CONCLUSIONS Guided implant surgery significantly reduces deviations during molar IIP compared to free-hand procedures. Furthermore, the use of open-sleeve sCAIS appears to be more effective in minimizing deviations in type B sockets when compared with the closed-sleeve guided system.
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Affiliation(s)
- Zhaozhao Chen
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Junying Li
- Department of Biologic and Materials Sciences, Division of Prosthodontics, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Chen Xuan Wei
- Department of Biologic and Materials Sciences, Division of Prosthodontics, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Gustavo Mendonca
- Department of General Practice, School of Dentistry, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
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Nulty A. A literature review on prosthetically designed guided implant placement and the factors influencing dental implant success. Br Dent J 2024; 236:169-180. [PMID: 38332076 PMCID: PMC10853061 DOI: 10.1038/s41415-024-7050-3] [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: 07/04/2023] [Accepted: 09/14/2023] [Indexed: 02/10/2024]
Abstract
This is an extensive review of the literature on prosthetically designed implant planning with particular regard to the factors influencing dental implant success. Electronic searches on PubMed and the Cochrane Central Register of Controlled Trials and manual searches were performed. The author selected the studies according to the inclusion and exclusion criteria. Meta-analysis of implant placement accuracy and a qualitative review of potential influencing factors were performed.This literature review will explore prosthetically designed implant placement and its influence on dental implant success. By examining the factors that impact implant outcomes, this review aims to provide clinicians with a comprehensive understanding of the key considerations and best practices in achieving successful implant placements. Ultimately, this knowledge can contribute to enhancing patient care and the long-term success of dental implant treatments.
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Affiliation(s)
- Adam Nulty
- International Digital Dental Academy, 128 Harley Street, London, W1G 7JT, UK; PhD Student, University of Leeds, Woodhouse Lane, Leeds, LS2 9JT, UK.
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Ali A, Brintouch I, Romanos G, Delgado-Ruiz R. Cooling Efficiency of Sleeveless 3D-Printed Surgical Guides with Different Cylinder Designs. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:239. [PMID: 38399527 PMCID: PMC10889961 DOI: 10.3390/medicina60020239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 01/11/2024] [Accepted: 01/26/2024] [Indexed: 02/25/2024]
Abstract
Background and Objectives: Surgical guides might impede the flow of coolant to the implant drills during the preparation of the implant bed, potentially contributing to increased temperatures during bone drilling. The objective of this experimental study was to assess the cooling efficiency of various guiding cylinder designs for sleeveless surgical guides used in guided surgery. Materials and Methods: In this experimental study, surgical guides with three different guiding cylinder designs were printed. One group had solid cylinders (control) and two test groups (cylinders with pores and cylinders with windows). Forty customized polyurethane blocks with type III bone characteristics were fitted into the guide and fixed in a vise, and implant bed preparations were completed using a simplified drilling protocol with and without irrigation. An infrared thermographic camera was used to record the temperature changes during drilling at the coronal, middle, and apical areas. ANOVA test and Games-Howell post hoc test were used to determine significant thermal differences among groups. Results: A significant thermal increase was observed at the coronal area in the group without irrigation (39.69 ± 8.82) (p < 0.05). The lowest thermal increase was recorded at the surgical guides with windows (21.451 ± 0.703 °C) compared to solid (25.005 ± 0.586 °C) and porous surgical guides (25.630 ± 1.004) (p < 0.05). In the middle and apical areas, there were no differences between solid and porous cylinders (p > 0.05). Conclusions: 3D-printed sleeveless surgical guides with window openings at the guiding cylinders reduce the temperature elevation at the cortical bone in guided implant surgery.
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Affiliation(s)
- Aisha Ali
- Department of Prosthodontics and Digital Technology, School of Dental Medicine, Stony Brook University, Stony Brook, NY 11794, USA; (A.A.); (I.B.)
| | - Ido Brintouch
- Department of Prosthodontics and Digital Technology, School of Dental Medicine, Stony Brook University, Stony Brook, NY 11794, USA; (A.A.); (I.B.)
| | - Georgios Romanos
- Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, NY 11794, USA;
| | - Rafael Delgado-Ruiz
- Department of Prosthodontics and Digital Technology, School of Dental Medicine, Stony Brook University, Stony Brook, NY 11794, USA; (A.A.); (I.B.)
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Sharma S, Tan E, Tran B, Siow HY, Tafesse E, Thong YHJ, Tan RJM, Son J, Todaro L, Teo J, Abduo J. Effect of pilot-guided implant placement concept on the accuracy of osteotomy preparation and implant placement. J Oral Sci 2024; 66:20-25. [PMID: 38030287 DOI: 10.2334/josnusd.23-0157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
PURPOSE To evaluate the accuracy of osteotomy preparation and implant placement for 3 pilot-guided (PG) concepts, namely, a surgical template with a metal sleeve (MS), a surgical template with an in-built nonmetal sleeve (NMS), and a surgical template with an in-built nonmetal sleeve for round bur indentation (RB). METHODS Surgical models with missing maxillary molars were studied. The MS templates were designed to accept metal sleeves, while the NMS and RB templates were designed with in-built nonmetal sleeves. Ten templates were tested per group (n = 10). After each step (pilot drilling, 2nd drilling, 3rd drilling, profiling, and implant placement), the surgical model was scanned and compared against the planning model to determine maximum horizontal deviation (MHD) and maximum angle deviation (MAD). RESULTS The MS and NMS templates exhibited a similar increase in MHD with successive drilling steps. The MAD for the pilot drilling step was significantly lower for MS than for the other groups. However, the differences among groups for MHD and MAD diminished in later steps. All templates had an MHD of 1.0 mm or less and an MAD less than 8°. CONCLUSION The investigated PG implant placement concepts resulted in similar deviations in the placed implants.
