1
|
Younis H, Lv C, Xu B, Zhou H, Du L, Liao L, Zhao N, Long W, Elayah SA, Chang X, He L. Accuracy of dynamic navigation compared to static surgical guides and the freehand approach in implant placement: a prospective clinical study. Head Face Med 2024; 20:30. [PMID: 38745297 PMCID: PMC11092008 DOI: 10.1186/s13005-024-00433-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 04/29/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Computer-guided implant surgery has improved the quality of implant treatment by facilitating the placement of implants in a more accurate manner. This study aimed to assess the accuracy of implant placement in a clinical setting using three techniques: dynamic navigation, static surgical guides, and freehand placement. We also investigated potential factors influencing accuracy to provide a comprehensive evaluation of each technique's advantages and disadvantages. MATERIALS AND METHODS Ninety-four implants in 65 patients were included in this prospective study. Patients were randomly assigned to one of three groups: dynamic navigation, static surgical guides, or freehand placement. Implants were placed using a prosthetically oriented digital implant planning approach, and postoperative CBCT scans were superimposed on preoperative plans to measure accuracy. Seven deviation values were calculated, including angular, platform, and apical deviations. Demographic and consistency analyses were performed, along with one-way ANOVA and post-hoc tests for deviation values. RESULTS The mean global platform, global apical, and angular deviations were 0.99 mm (SD 0.52), 1.14 mm (SD 0.56), and 3.66° (SD 1.64°) for the dynamic navigation group; 0.92 mm (SD 0.36), 1.06 mm (SD 0.47), and 2.52° (SD 1.18°) for the surgical guide group; and 1.36 mm (SD 0.62), 1.73 mm (SD 0.66), and 5.82° (SD 2.79°) for the freehand group. Both the dynamic navigation and surgical guide groups exhibited statistically significant differences in all values except depth deviations compared to the freehand group (p < 0.05), whereas only the angular deviation showed a significant difference between the dynamic navigation and surgical guide groups (p = 0.002). CONCLUSION Our findings highlight the superior accuracy and consistency of dynamic navigation and static surgical guides compared to freehand placement in implant surgery. Dynamic navigation offers precision and flexibility. However, it comes with cost and convenience considerations. Future research should focus on improving its practicality. TRIAL REGISTRATION This study was retrospectively registered at the Thai Clinical Trials Register-Medical Research Foundation of Thailand (MRF) with the TCTR identification number TCTR20230804001 on 04/08/2023. It was also conducted in accordance with the Declaration of Helsinki and approved by the institutional ethics committee at the Xian Jiaotong University Hospital of Stomatology, Xian, China (xjkqII[2021] No: 043). Written informed consent was obtained from all participants.
Collapse
Affiliation(s)
- Hamza Younis
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
- Department of Oral Implantology, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
- Department of Oral and Maxillofacial Surgery, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
- State Key Laboratory of Oral Diseases & National Center for Stomatology &, National Clinical Research Center for Oral Diseases and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Chengpeng Lv
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
- Department of Oral Implantology, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Boya Xu
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
- Department of Oral Implantology, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Huixia Zhou
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
- Department of Oral Implantology, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Liangzhi Du
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
- Department of Oral Implantology, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Lifan Liao
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
- Department of Oral Implantology, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Ningbo Zhao
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
- Department of Oral Implantology, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Wen Long
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
- Department of Oral Implantology, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Sadam Ahmed Elayah
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
- Department of Oral and Maxillofacial Surgery, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
- State Key Laboratory of Oral Diseases & National Center for Stomatology &, National Clinical Research Center for Oral Diseases and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Xiaofeng Chang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China.
- Department of Oral Implantology, College of Stomatology, Xi'an Jiaotong University, Xi'an, China.
| | - Longlong He
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China.
- Department of Oral Implantology, College of Stomatology, Xi'an Jiaotong University, Xi'an, China.
| |
Collapse
|
2
|
Wang Y, Yu S, Wang Y, Feng Y, Yan Q, Zhang Y. Effect of implant shape and length on the accuracy of robot-assisted immediate implant surgery: An in vitro study. Clin Oral Implants Res 2024; 35:350-357. [PMID: 38174662 DOI: 10.1111/clr.14232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 12/16/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024]
Abstract
OBJECTIVES To compare the accuracy of immediate implant placement of cylindrical implants (CI) and tapered implants (TI) of different lengths using a robotic dental implant system. MATERIALS AND METHODS CI and TI of three lengths (8, 10, and 12 mm) each were digitally planned and placed in a three-dimensional printed extraction socket model under robotic guidance. There were six groups with three samples in each group, resulting in a total of 18 samples. Implant angular deviation, platform point deviation (total, lateral, depth), and implant apical point deviation (total, lateral, depth) were recorded and compared between the different groups. RESULTS The angular deviations for CI 8 mm, CI 10 mm, CI 12 mm, TI 8 mm, TI 10 mm, and TI 12 mm were 1.32° ± 0.19°, 1.03° ± 0.56°, 1.31° ± 0.38°, 1.27° ± 0.64°, 1.10° ± 0.43° and 1.05° ± 0.45°, respectively. The total deviations of platform and apical points for CI 8 mm, CI 10 mm, CI 12 mm, TI 8 mm, TI 10 mm, and TI 12 mm were 0.79 ± 0.18 mm, 0.77 ± 0.33 mm; 0.64 ± 0.21 mm, 0.55 ± 0.17 mm; 0.64 ± 0.37 mm, 0.65 ± 0.34 mm; 0.68 ± 0.26 mm, 0.71 ± 0.20 mm; 0.70 ± 0.12 mm, 0.66 ± 0.23 mm; and 0.71 ± 0.15 mm, 0.77 ± 0.29 mm, respectively, and had no significant differences. CONCLUSIONS Within the limitation of this study, acceptable accuracy can be achieved for both TI and CI using robotic systems. Our study demonstrated that the implant shape and length did not affect the accuracy of immediate implant placement under robotic guidance in vitro. However, further trials are required to confirm their efficacy in clinical practice.
Collapse
Affiliation(s)
- Yunxiao Wang
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Oral Implantology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Shimin Yu
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Oral Implantology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Yulan Wang
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Oral Implantology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Yi Feng
- Department of Oral Implantology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Qi Yan
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Oral Implantology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Yufeng Zhang
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Oral Implantology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Oral Biomaterials and Application Technology Engineering Research Center of Hubei Province, Wuhan, China
| |
Collapse
|
3
|
Liu X, Lv H, Chen M, Chen S, Jia K, Quni S, Zhang L, Zhou Y. Case report and literature review: autonomous robotic system assisted palatal implantation at an anterior teeth site compromised by periapical cyst. Front Med (Lausanne) 2024; 11:1335043. [PMID: 38288274 PMCID: PMC10822917 DOI: 10.3389/fmed.2024.1335043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 01/02/2024] [Indexed: 01/31/2024] Open
Abstract
Background Immediate implant placement (IIP), which preserves gingival height and papilla shape while simultaneously accelerating the implant treatment period, has become a popular method due to its commendable clinical outcomes. Nonetheless, deploying immediate implants demands specific preconditions concerning the remaining alveolar bone. This poses a challenge to the accuracy of implant surgery. Case presentation In this report, we present the case of a 60-year-old woman with a left upper anterior tooth crown dislodged for over a month. Cone beam computed tomography (CBCT) revealed the absence of a labial bone wall on tooth 22, a remaining 1 mm bone wall on the labial side of the root apex, and a 17.2 mm*8.9 mm*4.7 mm shadow in the periapical region of the root apices of teeth 21 and 22, with the narrowest width on the sagittal plane being approximately 5 mm. After the surgeon removed the cyst, they completed the subsequent implantation surgery using an autonomous robot in a challenging aesthetic area. This method circumvented the potential exposure of the screw thread on the labial implant surface, assured initial implant stability. Conclusion Five months after the operation, the dental crown was restored. The implant remained stable, with yielding notable clinical results. To the best of our knowledge, this clinical case is the first to report the feasibility and precision of immediate implantation in anterior teeth site with periapical cyst removal, performed by an autonomous robotic surgical system. Autonomous robots exhibit exceptional accuracy by accurately controlling axial and angular errors. It can improve the accuracy of implant surgery, which may become a key technology for changing implant surgery. However, further clinical trials are still needed to provide a basis for the rapid development of robotic surgery field.