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Affiliation(s)
- Shruti Sharma
- Restorative Section, Melbourne Dental School, Melbourne University
| | - Emilie Tan
- Restorative Section, Melbourne Dental School, Melbourne University
| | - Britney Tran
- Restorative Section, Melbourne Dental School, Melbourne University
| | - Hui Y Siow
- Restorative Section, Melbourne Dental School, Melbourne University
| | | | - Yoong H J Thong
- Restorative Section, Melbourne Dental School, Melbourne University
| | - Row J M Tan
- Restorative Section, Melbourne Dental School, Melbourne University
| | - Jungwoo Son
- Restorative Section, Melbourne Dental School, Melbourne University
| | - Lisa Todaro
- Restorative Section, Melbourne Dental School, Melbourne University
| | - Josephine Teo
- Restorative Section, Melbourne Dental School, Melbourne University
| | - Jaafar Abduo
- Restorative Section, Melbourne Dental School, Melbourne University
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Takács A, Hardi E, Cavalcante BGN, Szabó B, Kispélyi B, Joób-Fancsaly Á, Mikulás K, Varga G, Hegyi P, Kivovics M. Advancing accuracy in guided implant placement: A comprehensive meta-analysis: Meta-Analysis evaluation of the accuracy of available implant placement Methods. J Dent 2023; 139:104748. [PMID: 37863173 DOI: 10.1016/j.jdent.2023.104748] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 10/16/2023] [Accepted: 10/18/2023] [Indexed: 10/22/2023] Open
Abstract
OBJECTIVES This meta-analysis aimed to determine the accuracy of currently available computer-assisted implant surgery (CAIS) modalities under in vitro conditions and investigate whether these novel techniques can achieve clinically acceptable accuracy. DATA In vitro studies comparing the postoperative implant position with the preoperative plan were included. Risk of bias was assessed using the Quality Assessment Tool For In Vitro Studies (QUIN Tool) and a sensitivity analysis was conducted using funnel plots. SOURCES A systematic search was performed on April 18, 2023, using the following three databases: MEDLINE (via PubMed), EMBASE, and Cochrane Central Register of Controlled Trials. No filters or restrictions were applied during the search. RESULTS A total of 5,894 studies were included following study selection. Robotic- and static CAIS (sCAIS) had the most accurate and clinically acceptable outcomes. sCAIS was further divided according to the guidance level. Among the sCAIS groups, fully guided implant placement had the greatest accuracy. Augmented reality-based CAIS (AR-based CAIS) had clinically acceptable results for all the outcomes except for apical global deviation. Dynamic CAIS (dCAIS) demonstrated clinically safe results, except for horizontal apical deviation. Freehand implant placement was associated with the greatest number of errors. CONCLUSIONS Fully guided sCAIS demonstrated the most predictable outcomes, whereas freehand sCAIS demonstrated the lowest accuracy. AR-based and robotic CAIS may be promising alternatives. CLINICAL SIGNIFICANCE To our knowledge, this is the first meta-analysis to evaluate the accuracy of robotic CAIS and investigate the accuracy of various CAIS modalities.
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Affiliation(s)
- Anna Takács
- Department of Community Dentistry, Semmelweis University, Szentkirályi utca 40. 1088 Budapest, Hungary; Centre for Translational Medicine, Semmelweis University, Üllői út 26. 1085 Budapest, Hungary
| | - Eszter Hardi
- Centre for Translational Medicine, Semmelweis University, Üllői út 26. 1085 Budapest, Hungary; Department of Oro-Maxillofacial Surgery and Stomatology, Semmelweis University, Mária utca 52. 1085 Budapest, Hungary
| | - Bianca Golzio Navarro Cavalcante
- Centre for Translational Medicine, Semmelweis University, Üllői út 26. 1085 Budapest, Hungary; Department of Oral Biology, Semmelweis University, Nagyvárad tér 4. 1089 Budapest, Hungary
| | - Bence Szabó
- Centre for Translational Medicine, Semmelweis University, Üllői út 26. 1085 Budapest, Hungary
| | - Barbara Kispélyi
- Centre for Translational Medicine, Semmelweis University, Üllői út 26. 1085 Budapest, Hungary; Department of Prosthodontics, Semmelweis University, Szentkirályi utca 47. 1088 Budapest, Hungary
| | - Árpád Joób-Fancsaly
- Centre for Translational Medicine, Semmelweis University, Üllői út 26. 1085 Budapest, Hungary; Department of Oro-Maxillofacial Surgery and Stomatology, Semmelweis University, Mária utca 52. 1085 Budapest, Hungary
| | - Krisztina Mikulás
- Centre for Translational Medicine, Semmelweis University, Üllői út 26. 1085 Budapest, Hungary; Department of Prosthodontics, Semmelweis University, Szentkirályi utca 47. 1088 Budapest, Hungary
| | - Gábor Varga
- Centre for Translational Medicine, Semmelweis University, Üllői út 26. 1085 Budapest, Hungary; Department of Oral Biology, Semmelweis University, Nagyvárad tér 4. 1089 Budapest, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Üllői út 26. 1085 Budapest, Hungary; Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Szigeti út 12. 7624 Pécs, Hungary; Division of Pancreatic Diseases, Heart and Vascular Center, Semmelweis University, Városmajor utca 68. 1122 Budapest, Hungary
| | - Márton Kivovics
- Department of Community Dentistry, Semmelweis University, Szentkirályi utca 40. 1088 Budapest, Hungary; Centre for Translational Medicine, Semmelweis University, Üllői út 26. 1085 Budapest, Hungary.