Collapse
Affiliation(s)
- Xiuyu Liu
- Hospital of Stomatogy, Jilin University, Changchun, China
| | - Huixin Lv
- Hospital of Stomatogy, Jilin University, Changchun, China
| | - Meiqing Chen
- Department of Stomatology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Siyu Chen
- Hospital of Stomatogy, Jilin University, Changchun, China
| | - Kewen Jia
- Hospital of Stomatogy, Jilin University, Changchun, China
| | - Sezhen Quni
- Hospital of Stomatogy, Jilin University, Changchun, China
| | - Lu Zhang
- Hospital of Stomatogy, Jilin University, Changchun, China
| | - Yanmin Zhou
- Hospital of Stomatogy, Jilin University, Changchun, China
| |
Collapse
|
4
|
Saini RS, Bavabeedu SS, Quadri SA, Gurumurthy V, Kanji MA, Kuruniyan MS, Binduhayyim RIH, Avetisyan A, Heboyan A. Impact of 3D imaging techniques and virtual patients on the accuracy of planning and surgical placement of dental implants: A systematic review. Digit Health 2024; 10:20552076241253550. [PMID: 38726220 PMCID: PMC11080757 DOI: 10.1177/20552076241253550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 04/18/2024] [Indexed: 05/12/2024] Open
Abstract
Aim The integration of advanced technologies, including three-dimensional (3D) imaging modalities and virtual simulations, has significantly influenced contemporary approaches to preoperative planning in implant dentistry. Through a meticulous analysis of relevant studies, this review synthesizes findings related to accuracy outcomes in implant placement facilitated by 3D imaging in virtual patients. Methods A comprehensive literature search was conducted across relevant databases to identify relevant studies published to date. The inclusion criteria were studies utilizing 3D imaging techniques, virtual patients, and those focusing on the accuracy of dental implant planning and surgical placement. The selected studies were critically appraised for their methodological quality. Results After a rigorous analysis, 21 relevant articles were included out of 3021 articles. This study demonstrates the versatility and applicability of these technologies in both in vitro and in vivo settings. Integrating Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM), cone bean computed tomography (CBCT), and advanced 3D reconstruction methodologies showcases a trend toward enhanced precision in implant planning and placement. Notably, the evaluation parameters varied, encompassing distances, discrepancies, and deviations in the implant placement. The ongoing integration of systems such as dynamic navigation systems, augmented reality, and sophisticated software platforms shows a promising trajectory for the continued refinement of virtual reality applications in dental implantology, providing valuable insights for future research and clinical implementation. Moreover, using stereolithographic surgical guides, virtual planning with CBCT data, and 3D-printed templates consistently demonstrates enhanced precision in dental implant placement compared to traditional methods. Conclusion The synthesis of the available evidence underscores the substantial positive impact of 3D imaging techniques and virtual patients on dental implant planning and surgical placement accuracy. Utilizing these technologies contributes to a more personalized and precise approach that enhances overall treatment outcomes. Future research directions and potential refinements to the application of these technologies in clinical practice should be discussed.
Collapse
Affiliation(s)
- Ravinder S Saini
- Department of Dental Technology, COAMS, King Khalid University, Abha, Saudi Arabia
| | - Shashit Shetty Bavabeedu
- Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | | | | | - Masroor Ahmed Kanji
- Department of Dental Technology, COAMS, King Khalid University, Abha, Saudi Arabia
| | | | | | - Anna Avetisyan
- Department of Therapeutic Stomatology, Faculty of Stomatology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
| | - Artak Heboyan
- Department of Prosthodontics, Faculty of Stomatology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| |
Collapse
|
5
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
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
| |
Collapse
|
6
|
Rutkunas V, Gendviliene I, Auskalnis L, Mangano F, Zlatev S, Ivanova V, Mijiritsky E, Borusevicius R. Influence of Kennedy class and number of implants on the accuracy of dynamic implant navigation: An in vitro study using an X-ray free evaluation methodology. J Dent 2023; 139:104679. [PMID: 37683800 DOI: 10.1016/j.jdent.2023.104679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 05/21/2023] [Accepted: 08/11/2023] [Indexed: 09/10/2023] Open
Abstract
OBJECTIVES The aim of this in vitro study was to evaluate the accuracy of fully guided dynamic implant navigation surgery in Kennedy I, II, and III class dental arch defects with two different implant designs, using an X-ray free evaluation method. METHODS Polyurethane resin maxillary models simulated posterior edentulous defects. Four cone beam computed tomography (CBCT) scans and four intraoral (IOS) scans were obtained for each model and a digital wax-up with the correct implant positions was made. The accuracy of implant positions was evaluated using an IOS-based X-ray-free method (3Shape). Four deviation characteristics were evaluated: insertion point, depth deviation, horizontal and angle deviation. RESULTS The insertion point deviation measures ranged from 0.19 mm to 1.71 mm. Depth (s) and (u) deviations ranged from -1.47 mm to 0.74 mm and from 0.02 mm to 1.47 mm, respectively. Horizontal deviation ranged from 0.09 mm to 1.37 mm. CONCLUSIONS There is a tendency of a decreasing insertion point deviation for an increasing number and distribution area of the teeth (increasing Kennedy class number). Kennedy class II and distal implant position had the most influence for the higher deviations. CLINICAL SIGNIFICANCE Dynamic implant guidance provides accurate spacing, angulation, depth and position of the implants. It is important to understand how the number of missing teeth and implant design could influence the accuracy of dynamic implant navigation. Thus, it is important to evaluate factors influencing the accuracy of dynamic systems by using a X-ray-free post-operative method and to overcome the limitations of providing multiple CBCT scans.
Collapse
Affiliation(s)
- Vygandas Rutkunas
- Institute of Odontology, Faculty of Medicine, Vilnius University, Vilnius 03101, Lithuania
| | - Ieva Gendviliene
- Institute of Odontology, Faculty of Medicine, Vilnius University, Vilnius 03101, Lithuania
| | - Liudas Auskalnis
- Institute of Odontology, Faculty of Medicine, Vilnius University, Vilnius 03101, Lithuania
| | - Francesco Mangano
- Honorary Professor in Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Stefan Zlatev
- CAD/CAM Center of Dental Medicine at the Research Institute, Medical University-Plovdiv, Plovdiv 4000, Bulgaria
| | - Vasilena Ivanova
- Oral Surgery Department, Faculty of Dental Medicine, Medical University of Plovdiv, Plovdiv 4000, Bulgaria
| | - Eitan Mijiritsky
- Head and Neck Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Department of Otolaryngology, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 699350, Israel
| | - Rokas Borusevicius
- Institute of Odontology, Faculty of Medicine, Vilnius University, Vilnius 03101, Lithuania.
| |
Collapse
|
7
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
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.
| |
Collapse
|
8
|
Mampilly M, Kuruvilla L, Tash Niyazi AA, Shyam A, Thomas PA, Ali AS, Pullishery F. Accuracy and Self-Confidence Level of Freehand Drilling and Dynamic Navigation System of Dental Implants: An In Vitro Study. Cureus 2023; 15:e49618. [PMID: 38161848 PMCID: PMC10755335 DOI: 10.7759/cureus.49618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 11/20/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND AND OBJECTIVE The impact of the experience of the clinician on learning a new skill or equipment was still an intriguing subject. The goal of this research is to determine the accuracy level of a dynamic navigation system to that of freehand drilling by expert and novice practitioners with varied levels of experience. Additionally, the duration of the surgical procedure and the self-confidence level of the surgeons were also evaluated. MATERIALS AND METHODS An analog impression of the patient was used to make 20 polyurethane simulation models of the maxilla. Five expert and five inexperienced surgeons prepared the site and placed the implants at random on ten models each. Two different techniques were used to insert dental implants: freehand and dynamic navigation systems. Dental implants were placed in Group 1 utilizing a computer-assisted dynamic navigation device. The implants in Group 2 were secured using free-hand drilling. The dental implants were inserted first in the maxillary right first molar, then in the maxillary right lateral incisor, and the maxillary left second premolar. Preoperative and postoperative CBCT scans were superimposed by employing the Evalunav software and contrasted. The coronal 3-D, apex 3-D, apex vertical depth, and angular deviations for both procedures were evaluated. A pre-tested self-confidence questionnaire was also administered to assess the self-confidence of the practitioners. The duration of the surgical time was also documented for each strategy. The t-test was used to measure the difference in accuracy and confidence levels between freehand and dynamic navigation systems among expert and novice surgeons using SPSS software (IBM Corp., Armonk, NY, USA). RESULTS A total of 60 implants were used (three insertion sites, two methods, and 10 practitioners). Each of the five expert and novice clinicians implanted 15 implants (five models each). Except for entry 3-D, there was a statistically significant difference between the two approaches in all of the primary outcome variables. The apex 3-D (5.89±1.08 mm) and apex vertical (2.08±1.27 mm) dimensions of the dynamic navigation system were significantly smaller than those of the freehand drilling approach (p<005). Dynamic navigation and freehand drilling had angular deviations of 7.16±1.76ᵒ and 9.06±2.18ᵒ, respectively (p=0.0004). The apex vertical deviation was reduced in the navigation technique (2.07±1.5 mm) than in the freehand drilling (2.86±1.4 mm) by experienced practitioners (p=0.04). The difference in time between the two procedures was determined to be statistically highly significant (p<0.001) by both expert and novice surgeons. Furthermore, when contrasting with experienced practitioners, novice practitioners had an overall increase in surgery time (p<0.001) for both approaches. CONCLUSION The current in vitro study found that the dynamic navigation system enables more accurate implant placement than the freehand drilling technique, irrespective of the experience of the surgeons. However, this technique appears to benefit novice practitioners more, as they can profoundly minimize their deviations while accomplishing results comparable to those of expert surgeons.
Collapse
Affiliation(s)
- Mathew Mampilly
- Oral and Maxillofacial Surgery, Esic Medical college and PG Institute, Bengaluru, IND
| | - Leelamma Kuruvilla
- Dentistry, Dr. Suzanne Caudry Implant Dentistry and Periodontics, Toronto, CAN
| | | | - Arun Shyam
- Conservative Dentistry and Endodontics, Kannur Dental College, Anjarakkandy, IND
| | | | - Anzil S Ali
- Public Health Dentistry, Royal Dental College, Palakkad, IND
| | - Fawaz Pullishery
- Community Dentistry and Research, Batterjee Medical College, Jeddah, SAU
| |
Collapse
|
9
|
Wu BZ, Ma FF, Sun F. Analysis of the accuracy of a dynamic navigation system when performing dental implant surgery with transcrestal sinus floor elevation: A pilot study. J Dent Sci 2023; 18:1747-1755. [PMID: 37799911 PMCID: PMC10547952 DOI: 10.1016/j.jds.2022.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 12/18/2022] [Indexed: 01/04/2023] Open
Abstract
Background/purpose The success of transcrestal sinus floor elevation (TSFE) is primarily reliant upon the experience of the surgeon owing to the limited operative visibility. To evaluate the accuracy associated with the use of a dynamic navigation system when conducting posterior maxilla implant surgery with TSFE. Materials and methods Twenty-eight implants were placed in 28 patients requiring implantation in the posterior maxilla via a TSFE approach. The drills were used to access the planned position (within 1 mm of the bottom of the maxillary sinus floor) under dynamic navigation system. TSFE was then accomplished using osteotomes and a piezoelectric device. Lastly, the implant was inserted under the dynamic navigation. Three effective deviations between planned and actual implant placement were then measured including angular deviation (AD, degrees), entry point horizontal deviation (EPHD, mm), and apical point horizontal deviation (APHD, mm). Results The AD, EPHD, and APHD between the planned and actual implant placement were 3.656 ± 1.665°, 1.073 ± 0.686 mm, and 1.086 ± 0.667 mm, respectively. Premolar site AD values were less than those for molar sites (P = 0.004). No significant differences in these outcomes were observed in different surgeons. Obvious sinus perforation was not detected by immediate postoperative cone beam computed tomography imaging. Conclusion The accuracy associated with using a dynamic navigation system when conducting posterior maxilla implant surgery via a TSFE approach using piezoelectric devices was comparable. This technique thus achieved appropriate interventional precision and safety while decreasing the morbidity associated with the TSFE approach.
Collapse
Affiliation(s)
- Bin-Zhang Wu
- First Clinical Division, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, PR China
| | - Fei-Fei Ma
- First Clinical Division, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, PR China
| | - Feng Sun
- First Clinical Division, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, PR China
| |
Collapse
|
10
|
Vinnakota DN, Kamatham R, Nagaraj E, Reddy PS. Is dynamic computer-assisted surgery more accurate than the static method for dental implant placement? A systematic review and meta-analysis. J Prosthet Dent 2023:S0022-3913(23)00493-6. [PMID: 37690856 DOI: 10.1016/j.prosdent.2023.07.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 07/22/2023] [Accepted: 07/26/2023] [Indexed: 09/12/2023]
Abstract
STATEMENT OF PROBLEM Dynamic computer-assisted surgery for dental implant placement has become popular, but systematic comparisons of the accuracy of computer-assisted surgery with static surgery are lacking. PURPOSE The purpose of this systematic review and meta-analysis was to determine evidence on the difference in the accuracy of dynamic computer-assisted surgery compared with the static method for dental implant placement. MATERIAL AND METHODS A systematic search was conducted in 3 electronic databases: PubMed, Ovid, and Cochrane. Studies conducted on dental implants that compared the accuracy of positioning implants with a dynamic system with that of a static system were included. Randomized clinical trials, prospective and retrospective cohort studies, and in vitro studies were included in the review. Review articles, case reports, letters, opinion articles, commentaries, and nonpeer-reviewed literature were excluded. RESULTS Of the 26 full-text articles, 14 fulfilled the inclusion criteria. Of these, 2 were randomized clinical trials, 2 were prospective studies, and 1 was a retrospective cohort study. The remaining 9 were in vitro studies. A total of 1633 implants were placed with the static and 902 with the dynamic method. A significant mean difference (-0.51 degrees [95% CI: -0.90, -0.13]) between dynamic and static systems was only observed in the angular deviation of in vitro studies (P=.009). Meta-analysis was performed using Review Manager statistical software and forest plots were generated. CONCLUSIONS A difference was found in the angular deviation of implants placed with the dynamic approach compared with the static system. The dynamic system was better, but this difference was not demonstrable in clinical studies. No significant difference was found in the apical and coronal deviations of the dynamic and static systems.
Collapse
Affiliation(s)
- Dileep Nag Vinnakota
- Professor, Department of Prosthodontics, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India.
| | - Rekhalakshmi Kamatham
- Associate Professor, Department of Paediatrics and Preventive Dentistry, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
| | - Edamadaka Nagaraj
- Professor, Department of Prosthodontics, PMNM Dental College and Hospital, Bagalkot, Karnataka, India
| | - Papala Sesha Reddy
- Professor, Department of Prosthodontics, Government Dental College and Hospital, RIMS, Kadapa, Andhra Pradesh, India
| |
Collapse
|
11
|
Luo T, Xie C, Wu J, Zhu J, Yu H. A digital strategy for intraoperative acquisition of actual drill position and rapid assessment of bony preparation accuracy using an intraoral scanner. Heliyon 2023; 9:e18004. [PMID: 37483804 PMCID: PMC10362229 DOI: 10.1016/j.heliyon.2023.e18004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 07/02/2023] [Accepted: 07/05/2023] [Indexed: 07/25/2023] Open
Abstract
A digital workflow to acquire actual position of the drill and assess bony preparation accuracy intraoperatively was described. Based on the widely used intraoral scanner, this digital workflow was a relatively practical and economical option for digital intraoperative measurement. As a result, it could help the clinician in accurate verification and immediate correction of the drill position and consequently facilitating the accurate implant placement in implant surgery.
Collapse
Affiliation(s)
- Tian Luo
- State Key Laboratory of Oral Disease, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Chenyang Xie
- Department of Dental Technology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jiacheng Wu
- Department of Dental Technology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jiakang Zhu
- State Key Laboratory of Oral Disease, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Haiyang Yu
- State Key Laboratory of Oral Disease, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| |
Collapse
|
12
|
González Rueda JR, Galparsoro Catalán A, de Paz Hermoso VM, Riad Deglow E, Zubizarreta-Macho Á, Pato Mourelo J, Montero Martín J, Hernández Montero S. Accuracy of computer-aided static and dynamic navigation systems in the placement of zygomatic dental implants. BMC Oral Health 2023; 23:150. [PMID: 36918837 PMCID: PMC10015906 DOI: 10.1186/s12903-023-02856-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 03/04/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Zygomatic implants are widely used in the rehabilitation of severely atrophic maxillae, but implant placement is not without risks, and it can potentially cause damage to related anatomical structures. The aim of this study was to perform a comparative analysis of the accuracy of static navigation systems in placing zygomatic dental implants in comparison to dynamic navigation systems. METHODS Sixty zygomatic dental implants were randomly allocated to one of three study groups, categorized by which implant placement strategy was used: A: computer-aided static navigation system (n = 20) (GI); B: computer-aided dynamic navigation system (n = 20) (NI); or C: free-hand technique (n = 20) (FHI). For the computer-aided study groups, a preoperative cone-beam computed tomography (CBCT) scan of the existing situation was performed in order to plan the approach to be used during surgery. Four zygomatic dental implants were inserted in each of fifteen polyurethane stereolithographic models (n = 15), with a postoperative CBCT scan taken after the intervention. The pre- and postoperative CBCT scans were then uploaded to a software program used in dental implantology to analyze the angular deviations, apical end point, and coronal entry point. Student's t-test was used to analyze the results. RESULTS The results found statistically significant differences in apical end-point deviations between the FHI and NI (p = 0.0053) and FHI and GI (p = 0.0004) groups. There were also statistically significant differences between the angular deviations of the FHI and GI groups (p = 0.0043). CONCLUSIONS The manual free-hand technique may enable more accurate placement of zygomatic dental implants than computer-assisted surgical techniques due to the different learning curves required for each zygomatic dental implant placement techniques.