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Zhang Y, Tao B, Wang F, Wu Y. Integrating a mouth opening assessment of virtual patients to prevent intraoperative challenges during treatment. J Prosthet Dent 2023:S0022-3913(23)00697-2. [PMID: 37978006 DOI: 10.1016/j.prosdent.2023.09.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 09/27/2023] [Accepted: 09/28/2023] [Indexed: 11/19/2023]
Abstract
Template-guided implant surgery in the posterior region or zygomatic implant surgery using dynamic navigation systems is often hindered if a patient has limited mouth opening. To overcome the problem, the authors have proposed a novel digital protocol that integrates the use of a facial scan for the assessment of the maximal mouth opening of a virtual patient to assist in preoperative planning, thereby minimizing the likelihood of intraoperative obstruction of the surgical site. The proposed method is cost effective and can be easily used in clinical practice.
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Affiliation(s)
- Yun Zhang
- Doctoral student, Department of 2nd Dental Center, 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
| | - Baoxin Tao
- Doctoral student, Department of 2nd Dental Center, 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
| | - Feng Wang
- Professor, Department of 2nd Dental Center, 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
| | - Yiqun Wu
- Professor, Department of 2nd Dental Center, 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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7
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Shi Y, Wang J, Ma C, Shen J, Dong X, Lin D. A systematic review of the accuracy of digital surgical guides for dental implantation. Int J Implant Dent 2023; 9:38. [PMID: 37875645 PMCID: PMC10597938 DOI: 10.1186/s40729-023-00507-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: 04/26/2023] [Accepted: 10/08/2023] [Indexed: 10/26/2023] Open
Abstract
PURPOSE This review aimed to reveal the influence of implant guides on surgical accuracy with regard to supporting types, manufacturing methods and design (including fixation screws and sleeves). METHODS A literature search related to accuracy of surgical guides for dental implantation was performed in Web of Science and PubMed. Studies with in vivo or in vitro deviation data published in recent 5 years (2018-2022) were included and assessed by Newcastle-Ottawa Scale with regard to risk of bias and reliability degree of clinical studies. Accuracy-related deviation data were summarized as forest plots and normal distributions. RESULTS Forty-one articles were included with high degree of credibility. Data showed that implant surgery accuracy can be achieved with mean distance deviation < 2 mm (most < 1 mm) and angular deviation < 8° (most < 5°). CONCLUSIONS Bilateral tooth-supported guides exhibited highest in vitro accuracy and similar in vivo accuracy to unilateral tooth-supported guides; mucosa-supported guides exhibit lowest in vivo accuracy, while its in vitro data showed low credibility due to mechanical complexity of living mucosa tissue. Milling exhibited higher in vivo accuracy of guides than 3d-printing, though further data support was needed. Design of fixation screws and sleeves of implant guides affected the surgical accuracy and might remain a research focus in near future. However, lack of universal evaluation standards for implantation accuracy remained a major problem in this field. The influence of implant guides on surgical accuracy revealed in this review might shed light on future development of dental implantology.
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Affiliation(s)
- Yiting Shi
- Shanghai University of Medicine and Health Sciences, Shanghai, 201318, People's Republic of China
| | - JunKai Wang
- Shanghai University of Medicine and Health Sciences, Shanghai, 201318, People's Republic of China
| | - Chao Ma
- Shanghai University of Medicine and Health Sciences, Shanghai, 201318, People's Republic of China
| | - Jiayi Shen
- Shanghai University of Medicine and Health Sciences, Shanghai, 201318, People's Republic of China
| | - Xian Dong
- Shanghai University of Medicine and Health Sciences, Shanghai, 201318, People's Republic of China.
| | - Dan Lin
- Shanghai University of Medicine and Health Sciences, Shanghai, 201318, People's Republic of China.