Collapse
Affiliation(s)
- Juan Ramón González Rueda
- grid.464699.00000 0001 2323 8386Department of Implant Surgery, Faculty of Health Sciences, Alfonso X El Sabio University, Avda. Universidad, 1, Villanueva de la Cañada, 28691 Madrid, Spain
| | - Agustín Galparsoro Catalán
- grid.464699.00000 0001 2323 8386Department of Implant Surgery, Faculty of Health Sciences, Alfonso X El Sabio University, Avda. Universidad, 1, Villanueva de la Cañada, 28691 Madrid, Spain
| | | | - Elena Riad Deglow
- grid.464699.00000 0001 2323 8386Department of Implant Surgery, Faculty of Health Sciences, Alfonso X El Sabio University, Avda. Universidad, 1, Villanueva de la Cañada, 28691 Madrid, Spain
| | - Álvaro Zubizarreta-Macho
- grid.464699.00000 0001 2323 8386Department of Implant Surgery, Faculty of Health Sciences, Alfonso X El Sabio University, Avda. Universidad, 1, Villanueva de la Cañada, 28691 Madrid, Spain
- grid.11762.330000 0001 2180 1817Department of Surgery, Faculty of Medicine, University of Salamanca, 37008 Salamanca, Spain
| | - Jesús Pato Mourelo
- grid.5924.a0000000419370271Department of Surgery, Faculty of Dentistry, University of Navarra, 31009 Pamplona, Navarra Spain
| | - Javier Montero Martín
- grid.11762.330000 0001 2180 1817Department of Surgery, Faculty of Medicine, University of Salamanca, 37008 Salamanca, Spain
| | - Sofía Hernández Montero
- grid.464699.00000 0001 2323 8386Department of Implant Surgery, Faculty of Health Sciences, Alfonso X El Sabio University, Avda. Universidad, 1, Villanueva de la Cañada, 28691 Madrid, Spain
| |
Collapse
|
13
|
Wu BZ, Xue F, Ma Y, Sun F. Accuracy of automatic and manual dynamic navigation registration techniques for dental implant surgery in posterior sites missing a single tooth: A retrospective clinical analysis. Clin Oral Implants Res 2023; 34:221-232. [PMID: 36691811 DOI: 10.1111/clr.14034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/24/2022] [Accepted: 01/12/2023] [Indexed: 01/25/2023]
Abstract
OBJECTIVES To assess the relative accuracy of manual (U-shaped tube) and automatic (two-in-one) dynamic navigation registration techniques for implant surgery performed in posterior sites missing one tooth. MATERIALS AND METHODS This study included 58 partially edentulous patients with 58 implants, including 31 and 27 in the manual and automatic groups. Deviations between the planned and actual implant placement were assessed. RESULTS The angular deviation in the overall study cohort was 2.54 ± 1.21°, while the 3D deviations at the implant platform and apex were 0.90 ± 0.46 mm and 1.04 ± 0.47 mm, respectively. The respective angular deviations in the manual and automatic groups were 2.82 ± 1.17° and 2.21 ± 1.19° (p > .05), while platform deviations were 0.89 ± 0.48 mm and 0.91 ± 0.45 mm (p > .05), and apex deviations were 0.99 ± 0.48 mm and 1.11 ± 0.46 mm (p > .05). No significant differences in absolute buccolingual, mesiodistal, or apicocoronal deviations were detected between these groups at either level (p > .05) nor were did deviation distributions differ in the buccolingual, mesiodistal, or apicocoronal directions at the platform or apex levels (p > .05). CONCLUSIONS Manual and automatic dynamic navigation registration techniques can achieve excellent accuracy when placing implants in posterior sites missing a single tooth. The two-in-one automatic registration technique can reduce the amount of time and intraoperative steps necessary to complete the registration process relative to the manual U-shaped tube registration technique. Further follow-up studies are necessary to expand on these results.
Collapse
Affiliation(s)
- Bin-Zhang Wu
- First Clinical Division, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Fei Xue
- First Clinical Division, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Yu Ma
- First Clinical Division, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Feng Sun
- First Clinical Division, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| |
Collapse
|
14
|
Wang X, Shujaat S, Meeus J, Shaheen E, Legrand P, Lahoud P, Gerhardt MDN, Jacobs R. Performance of novice versus experienced surgeons for dental implant placement with freehand, static guided and dynamic navigation approaches. Sci Rep 2023; 13:2598. [PMID: 36788333 PMCID: PMC9929278 DOI: 10.1038/s41598-023-29633-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 02/08/2023] [Indexed: 02/16/2023] Open
Abstract
Lack of evidence exists related to the investigation of the accuracy and efficacy of novice versus experienced practitioners for dental implant placement. Hence, the following in vitro study was conducted to assess the accuracy of implant positioning and self-efficacy of novice compared to experienced surgeons for placing implant using freehand (FH), pilot drill-based partial guidance (PPG) and dynamic navigation (DN) approaches. The findings revealed that DN significantly improved the angular accuracy of implant placement compared with FH (P < 0.001) and PPG approaches (P < 0.001). The time required with DN was significantly longer than FH and PPG (P < 0.001), however, it was similar for both novice and experienced practitioners. The surgeon's self-confidence questionnaire suggested that novice practitioners scored higher with both guided approaches, whereas experienced practitioners achieved higher scoring with PPG and FH compared to DN. In conclusion, implant placement executed under the guidance of DN showed high accuracy irrespective of the practitioner's experience. The application of DN could be regarded as a beneficial tool for novices who offered high confidence of using the navigation system with the same level of accuracy and surgical time as that of experienced practitioners.
Collapse
Affiliation(s)
- Xiaotong Wang
- OMFS IMPATH Research Group, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Sohaib Shujaat
- OMFS IMPATH Research Group, Department of Imaging and Pathology, KU 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
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Jan Meeus
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Eman Shaheen
- OMFS IMPATH Research Group, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Paul Legrand
- OMFS IMPATH Research Group, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Pierre Lahoud
- OMFS IMPATH Research Group, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Maurício do Nascimento Gerhardt
- OMFS IMPATH Research Group, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
- School of Health Sciences, Faculty of Dentistry, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium.
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.
- Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.
| |
Collapse
|
15
|
Geng N, Ren J, Zhou T, Xia Y, Chen S. Clinical study of dynamic real-time navigation assisted immediate implant without flapping in the esthetic zone. J Stomatol Oral Maxillofac Surg 2023; 124:101278. [PMID: 36064144 DOI: 10.1016/j.jormas.2022.08.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 07/16/2022] [Accepted: 08/31/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The purpose of this study is to investigate the clinical effect of Dynamic real-time navigation to assist immediate implant without flapping in the esthetic zone. METHODS Eight patients who underwent immediate implantation in the aesthetic area were included. A total of 11 implants were implanted using dynamic real-time navigation system combined with non-flap technology. Clinical indicators including implant deviation, initial stability, alveolar bone absorption, implant success rate, pink esthetic score (PES), Papilla index score (PIS), and the thickness of labial side bone plate of the implant were recorded. RESULTS The deviation between the actual implant position and the preoperative design was (0.76±0.08) mm at the top, (1.11±0.18) mm at the root, (0.90±0.16) mm at the depth, and (1.48±0.91)°at the Angle. ISO values of all implants were greater than 59. PES was greater than 8. PIS index was 2 or 3. The average alveolar bone absorption was (0.34±0.09) mm and the thickness of bone plate on the lip of implant was greater than 1.6 mm. The success rate of implantation was 100%. CONCLUSION The use of dynamic real-time navigation assisted non-flap implantation in the aesthetic area can effectively reduce implant deviation and improve the aesthetic effect.