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Tuce RA, Neagu M, Pupazan V, Neagu A, Arjoca S. The 3D Printing and Evaluation of Surgical Guides with an Incorporated Irrigation Channel for Dental Implant Placement. Bioengineering (Basel) 2023; 10:1168. [PMID: 37892898 PMCID: PMC10603942 DOI: 10.3390/bioengineering10101168] [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: 08/30/2023] [Revised: 09/28/2023] [Accepted: 10/04/2023] [Indexed: 10/29/2023] Open
Abstract
Dental implant insertion requires the preparation of the implant bed via surgical drilling. During this stage, irrigation is essential to avoid thermal damage to the surrounding bone. Surgical guides enhance the accuracy of the implant site preparation, but they mask the drilling site, hampering coolant delivery. A variety of designs are aimed at improving the coolant access to the target site. Using standard dental implant simulation software, this paper presents an in-house design and 3D printing workflow for building surgical guides that incorporate a coolant channel directed toward the entry point of the burr. The proposed design was evaluated in terms of the bone temperature elevations caused by drilling performed at 1500 rpm, under an axial load of 2 kg, and irrigation with 40 mL/min of saline solution at 25 °C. Temperature measurements were performed on porcine femoral pieces, in the middle of the cortical bone layer, at 1 mm from the edge of the osteotomy. The mean temperature rise was 3.2 °C for a cylindrical sleeve guide, 2.7 °C for a C-shaped open-sleeve guide, and 2.1 °C for the guide with an incorporated coolant channel. According to a one-way ANOVA, the differences between these means were marginally insignificant (p = 0.056). The individual values of the peak temperature change remained below the bone damage threshold (10 °C) in all cases. Remarkably, the distribution of the recorded temperatures was the narrowest for the guide with internal irrigation, suggesting that, besides the most effective cooling, it provides the most precise control of the intraosseous temperature. Further studies could test different design variants, experimental models (including live animals), and might involve computer simulations of the bone temperature field.
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Affiliation(s)
- Robert-Angelo Tuce
- Department of Functional Sciences, Victor Babes University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (R.-A.T.); (M.N.); (V.P.); (S.A.)
| | - Monica Neagu
- Department of Functional Sciences, Victor Babes University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (R.-A.T.); (M.N.); (V.P.); (S.A.)
- Center for Modeling Biological Systems and Data Analysis, Victor Babes University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania
| | - Vasile Pupazan
- Department of Functional Sciences, Victor Babes University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (R.-A.T.); (M.N.); (V.P.); (S.A.)
| | - Adrian Neagu
- Department of Functional Sciences, Victor Babes University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (R.-A.T.); (M.N.); (V.P.); (S.A.)
- Center for Modeling Biological Systems and Data Analysis, Victor Babes University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania
- Department of Physics and Astronomy, University of Missouri, Columbia, MO 65211, USA
| | - Stelian Arjoca
- Department of Functional Sciences, Victor Babes University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (R.-A.T.); (M.N.); (V.P.); (S.A.)
- Center for Modeling Biological Systems and Data Analysis, Victor Babes University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania
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Hüfner M, David S, Brunello G, Kerberger R, Rauch N, Busch CV, Drescher D, Bourauel C, Becker K. Autoclaving-induced dimensional changes of three-dimensional printed surgical guides: An in vitro study. Clin Oral Implants Res 2023. [PMID: 37565539 DOI: 10.1111/clr.14158] [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: 04/25/2023] [Revised: 07/20/2023] [Accepted: 07/26/2023] [Indexed: 08/12/2023]
Abstract
OBJECTIVES Surgical guides are frequently used for dental implant placement. The aim of this study was to evaluate the impact of the 3D printing process itself and subsequent steam autoclaving on the dimensional stability of five different resin/printer combinations (RPCs). MATERIALS AND METHODS Fifty identical surgical guides (10 per group) were produced consisting of five RPCs. Half of the guides (5 per group) were steam autoclaved with cycle 1 (121°C, 1 bar, 20.5 min) and the other half with cycle 2 (134°C, 2 bar, 5.5 min). All guides were scanned with a structured-light (SL) 3D scanner before (T0) and after (T1) autoclaving. Linear measurements along the x-, y-, and z-axes were performed at landmarks on the original STL file and on SL scans at T0 and T1, respectively. Wilcoxon signed-rank test, Kruskal-Wallis test, and linear mixed-effects models were performed, depending on the analysis. RESULTS Three-dimensional printing was associated with significant dimensional alterations for all RPCs. Steam autoclaving using cycle 1 was associated with significant shrinkage in x- (1 RPC), y- (2 RPCs), and z-direction (2 RPCs), while cycle 2 was also associated with shrinkage in x- (2 RPCs), y- (1 RPC), and z-direction (1 RPC). One resin did not present any dimensional changes independently of the cycle. CONCLUSIONS The majority of the guides presented minor but significant shrinkage due to 3D printing itself and both steam autoclaving cycles, the extent varied between different RPCs. Whether these changes compromise implant placement accuracy remains to be investigated.
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Affiliation(s)
- Mira Hüfner
- Department of Orthodontics, University Hospital of Düsseldorf, Düsseldorf, Germany
| | - Samuel David
- Department of Orthodontics, University Hospital of Düsseldorf, Düsseldorf, Germany
| | - Giulia Brunello
- Department of Oral Surgery, University Hospital of Düsseldorf, Düsseldorf, Germany
- Department of Neurosciences, University of Padua, Padua, Italy
| | - Robert Kerberger
- Department of Orthodontics, University Hospital of Düsseldorf, Düsseldorf, Germany
| | - Nicole Rauch
- Department of Oral Surgery, University Hospital of Düsseldorf, Düsseldorf, Germany
| | - Caroline Viola Busch
- Department of Oral Surgery, University Hospital of Düsseldorf, Düsseldorf, Germany
| | - Dieter Drescher
- Department of Orthodontics, University Hospital of Düsseldorf, Düsseldorf, Germany
| | | | - Kathrin Becker
- Department of Orthodontics, University Hospital of Düsseldorf, Düsseldorf, Germany
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10
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Elnashoukaty HM, ElDakkak S, Abdelhakim A. Accuracy of a custom two-piece surgical guide for all-on-four dental implant placement: An in vitro study. J Prosthet Dent 2023:S0022-3913(23)00279-2. [PMID: 37230911 DOI: 10.1016/j.prosdent.2023.04.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 03/31/2023] [Accepted: 04/04/2023] [Indexed: 05/27/2023]
Abstract
STATEMENT OF PROBLEM Although fully guided dental implant surgery has been reported to provide a high degree of accuracy, it has disadvantages including the lack of external irrigation during osteotomy formation and the need for special drills and equipment. Whether a custom 2-piece surgical guide has sufficient accuracy is unclear. PURPOSE The purpose of this in vitro study was to design and fabricate a new surgical guide concept that fully guides the placement of implants to the desired position and angulation without affecting the external irrigation during osteotomy preparation, to eliminate the need for a special armamentarium, and to determine the accuracy of the guide. MATERIAL AND METHODS A 2-piece surgical guide was 3-dimensionally designed and fabricated. Implants were placed according to the all-on-4 concepts in laboratory casts using the newly fabricated surgical guide. Placement accuracy was determined from a postoperative cone beam computed tomography scan that was superimposed over the preplanned implant positions to calculate the degree of angular deviation and position of placement. Adopting 5% alpha error and 80% study power in estimating sample size, a total of 88 implants were placed according to the all-on-4 concept in 22 mandibular laboratory casts. These were divided into 2 groups: with the newly fabricated surgical guide and with a traditional fully guided protocol. Deviations at the point of entry, at the apex horizontally, the vertical apical depth, and angular deviations from the proposed plan were measured from the superimposed scans. Differences in apical depth, horizontal deviation at the apex, and horizontal deviation in the hexagon measurements were compared with the independent t test, while differences in angular deviation were assessed with the Mann-Whitney U test (α=.05). RESULTS No statistically significant difference was found in the apical depth deviation (P>.05), but significant differences were found in the apex (P=.002), hexagon (P<.001), and angular deviation (P<.001) between the new guide and the traditional guide. CONCLUSIONS The new surgical guide showed potential for higher accuracy in implant placement when compared with the fully guided sleeveless surgical guide. In addition, it provided an undisturbed flow of irrigation around the drill throughout the drilling procedure, with the advantage of eliminating the special armamentarium usually required.
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Affiliation(s)
- Hassan M Elnashoukaty
- Postgraduate student, Prosthodontic Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
| | - Sherif ElDakkak
- Assistant Professor, Prosthodontic Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Ahmed Abdelhakim
- Professor and Dean, Prosthodontic Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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11
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Dulla FA, Couso-Queiruga E, Chappuis V, Yilmaz B, Abou-Ayash S, Raabe C. Influence of alveolar ridge morphology and guide-hole design on the accuracy of static Computer-Assisted Implant Surgery with two implant macro-designs: An in vitro study. J Dent 2023; 130:104426. [PMID: 36652971 DOI: 10.1016/j.jdent.2023.104426] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/05/2023] [Accepted: 01/14/2023] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVES The primary aim of this in vitro study was to evaluate the influence of alveolar ridge morphologies on the accuracy of static Computer-Assisted Implant Surgery (sCAIS). The secondary aims were to evaluate the influence of guide-hole design and implant macro-design on the accuracy of the final implant position. METHODS Eighteen standardized partially edentulous maxillary models with two different types of alveolar ridge morphologies were used. Each model was scanned via cone beam computer tomography prior to implant placement and scanned with a laboratory scanner prior to and following implant placement using sCAIS. The postsurgical scans were superimposed on the initial treatment planning position to measure the deviations between planned and postsurgical implant positions. RESULTS Seventy-two implants were equally distributed to the study groups. Implants placed in healed alveolar ridges showed significantly lower mean deviations at the crest (0.36 ± 0.17 mm), apex (0.69 ± 0.36 mm), and angular deviation (1.86 ± 0.99°), compared to implants placed in fresh extraction sites (0.80 ± 0.29 mm, 1.61 ± 0.59 mm, and 4.33 ± 1.87°; all p<0.0001). Implants placed with a sleeveless guide-hole design demonstrated significantly lower apical (1.02 ± 0.66 mm) and angular (2.72 ± 1.93°) deviations compared to those placed with manufacturer's sleeves (1.27 ± 0.67 mm; p = 0.01, and 3.46 ± 1.9°; p = 0.02). Deep-threaded tapered bone level implants exhibited significantly lower deviations at the crest (0.49 ± 0.28 mm), apex (0.97 ± 0.63 mm), and angular deviations (2.63 ± 1.85°) compared to shallow-threaded parallel-walled bone level implants (0.67 ± 0.34 mm; p = 0.0005, 1.32 ± 0.67 mm; p = 0.003, and 3.56 ± 1.93°; p = 0.01). CONCLUSIONS The accuracy of the final implant position with sCAIS is determined by the morphology of the alveolar ridge, the design of the guide holes, and the macrodesign of the implant. CLINICAL SIGNIFICANCE Higher accuracy in the final implant position was observed with implants placed in healed alveolar ridge morphologies, in implants with deep-threaded tapered macro-design, and when sleeveless surgical guide holes were used.