Collapse
Affiliation(s)
- Ningbo Geng
- Department of stomatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - Jing Ren
- Department of stomatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - Tianren Zhou
- Department of stomatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - Yixin Xia
- Department of stomatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - Songling Chen
- Department of stomatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, People's Republic of China.
| |
Collapse
|
16
|
Wei T, Ma F, Sun F, Ma Y. Assessment of the Accuracy of Two Different Dynamic Navigation System Registration Methods for Dental Implant Placement in the Posterior Area: An In Vitro Study. J Pers Med 2023; 13. [PMID: 36675800 DOI: 10.3390/jpm13010139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/05/2023] [Accepted: 01/09/2023] [Indexed: 01/12/2023] Open
Abstract
Purpose: To compare the U-tube and cusp dynamic navigation system registration methods in the use of dental implant placement, and to assess the influence of the location of missing teeth on these registrations. Methods: 32 resin mandible models and 64 implants were utilized, with implants being placed using one of the two registration methods selected at random. Accuracy was measured through the superimposition of the final and planned implant positions. Angular deviation, 3D entry deviation, and 3D apex deviation were analyzed. Results: The overall mean 3D deviation was 1.089 ± 0.515 mm at the entry point and 1.174 ± 0.531 mm at the apex point, and mean angular deviation was 1.970 ± 1.042 degrees. No significant difference (p > 0.05) was observed when comparing these two registration methods. However, the U-tube method showed significant difference when assessing the location of missing teeth (without distal-extension absence and distal-extension absence), whereas cusp registration was unaffected. Conclusions: Both the U-tube and cusp dynamic navigation system registration methods are accurate when implemented in vitro. Besides, the cusp registration technique can also overcome several of the limitations of the U-tube approach and the accuracy of it was not influenced by the location of the missing teeth, highlighting it as a method worthy of further clinical research.
Collapse
|
17
|
Akin R, Chapple AG. Clinical Advantages of Immediate Posterior Implants With Custom Healing Abutments: Up to 8-Year Follow-Up of 115 Cases. J Oral Maxillofac Surg 2022; 80:1952-1965. [PMID: 36155739 DOI: 10.1016/j.joms.2022.08.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 08/22/2022] [Accepted: 08/22/2022] [Indexed: 11/18/2022]
Abstract
PURPOSE Proper management of the soft tissues around dental implants is crucial to their long-term function and esthetics. The purpose of this article is to report the survival rate of immediate posterior implants when using an immediate chair-side technique for custom healing abutments. MATERIALS AND METHODS The investigator implemented a retrospective case series analysis of a sample of 115 consecutive patients with 1 posterior dental implant placed between February 1, 2012 and December 9, 2014, in the author's private practice who underwent the previously published technique for immediate custom chair-side healing abutment fabrication. In this descriptive analysis, the primary outcome variable was implant survival. Other variables included patient gender and age. RESULTS Of the 115 patients in this cohort, 66 were female and 49 were male, with a mean age of 58 years, with 73% of the sites being first molars and 27% second molars. This study sample had a 98.26% overall implant survival rate with 3 implant failures. Median follow-up time was 1 year with identical 1-year and 5-year survival rates. Follow-up at up to 8 years demonstrated a 98.26% overall survival rate with 100% survival in the maxilla and 96.08% in the mandible. CONCLUSIONS This case series demonstrates that the Anatomic Harmony Abutment technique, by applying principles of flapless posterior immediate implant surgery with immediate custom healing abutment placement, can lead to highly successful implant outcomes.
Collapse
Affiliation(s)
- Richard Akin
- Board Certified Oral and Maxillofacial Surgeon, Clinical Assistant Professor, LSU Health Sciences Center, Private Practice, Baton Rouge, LA.
| | - Andrew G Chapple
- Biostatistics Assistant Professor, School of Public Health, LSU Health Sciences Center, New Orleans, LA
| |
Collapse
|
18
|
Wang X, Shaheen E, Shujaat S, Meeus J, Legrand P, Lahoud P, do Nascimento Gerhardt M, Politis C, Jacobs R. Influence of experience on dental implant placement: an in vitro comparison of freehand, static guided and dynamic navigation approaches. Int J Implant Dent 2022; 8. [PMID: 36210395 PMCID: PMC9548458 DOI: 10.1186/s40729-022-00441-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 09/20/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Purpose
This study aimed to investigate the performance of novice versus experienced practitioners for placing dental implant using freehand, static guided and dynamic navigation approaches.
Methods
A total of 72 implants were placed in 36 simulation models. Three experienced and three novice practitioners were recruited for performing the osteotomy and implant insertion with freehand, surgical guide (pilot-drill guidance) and navigation (X-Guide, X-Nav technologies) approaches. Each practitioner inserted 4 implants per approach randomly with a 1-week gap to avoid memory bias (4 insertion sites × 3 approaches × 6 practitioners = 72 implants). The performance of practitioners was assessed by comparing actual implant deviation to the planned position, time required for implant placement and questionnaire-based self-confidence evaluation of practitioners on a scale of 1–30.
Results
The navigation approach significantly improved angular deviation compared with freehand (P < 0.001) and surgical guide (P < 0.001) irrespective of the experience. Surgical time with navigation was significantly longer compared to the freehand approach (P < 0.001), where experienced practitioners performed significantly faster compared to novice practitioners (P < 0.001). Overall, self-confidence was higher in favor of novice practitioners with both guided approaches. In addition, the confidence of novice practitioners (median score = 26) was comparable to that of experienced practitioners (median score = 27) for placing implants with the navigation approach.
Conclusions
Dynamic navigation system could act as a viable tool for dental implant placement. Unlike freehand and static-guided approaches, novice practitioners showed comparable accuracy and self-confidence to that of experienced practitioners with the navigation approach.
Graphical Abstract
Collapse
|
19
|
Stünkel R, Zeller AN, Bohne T, Böhrnsen F, Wedi E, Raschke D, Kauffmann P. Accuracy of intraoral real-time navigation versus static, CAD/CAM-manufactured pilot drilling guides in dental implant surgery: an in vitro study. Int J Implant Dent 2022; 8:41. [PMID: 36198996 PMCID: PMC9535055 DOI: 10.1186/s40729-022-00430-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 07/11/2022] [Indexed: 11/18/2022] Open
Abstract
Background Nowadays, 3D planning and static for dynamic aids play an increasing role in oral rehabilitation of the masticatory apparatus with dental implants. The aim of this study is to compare the accuracy of implant placement using a 3D-printed drilling guide and an intraoral real-time dynamic navigation system. Methods A total of 60 implants were placed on 12 partially edentulous lower jaw models. 30 were placed with pilot drilling guides, the other half with dynamic navigation (DENACAM®). In addition, implant placement in interdental gaps and free-end situations were investigated. Accuracy was assessed by cone-beam computed tomography (CBCT). Results Both systems achieved clinically acceptable results, yet more accurate results regarding the offset of implant base and tip in several spatial dimensions were achieved using drilling guides (each p < 0.05). With regard to angulation, real-time navigation was more precise (p = 0.0016). Its inaccuracy was 3°; the template-guided systems was 4.6°. Median horizontal deviation was 0.52 mm at base and 0.75 mm at tip using DENACAM®. When using the pilot drill guide, horizontal deviation was 0.34 mm in the median and at the tip by 0.59 mm. Regarding angulation, it was found that the closer the drill hole was to the system's marker, the better navigation performed. The template did not show this trend (p = 0.0043; and p = 0.0022). Conclusion Considering the limitations of an in vitro study, dynamic navigation can be used be a tool for reliable and accurate implantation. However, further clinical studies need to follow in order to provide an evidence-based recommendation for use in vivo. Supplementary Information The online version contains supplementary material available at 10.1186/s40729-022-00430-6.