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Affiliation(s)
- Fabrice Alain Dulla
- Department of Oral Surgery and Stomatology; School of Dental Medicine, University of Bern, Switzerland
| | - Emilio Couso-Queiruga
- ITI Scholar, Department of Oral Surgery and Stomatology; School of Dental Medicine, University of Bern, Switzerland
| | - Vivianne Chappuis
- Chair, Department of Oral Surgery and Stomatology; School of Dental Medicine, University of Bern, Switzerland
| | - Burak Yilmaz
- Faculty member, Department of Reconstructive Dentistry and Gerodontology; School of Dental Medicine, University of Bern, Switzerland; Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, OH, USA
| | - Samir Abou-Ayash
- Deputy Department Chair, Department of Reconstructive Dentistry and Gerodontology; School of Dental Medicine, University of Bern, Switzerland
| | - Clemens Raabe
- Senior Lecturer, Department of Oral Surgery and Stomatology; School of Dental Medicine, University of Bern, Switzerland.
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Accuracy of keyless vs drill-key implant systems for static computer-assisted implant surgery using two guide-hole designs compared to freehand implant placement: an in vitro study. Int J Implant Dent 2023; 9:4. [PMID: 36749441 PMCID: PMC9905371 DOI: 10.1186/s40729-023-00470-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 01/31/2023] [Indexed: 02/08/2023] Open
Abstract
PURPOSE This in vitro study aimed at comparing the accuracy of freehand implant placement with static computer-assisted implant surgery (sCAIS), utilizing a keyless and a drill-key implant system and two guide-hole designs. METHODS A total of 108 implants were placed in 18 partially edentulous maxillary models simulating two different alveolar ridge morphologies. 3D digital deviations between pre-planned and post-operative implant positions were obtained. Guide material reduction was assessed in the keyless implant system for the manufacturer's sleeve and sleeveless guide-hole designs. RESULTS sCAIS using a sleeveless guide-hole design demonstrated smaller mean angular, crestal and apical deviations compared to sCAIS utilizing a manufacturer's sleeve and the freehand group (2.6 ± 1.6°, vs 3.3 ± 1.9°, vs 4.0 ± 1.9°; 0.5 ± 0.3 mm, vs 0.6 ± 0.3 mm, vs 0.8 ± 0.3 mm; and 1.0 ± 0.5 mm, vs 1.2 ± 0.7 mm, vs 1.5 ± 0.6 mm). Smaller angular and apical mean deviations were observed in the keyless implant system as compared with the drill-key implant system (3.1 ± 1.7°, vs 3.5 ± 1.9°, p = 0.03; and 1.2 ± 0.6 mm, vs 1.4 ± 0.7 mm, p = 0.045). Overall, smaller angular, crestal, and apical deviations (p < 0.0001) were observed in healed alveolar ridges (2.4 ± 1.7°, 0.5 ± 0.3 mm, and 0.9 ± 0.5 mm) than in extraction sockets (4.2 ± 1.6°, 0.8 ± 0.3 mm, and 1.6 ± 0.5 mm). Higher mean volumetric material reduction was observed in sleeveless than in manufacturer's sleeve guide-holes (- 0.10 ± 0.15 mm3, vs - 0.03 ± 0.03 mm3, p = 0.006). CONCLUSIONS Higher final implant positional accuracy was observed in sCAIS for the keyless implant system, with a sleeveless guide-hole design, and in healed ridges. Sleeveless guide holes resulted in higher volumetric material reduction compared with the manufacturer's sleeve.
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Raabe C, Dulla FA, Yilmaz B, Chappuis V, Abou-Ayash S. Influence of drilling sequence and guide-hole design on the accuracy of static computer-assisted implant surgery in extraction sockets and healed sites-An in vitro investigation. Clin Oral Implants Res 2023; 34:320-329. [PMID: 36727584 DOI: 10.1111/clr.14042] [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: 10/07/2022] [Revised: 01/10/2023] [Accepted: 01/14/2023] [Indexed: 02/03/2023]
Abstract
OBJECTIVES To evaluate the effect of drilling sequence, guide-hole design, and alveolar ridge morphology on the accuracy of implant placement via static computer-assisted implant surgery (sCAIS). MATERIALS AND METHODS Standardized maxillary bone models including single-tooth gaps with fresh extraction sockets or healed alveolar ridge morphologies were evaluated in this study. Implants were placed using different drilling sequences (i.e., complete [CDS] or minimum [MDS]), and guide-hole designs (i.e., manufacturer's sleeve [MS] or sleeveless [SL] guide-hole designs). The time for implant placement via sCAIS procedures was also recorded. The angular, crestal, and apical three-dimensional deviations between planned and final implant positions were digitally obtained. Statistical analyses were conducted by a non-parametric three-way ANOVA (α = .05). RESULTS Based on a sample size analysis, a total of 72 implants were included in this study. Significantly higher implant position accuracy was found at healed sites compared to extraction sockets and in SL compared to MS guide-hole design in angular, crestal, and apical 3D deviations (p ≤ .048). A tendency for higher accuracy was observed for the CDS compared to the MDS, although the effect was not statistically significant (p = .09). The MDS required significantly shorter preparation times compared with CDS (p < .0001). CONCLUSION Implant placement via sCAIS resulted in higher accuracy in healed sites than extraction sockets, when using SL compared to MS guides, and tended to be more accurate when using CDS compared to MDS. Therefore, even though surgery time was shorter with MDS, its use should be limited to strictly selected cases.
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Affiliation(s)
- Clemens Raabe
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Fabrice Alain Dulla
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland.,Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, Ohio, USA
| | - Vivianne Chappuis
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Samir Abou-Ayash
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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Choi YS, Oh JW, Lee Y, Lee DW. Thermal changes during implant site preparation with a digital surgical guide and slot design drill: an ex vivo study using a bovine rib model. J Periodontal Implant Sci 2022; 52:411-421. [PMID: 36302647 PMCID: PMC9614178 DOI: 10.5051/jpis.2106040302] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 03/07/2022] [Accepted: 03/22/2022] [Indexed: 10/29/2023] Open
Abstract
PURPOSE In this study, we aimed to evaluate the degree of heat generation when a novel drill design with an irrigation slot was used with metal sleeve-free (MF) and metal sleeve-incorporated (MI) surgical guides in an environment similar to that of the actual oral cavity. METHODS A typodont with a missing mandibular right first molar and 21 bovine rib blocks were used. Three-dimensional-printed MF and MI surgical guides, designed for the placement of internal tapered implant fixtures, were used with slot and non-slot drills. The following groups were compared: group 1, MI surgical guide with slot drill; group 2, MI surgical guide with a non-slot drill; and group 3, MF surgical guide with a slot drill. A constant-temperature water bath at 36°C was used. The drilling was performed in 6 stages, and the initial, highest, and lowest temperatures of the cortical bone were measured at each stage using a non-contact infrared thermometer. RESULTS There were no temperature increases above the initial temperature in any drilling procedure. The only significant difference between the non-slot and slot groups was observed with the use of the first drill in the MI group, with a higher temperature in the non-slot group (P=0.012). When the heat generation during the first and the second drilling was compared in the non-slot group, the heat generation during the first drilling was significantly higher (P<0.001), and there was no significant difference in heat generation between the drills in the slot group. CONCLUSIONS Within the limitations of this study, implant-site preparation with the surgical guide showed no critical increase in the temperature of the cortical bone, regardless of whether there was a slot in the drill. In particular, the slotted drill had a cooling effect during the initial drilling.
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Affiliation(s)
- Yoon-Sil Choi
- Department of Periodontology, Veterans Health Service Medical Center, Seoul, Korea
| | - Jae-Woon Oh
- Department of Periodontology, Veterans Health Service Medical Center, Seoul, Korea
| | - Young Lee
- Veterans Medical Research Institute, Veterans Health Service Medical Center, Seoul, Korea
| | - Dong-Woon Lee
- Department of Periodontology, Veterans Health Service Medical Center, Seoul, Korea
- Department of Periodontology, Dental Hospital, Wonkwang University College of Dentistry, Iksan, Korea.
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Afshari A, Shahmohammadi R, Mosaddad SA, Pesteei O, Hajmohammadi E, Rahbar M, Alam M, Abbasi K. Free-Hand versus Surgical Guide Implant Placement. ADVANCES IN MATERIALS SCIENCE AND ENGINEERING 2022; 2022:1-12. [DOI: 10.1155/2022/6491134] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
One of the most key areas of dentistry is dental implant surgery. The use of digital equipment and software in dentistry has developed considerably in recent years compared to other fields of medicine. Since examining the advantages and disadvantages of each approach, along with case studies, can help physicians make informed decisions, this review study aims to raise the awareness of dentists to make easier decisions about using guided or free-hand surgery. When planning for a dental implant, one of the most challenging questions that doctors face is which method to use (guided surgery or free-hand). Choosing the right method, such as other clinical considerations, will depend on the individual circumstances of each patient and the preference of the treating physician. Free-hand surgery is a cost-effective method in which the flap is reflected, and, according to the doctor's diagnostic information, an implant is placed, which in many cases is a useful method. Guided surgery has the highest level of accuracy and control, in which osteotomy is designed and printed through a digital surgery guide, and depending on the complexity of the case and the patient's anatomy, it has a higher level of value than free surgery. The surgical guide helps the surgeon make the implant surgery more accurate, safer, simpler, at a lower cost, and in less time. In fact, there are patterns that convey information about the position of the tooth to the dentist before the implant is placed.