Collapse
Affiliation(s)
- Robert Stünkel
- Department of Maxillofacial Surgery, Georg August University, Göttingen, Germany
| | - Alexander-Nicolai Zeller
- Department of Maxillofacial Surgery, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany.
| | | | - Florian Böhrnsen
- Department of Maxillofacial Surgery, Georg August University, Göttingen, Germany
| | - Edris Wedi
- Department of Gastroenterology and Gastrointestinal Oncology, Interdisciplinary Endoscopy, University Medical Center, Georg August University, Göttingen, Germany
| | - David Raschke
- Department of Maxillofacial Surgery, Georg August University, Göttingen, Germany
| | - Philipp Kauffmann
- Department of Maxillofacial Surgery, Georg August University, Göttingen, Germany
| |
Collapse
|
20
|
Spille J, Helmstetter E, Kübel P, Weitkamp JT, Wagner J, Wieker H, Naujokat H, Flörke C, Wiltfang J, Gülses A. Learning Curve and Comparison of Dynamic Implant Placement Accuracy Using a Navigation System in Young Professionals. Dent J (Basel) 2022; 10. [PMID: 36285997 DOI: 10.3390/dj10100187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/26/2022] [Accepted: 09/29/2022] [Indexed: 11/30/2022] Open
Abstract
The aim of the current study was to evaluate the learning curve and accuracy of implant placement by young professionals using a dynamic computer-assisted surgical system for dental implant placement. Ten students tried to place eight implants with a dynamic surgical system in predefined positions on two consecutive weekends, resulting in 160 implant placements in total. Postoperatively, the positions of the implants were scanned with an intraoral scanner and compared for deviations at the entry point, the apex, as well as angular deviations to the master model. The mean values of all measurements improved; statistical significance was found for the changes in the angle as well as for the position of the implants to the apex (p < 0.001). Furthermore, the young professionals indicated subjective improvement in handling the dynamic surgery system. Navigated surgical dental implant placement can be learned quickly and can support young professionals in everyday clinical practice, especially in difficult anatomic situations.
Collapse
|
21
|
Faus-Matoses V, Faus-Llácer V, Moradian T, Riad Deglow E, Ruiz-Sánchez C, Hamoud-Kharrat N, Zubizarreta-Macho Á, Faus-Matoses I. Accuracy of Endodontic Access Cavities Performed Using an Augmented Reality Appliance: An In Vitro Study. Int J Environ Res Public Health 2022; 19:11167. [PMID: 36141439 PMCID: PMC9517686 DOI: 10.3390/ijerph191811167] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 08/29/2022] [Accepted: 09/03/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION The purpose of this study was to compare and contrast the accuracy of endodontic access cavities created using an augmented reality appliance to those performed using the conventional technique. MATERIALS AND METHODS 60 single-rooted anterior teeth were chosen for study and randomly divided between two study groups: Group A-endodontic access cavities created using an augmented reality appliance as a guide (n = 30) (AR); and Group B-endodontic access cavities performed with the manual (freehand) technique (n = 30) (MN). A 3D implant planning software was used to plan the endodontic access cavities for the AR group, with a cone-beam computed tomography (CBCT) and 3D intraoral surface scan taken preoperatively and subsequently transferred to the augmented reality device. A second CBCT scan was taken after performing the endodontic access cavities to compare the planned and performed endodontic access for accuracy. Therapeutic planning software and Student's t-test were used to analyze the cavities at the apical, coronal, and angular levels. The repeatability and reproducibility of the digital measurement technique were analyzed using Gage R&R statistical analysis. RESULTS The paired t-test found statistically significant differences between the study groups at the coronal (p = 0.0029) and apical (p = 0.0063) levels; no statistically significant differences were found between the AR and MN groups at the angular (p = 0.6596) level. CONCLUSIONS Augmented reality devices enable the safer and more accurate performance of endodontic access cavities when compared with the conventional freehand technique.
Collapse
Affiliation(s)
- Vicente Faus-Matoses
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain
| | - Vicente Faus-Llácer
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain
| | - Tanaz Moradian
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain
| | - Elena Riad Deglow
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X El Sabio University, 28691 Madrid, Spain
| | - Celia Ruiz-Sánchez
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain
| | - Nirmine Hamoud-Kharrat
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain
| | - Álvaro Zubizarreta-Macho
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X El Sabio University, 28691 Madrid, Spain
- Department of Surgery, Faculty of Medicine and Dentistry, University of Salamanca, 37008 Salamanca, Spain
| | - Ignacio Faus-Matoses
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain
| |
Collapse
|
22
|
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: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
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
| |
Collapse
|
23
|
Tao B, Feng Y, Fan X, Zhuang M, Chen X, Wang F, Wu Y. Accuracy of dental implant surgery using dynamic navigation and robotic systems: An in vitro study. J Dent 2022; 123:104170. [DOI: 10.1016/j.jdent.2022.104170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 04/21/2022] [Accepted: 05/31/2022] [Indexed: 10/18/2022] Open
|
24
|
Wang M, Rausch-Fan X, Zhan Y, Shen H, Liu F. Comparison of Implant Placement Accuracy in Healed and Fresh Extraction Sockets between Static and Dynamic Computer-Assisted Implant Surgery Navigation Systems: A Model-Based Evaluation. Materials (Basel) 2022; 15:2806. [PMID: 35454496 DOI: 10.3390/ma15082806] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 03/10/2022] [Accepted: 04/07/2022] [Indexed: 02/01/2023]
Abstract
The aim of this model-base study was to compare the accuracy of implant placement between static and dynamic computer-assisted implant surgery (CAIS) systems in a fresh extraction socket and healed ridge. A randomized in vitro study was conducted. Twenty 3D-printed maxillary models and 80 implants were used. One experienced researcher placed the implants using either the static navigation or dynamic navigation system. Accuracy was measured by overlaying the real position in the postoperative CBCT on the virtual presurgical placement of the implant in a CBCT image. Descriptive and bivariate analyses of the data were performed. In the fresh sockets, the mean deviation was 1.24 ± 0.26 mm (entry point), 1.69 ± 0.34 mm (apical point), and 3.44 ± 1.06° (angle discrepancy) in the static CAIS group, and 0.60 ± 0.29 mm, 0.78 ± 0.33 mm, and 2.47 ± 1.09° in the dynamic CIAS group, respectively. In the healed ridge, the mean deviation was 1.09 ± 0.17 mm and 1.40 ± 0.30 mm, and 2.12 ± 1.11° in the static CAIS group, and 0.80 ± 0.29 mm, 0.98 ± 0.37 mm, and 1.69 ± 0.76° in the dynamic CIAS group, respectively. Compared with the static CAIS system, the dynamic CAIS system resulted in significantly lower entry and apical errors in both fresh sockets and healed ridges. Differences in bone morphology therefore seem to have little effect on accuracy in the dynamic CAIS group.
Collapse
|
25
|
González Rueda JR, García Ávila I, de Paz Hermoso VM, Riad Deglow E, Zubizarreta-Macho Á, Pato Mourelo J, Montero Martín J, Hernández Montero S. Accuracy of a Computer-Aided Dynamic Navigation System in the Placement of Zygomatic Dental Implants: An In Vitro Study. J Clin Med 2022; 11:jcm11051436. [PMID: 35268527 PMCID: PMC8910948 DOI: 10.3390/jcm11051436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 02/28/2022] [Accepted: 03/03/2022] [Indexed: 11/16/2022] Open
Abstract
The objective of this in vitro study was to evaluate and compare the accuracy of zygomatic dental implant (ZI) placement carried out using a dynamic navigation system. Materials and Methods: Forty (40) ZIs were randomly distributed into one of two study groups: (A) ZI placement via a computer-aided dynamic navigation system (n = 20) (navigation implant (NI)); and (B) ZI placement using a conventional free-hand technique (n = 20) (free-hand implant (FHI)). A cone-beam computed tomography (CBCT) scan of the existing situation was performed preoperatively to plan the surgical approach for the computer-aided study group. Four zygomatic dental implants were placed in anatomically based polyurethane models (n = 10) manufactured by stereolithography, and a postoperative CBCT scan was performed. Subsequently, the preoperative planning and postoperative CBCT scans were added to dental implant software to analyze the coronal entry point, apical end point, and angular deviations. Results were analyzed using the Student’s t-test. Results: The results showed statistically significant differences in the apical end-point deviations between FHI and NI (p = 0.0018); however, no statistically significant differences were shown in the coronal entry point (p = 0.2617) or in the angular deviations (p = 0.3132). Furthermore, ZIs placed in the posterior region showed more deviations than the anterior region at the coronal entry point, apical end point, and angular level. Conclusions: The conventional free-hand technique enabled more accurate placement of ZIs than the computer-assisted surgical technique. In addition, placement of ZIs in the anterior region was more accurate than that in the posterior region.
Collapse
Affiliation(s)
- Juan Ramón González Rueda
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X El Sabio University, 28691 Madrid, Spain; (J.R.G.R.); (I.G.Á.); (E.R.D.); (S.H.M.)
| | - Irene García Ávila
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X El Sabio University, 28691 Madrid, Spain; (J.R.G.R.); (I.G.Á.); (E.R.D.); (S.H.M.)
| | | | - Elena Riad Deglow
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X El Sabio University, 28691 Madrid, Spain; (J.R.G.R.); (I.G.Á.); (E.R.D.); (S.H.M.)
| | - Álvaro Zubizarreta-Macho
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X El Sabio University, 28691 Madrid, Spain; (J.R.G.R.); (I.G.Á.); (E.R.D.); (S.H.M.)