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Affiliation(s)
- Aysooda Afshari
- Postgraduate Student of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Rojin Shahmohammadi
- Postgraduate Student of Periodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Ali Mosaddad
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ozra Pesteei
- Postgraduate Student of Periodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Emran Hajmohammadi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mahdi Rahbar
- Department of Restorative Dentistry, School of Dentistry, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mostafa Alam
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kamyar Abbasi
- Department of Prosthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Guentsch A, An H, Dentino AR. Precision and trueness of computer-assisted implant placement using static surgical guides with open and closed sleeves: An in-vitro analysis. Clin Oral Implants Res 2022; 33:441-450. [PMID: 35148444 PMCID: PMC9302989 DOI: 10.1111/clr.13904] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 12/28/2021] [Accepted: 02/03/2022] [Indexed: 12/02/2022]
Abstract
Objectives The aim of this in vitro study was to determine accuracy defined by trueness and precision of computer‐assisted implant surgery comparing two guided surgery kits designed for either closed sleeves or open sleeves with a lateral window. Material and methods Each n=20 implants were placed fully guided (sleeve‐bone distance of 2 or 4 mm) in identical replicas using a surgical guide with both closed sleeve or an open sleeve, partially guided, or free hand. The achieved implant position was digitized and compared with the planned position. Trueness and precision were determined. The angular deviation was defined as the primary outcome parameter. The means, standard deviation, and 95%‐confidence intervals were analyzed statistically with 1‐way ANOVA and the Scheffé procedure. Results The accuracy of guided implant placement using closed and open sleeves was comparable when the sleeve‐bone distance was 2 mm. Accuracy decreased when the sleeve‐bone distance increased in both fully guided groups, more so in the open than in the closed sleeve group. The least accurate method was the free‐hand group. Partially guided implant surgery was more accurate than free‐hand placement, but less accurate than the fully guided groups with 2‐mm sleeve‐bone distance. Conclusions The closer the sleeve to the bone, the more accurate and precise is computer‐assisted implant surgery using a closed system and a system using open sleeves. Partially guided implant surgery using only the static guide for the pilot drill is less accurate than both fully guided approaches, but more accurate than free‐hand surgery.
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Affiliation(s)
- Arndt Guentsch
- Professor of Periodontics and Department Chair, Department of Surgical Sciences, Marquette University School of Dentistry, Milwaukee, Wisconsin, USA
| | - Hongseok An
- Assistant Professor of Restorative Dentistry, Department of Restorative Dentistry, School of Dentistry, Oregon Health & Science University, Portland, OR, 97201, USA
| | - Andrew R Dentino
- Professor of Periodontics and Associate Dean for Research and Graduate Studies, Marquette University School of Dentistry, Milwaukee, Wisconsin, USA
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Sittikornpaiboon P, Arunjaroensuk S, Kaboosaya B, Subbalekha K, Mattheos N, Pimkhaokham A. Comparison of the accuracy of implant placement using different drilling systems for static computer-assisted implant surgery: A simulation-based experimental study. Clin Implant Dent Relat Res 2021; 23:635-643. [PMID: 34288341 DOI: 10.1111/cid.13032] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 06/01/2021] [Accepted: 07/05/2021] [Indexed: 01/15/2023]
Abstract
BACKGROUND Different designs of surgical drilling systems have been developed for the purpose of static Computer-Assisted Implant Surgery (sCAIS), but there is at present little understanding of how design principles affect the accuracy of implant placement. PURPOSE The aim of this in vitro study was to compare the accuracy of implant placement among five drilling systems of sCAIS in a controlled experimental setting. MATERIALS AND METHODS Twenty-five 3D printed models with two edentulous bilateral premolar spaces were allocated to five different drilling systems: group A: sleeve-in-sleeve, group B: sleeve-in-sleeve with self-locking, group C: mounted sleeve-on-drill, group D: integrated sleeve-on-drill with metal sleeve in the guide, group E: integrated sleeve-on-drill without metal sleeve. Models were scanned with CBCT and optical scanner. All implants were digitally planned and 10 implants placed with sCAIS in each group. Postoperative 3D deviation of placed vs planned position was measured by means of platform, apex and angular deviation. Data was analyzed using Kruskal-Wallis test (P ≤ .05). Pairwise comparisons were tested with Dunn's test with adjusted P values. RESULTS The overall platform deviation ranged from 0.42 ± 0.12 mm (group B) to 1.18 ± 0.19 mm (group C). The overall apex deviation ranged from 0.76 ± 0.22 mm (group B) to 1.95 ± 0.48 mm (group D). The overall angular deviation ranged from 2.50 ± 0.89 degree (group B) to 5.30 ± 1.04 degree (group E). Group A and B showed significantly less angular deviation than groups D and E (P < .05). There was no statistically significant differences in all parameters between group A and B, as well as between group D and E (P > .05). CONCLUSIONS Significant differences were found with regards to accuracy among the five sCAIS systems tested, suggesting that the drilling protocol, the devices used and the design principles of the guides could influence the accuracy of implant placement.
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Affiliation(s)
- Paknisa Sittikornpaiboon
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Chulalongkorn University, Bangkok, Thailand
| | - Sirida Arunjaroensuk
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Chulalongkorn University, Bangkok, Thailand
| | - Boosana Kaboosaya
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Chulalongkorn University, Bangkok, Thailand
| | - Keskanya Subbalekha
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Chulalongkorn University, Bangkok, Thailand
| | - Nikos Mattheos
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Chulalongkorn University, Bangkok, Thailand.,Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Atiphan Pimkhaokham
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Chulalongkorn University, Bangkok, Thailand
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