- Department of Surgery, Faculty of Medicine, University of Salamanca, 37008 Salamanca, Spain;
- Correspondence:
| | - Jesús Pato Mourelo
- Department of Surgery, Faculty of Dentistry, University of Navarra, 31009 Pamplona, Spain;
| | - Javier Montero Martín
- Department of Surgery, Faculty of Medicine, University of Salamanca, 37008 Salamanca, Spain;
| | - Sofía Hernández Montero
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X El Sabio University, 28691 Madrid, Spain; (J.R.G.R.); (I.G.Á.); (E.R.D.); (S.H.M.)
| |
Collapse
|
26
|
Silva EJNL, De-Deus G, Souza EM, Belladonna FG, Cavalcante DM, Simões-Carvalho M, Versiani MA. Present status and future directions - Minimal endodontic access cavities. Int Endod J 2022; 55 Suppl 3:531-587. [PMID: 35100441 DOI: 10.1111/iej.13696] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 01/26/2022] [Accepted: 01/28/2022] [Indexed: 11/29/2022]
Abstract
In the last decades, the move of Medicine towards minimally invasive treatments is notorious and scientifically grounded. As Dentistry naturally follows its footsteps, minimal access preparation also became a trend topic in the endodontic field. This procedure aims to maximize preservation of dentine tissue, backed up by the idea that this is an effective way to reduce the incidence of post-treatment tooth fracture. However, with the assessment of the body of evidence on this topic, it is possible to observe some key-points (a) the demand for nomenclature standardization, (b) the requirement of specific tools such as ultra-flexible instruments, visual magnification, superior illumination, and three-dimensional imaging technology, (c) minimally invasive treatment does not seem to affect orifice location and mechanical preparation when using adequate armamentarium, but it (d) may impair adequate canal cleaning, disinfection, and filling procedures, and also (e) it displays contradictory results regarding the ability to increase the tooth strengthen compared to the traditional access cavity. In spite of that, it is undeniable that methodological flaws of some benchtop studies using extracted teeth may be responsible for the conflicting data, thus triggering the need for more sophisticated devices/facilities and specifically designed research in an attempt to make it clear the role of the access size/design on long-term teeth survival. Moreover, it is inevitable that a clinical approach like minimal endodontic access cavities that demands complex tools and skilled and experienced operators bring to the fore doubts on its educational impact mainly when confronted with the conflicting scientific output, ultimately provoking a cost-benefit analysis of its implementation as a routine technique. In addition, this review discusses the ongoing scientific and clinical status of minimally invasive access cavities aiming to input an in-depth and unbiased view over the rationale behind them, uncovering not only the related conceptual and scientific flaws, but also outlining future directions for research and clinical practices. The conclusions attempt to skip from passionate disputes highlighting the current body of evidence as weak and incomplete to guide decision making, demanding the development of a close-to-in-situ laboratory model or a large and well-controlled clinical trial to solve this matter.
Collapse
Affiliation(s)
- Emmanuel João Nogueira Leal Silva
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil.,Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Gustavo De-Deus
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Erick Miranda Souza
- Department of Dentistry II, Federal University of Maranhão, São Luís, Maranhão
| | | | | | - Marco Simões-Carvalho
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | | |
Collapse
|
27
|
Wei SM, Shi JY, Qiao SC, Zhang X, Lai HC, Zhang XM. Accuracy and primary stability of tapered or straight implants placed into fresh extraction socket using dynamic navigation: a randomized controlled clinical trial. Clin Oral Investig 2021. [PMID: 34797431 DOI: 10.1007/s00784-021-04247-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 10/23/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To compare the accuracy and primary stability of tapered and straight implants undergoing immediate implant placement with dynamic navigation. MATERIALS AND METHODS Patients with compromised anterior teeth in maxilla were recruited and allocated randomly into (1) tapered implant group (TI group) and (2) straight implant group (SI group). Implants were inserted into fresh sockets with dynamic navigation. Three-dimensional platform deviation, apex deviation, angular deviation, insertion torque value (ITV) and implant stability quotient (ISQ) were recorded. RESULTS Twenty patients with 20 implants were included. The overall platform, apex, and angular deviation were 0.87 ± 0.35 mm, 0.81 ± 0.34 mm, and 2.40 ± 1.31°, respectively. The accuracy was 0.86 ± 0.26 mm, 0.76 ± 0.33 mm, and 2.49 ± 1.54° for TI, and 0.89 ± 0.44 mm, 0.88 ± 0.36 mm, and 2.31 ± 1.01° for SI, with no significant difference (p = 0.85, 0.45, 0.76). Sagittal root position classification (SRP) class I may obtain greater error in numerical values in straight implants (0.97 ± 0.47 mm vs. 0.6 ± 0.16 mm, 0.92 ± 0.36 mm vs. 0.73 ± 0.36 mm, 2.48 ± 1.19° vs. 1.71 ± 0.14°). The overall ISQ was 60.74. ISQ was 60.48 for TI and 60.96 for SI, with no significant difference. Acceptable ITV (> 15 Ncm) was achieved in most of the included patients (SI 7/10, TI 9/10). CONCLUSIONS High accuracy and primary stability of immediate implant placement could be achieved both in tapered and straight implants with dynamic navigation systems. CLINICAL RELEVANCE Tapered and straight implants did not reach a consensus on which was better in immediate implant regarding to accuracy and primary stability. Our study demonstrated implant macrodesign did not affect accuracy and primary stability in immediate implant using dynamic navigation.
Collapse
|
28
|
Meng T, Zhang X. Accuracy of intentionally tilted implant placement in the maxilla using dynamic navigation: a retrospective clinical analysis. Int J Oral Maxillofac Surg 2021; 51:552-557. [PMID: 34561112 DOI: 10.1016/j.ijom.2021.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 07/03/2021] [Accepted: 09/07/2021] [Indexed: 11/15/2022]
Abstract
The aim of this retrospective study was to investigate the accuracy of dynamic navigation for the placement of intentionally tilted implants in the posterior maxilla. The study included 12 patients with edentulism or continuous multiple tooth loss, who had 48 implants inserted under dynamic navigation guidance in the posterior maxilla. Twenty-four implants near maxillary sinuses were intentionally tilted. The average platform deviation was 1.3 ± 0.4 mm (range 0.8-2.3 mm), apex deviation was 1.1 ± 0.5 mm (range 0.2-2.3 mm), and axis deviation was 3.1 ± 1.0° (range 1.8-6.7°). The other 24 implants were axially positioned. The average platform deviation was 1.5 ± 0.5 mm (range 0.7-3.1 mm), apex deviation was 1.3 ± 0.7 mm (range 0.5-3.1 mm), and axis deviation was 3.2 ± 1.5° (range 1.5-7.7°). There was no significant difference in platform deviation, apex deviation, or axis deviation between the tilted implants and implants in the axial position (P > 0.05). This analysis indicates that a dynamic navigation system can be used as a method of guidance to place intentionally tilted implants as accurately as axially positioned implants in the posterior maxilla, thereby preventing damage to the maxillary sinuses and the need to graft bone.
Collapse
Affiliation(s)
- T Meng
- First Clinical Division, Peking University School and Hospital of Stomatology & National Clinical Research Centre for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Haidian District, Beijing, PR China
| | - X Zhang
- First Clinical Division, Peking University School and Hospital of Stomatology & National Clinical Research Centre for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Haidian District, Beijing, PR China.
| |
Collapse
|
29
|
Gutiérrez Muñoz D, Obrador Aldover C, Zubizarreta-Macho Á, González Menéndez H, Lorrio Castro J, Peñarrocha-Oltra D, Montiel-Company JM, Hernández Montero S. Survival Rate and Prosthetic and Sinus Complications of Zygomatic Dental Implants for the Rehabilitation of the Atrophic Edentulous Maxilla: A Systematic Review and Meta-Analysis. Biology (Basel) 2021; 10:biology10070601. [PMID: 34209770 PMCID: PMC8301194 DOI: 10.3390/biology10070601] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 06/18/2021] [Accepted: 06/24/2021] [Indexed: 12/26/2022]
Abstract
Simple Summary Zygomatic dental implants have been proposed as an alternative to atrophic total edentulous maxillae rehabilitation with the necessity of bone grafting procedures. However, surgical, prosthetic, and maxillary sinus complications have been associated with this surgical procedure. Therefore, it is necessary to produce a systematic review and meta-analysis that provides evidence associated with the prognosis when using zygomatic dental implants as an alternative to atrophic total edentulous maxillae rehabilitation. Abstract The aim of this systematic review and meta-analysis was to analyze and compare the survival rate and prosthetic and sinus complications of zygomatic dental implants for the rehabilitation of the atrophic edentulous maxilla. Materials and methods: We conducted a systematic literature review and meta-analysis, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations, of clinical studies that evaluated the survival rate and prosthetic and sinus complications of zygomatic dental implants for the rehabilitation of the atrophic edentulous maxilla. Four databases were consulted during the literature search: Pubmed–Medline, Scopus, Embase, and Web of Science. After eliminating duplicate articles and applying the inclusion criteria, 46 articles were selected for the qualitative analysis and 32 for the quantitative analysis. Results: Four randomized controlled trials, 19 prospective clinical studies, 20 retrospective studies, and 3 case series were included in the meta-analysis. Conventional dental implants failure (n = 3549) were seen in 2.89% (IC-95% 1.83–3.96%), while zygomatic dental implants failure (n = 1895) were seen in 0.69% (IC-95% 0.21–1.16%). The measure of the effect size used was the Odds Ratio, which was estimated at 2.05 with a confidence interval of 95% between 1.22 and 3.44 (z test = 2.73; p-value = 0.006). The failure risk of conventional dental implants is 2.1 times higher than that of zygomatic dental implants. Slight heterogeneity was determined in the meta-analysis between 23 combined studies (Q test = 32.4; p-value = 0.070; I2 = 32.1%). Prosthetic complications were recorded in 4.9% (IC-95% 2.7–7.3%) and mild heterogeneity was observed in a meta-analysis of 28 combined studies (Q test = 88.2; p-value = 0.001; I2 = 69.4%). Sinus complications were seen in 4.7% (IC-95% 2.8–6.5%) and mild heterogeneity was observed in a meta-analysis of 32 combined studies (Q test = 75.3; p-value = 0.001; I2 = 58.8%). Conclusions: The high survival rate and low prosthetic and sinus complications related to zygomatic dental implants suggest the use of zygomatic dental implants for the rehabilitation of the atrophic edentulous maxilla.
Collapse
Affiliation(s)
- David Gutiérrez Muñoz
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X el Sabio University, 28691 Madrid, Spain; (D.G.M.); (C.O.A.); (H.G.M.); (J.L.C.); (S.H.M.)
| | - Caterina Obrador Aldover
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X el Sabio University, 28691 Madrid, Spain; (D.G.M.); (C.O.A.); (H.G.M.); (J.L.C.); (S.H.M.)
| | - Álvaro Zubizarreta-Macho
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X el Sabio University, 28691 Madrid, Spain; (D.G.M.); (C.O.A.); (H.G.M.); (J.L.C.); (S.H.M.)
- Department of Surgery, Faculty of Medicine and Dentistry, University of Salamanca, 37008 Salamanca, Spain
- Correspondence:
| | - Héctor González Menéndez
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X el Sabio University, 28691 Madrid, Spain; (D.G.M.); (C.O.A.); (H.G.M.); (J.L.C.); (S.H.M.)
| | - Juan Lorrio Castro
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X el Sabio University, 28691 Madrid, Spain; (D.G.M.); (C.O.A.); (H.G.M.); (J.L.C.); (S.H.M.)
| | - David Peñarrocha-Oltra
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain; (D.P.-O.); (J.M.M.-C.)
| | - José María Montiel-Company
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain; (D.P.-O.); (J.M.M.-C.)
| | - Sofía Hernández Montero
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X el Sabio University, 28691 Madrid, Spain; (D.G.M.); (C.O.A.); (H.G.M.); (J.L.C.); (S.H.M.)
| |
Collapse
|
30
|
Son K, Son YT, Kim JY, Lee JM, Yu WJ, Kim JW, Lee KB. Effect of repeated use of an implant handpiece on an output torque: An in-vitro study. J Adv Prosthodont 2021; 13:136-143. [PMID: 34234923 PMCID: PMC8250193 DOI: 10.4047/jap.2021.13.3.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 05/13/2021] [Accepted: 05/27/2021] [Indexed: 11/17/2022] Open
Abstract
PURPOSE This study aimed to evaluate the effect of repeated use of an implant handpiece under an implant placement torque (35 Ncm) and overloading torque condition (50 Ncm) on an output torque. MATERIALS AND METHODS Two types of implant handpiece systems (Surgicpro/X-DSG20L [NSK, Kanuma, Japan] and SIP20/CRB46LN [SAESHIN, Daegu, South Korea]) were used. The output torque was measured using a digital torque gauge. The height and angle (x, y, and z axes) of the digital torque gauge and implant handpiece were adjusted through a jig for passive connection. The experiment was conducted under the setting torque value of 35 Ncm (implant placement torque) and 50 Ncm (overloading torque condition) and 30 times per set; a total of 5 sets were performed (N = 150). For statistical analysis, the difference between the groups was analyzed using the Mann-Whitney U test and the Friedman test was used to confirm the change in output torque (α=.05). RESULTS NSK and SAESHIN implant handpieces showed significant differences in output torque results at the setting torques of 35 Ncm and 50 Ncm (P<.001). The type of implant handpiece and repeated use influenced the output torque (P<.001). CONCLUSION There may be a difference between the setting torque and actual output torque due to repeated use, and the implant handpiece should be managed and repaired during long-term use. In addition, for successful implant results in dental clinics, the output torque of the implant handpiece system should be checked before implant placement.
Collapse
Affiliation(s)
- KeunBaDa Son
- Department of Dental Science, Graduate School, Kyungpook National University, Daegu, Republic of Korea.,Advanced Dental Device Development Institute (A3DI), Kyungpook National University, Daegu, Republic of Korea
| | - Young-Tak Son
- Department of Dental Science, Graduate School, Kyungpook National University, Daegu, Republic of Korea.,Advanced Dental Device Development Institute (A3DI), Kyungpook National University, Daegu, Republic of Korea
| | - Ji-Young Kim
- Advanced Dental Device Development Institute (A3DI), Kyungpook National University, Daegu, Republic of Korea
| | - Jae-Mok Lee
- Department of Periodontology, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
| | - Won-Jae Yu
- Department of Orthodontics, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
| | - Jin-Wook Kim
- Department of Oral & Maxillofacial Surgery, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
| | - Kyu-Bok Lee
- Advanced Dental Device Development Institute (A3DI), Kyungpook National University, Daegu, Republic of Korea.,Department of Prosthodontics, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
| |
Collapse
|
31
|
Schnutenhaus S, Wagner M, Edelmann C, Luthardt RG, Rudolph H. Factors Influencing the Accuracy of Freehand Implant Placement: A Prospective Clinical Study. Dent J (Basel) 2021; 9:54. [PMID: 34068734 DOI: 10.3390/dj9050054] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/14/2021] [Accepted: 05/07/2021] [Indexed: 12/25/2022] Open
Abstract
(1) Background: The objective of implant prosthetic restoration is to ensure the best possible rehabilitation of function and esthetics. Optimal positioning of the implant with regard to the bone availability, surrounding soft tissue, and prosthetic sustainability should be strived for during implant placement. The factors influencing freehand implant placement and the accuracy achieved with this procedure are investigated in this prospective clinical study. (2) Methods: Implants were placed in the single-tooth edentulous sites of the premolar and molar areas in 52 patients. Three-dimensional (3D)-planning was performed virtually prior to the freehand implant operation, and the desired position of the implant was provided to the surgeon. (3) Results: The deviations between the planned and the actually achieved position with freehand implant placement showed the following mean values and standard deviations: angle 8.7 ± 4.8°, 3D deviation at the implant shoulder 1.62 ± 0.87 mm, mesiodistal deviation 0.87 ± 0.75 mm, buccolingual deviation 0.70 ± 0.66 mm, and apiocoronal deviation 0.95 ± 0.61 mm. The type of jaw had a significant influence on accuracy. Major deviations were observed in the lower jaw. Furthermore, the timing of implant placement influenced the mesiodistal deviation and angular deviation; (4) Conclusions: Freehand implant placement demonstrated a higher level of deviation between the planned and actually achieved implant positions. In particular, the ranges showed a large spread. From a prosthetic point of view, there may be complications during the restoration of the prosthetic crown if the implant exit point is not optimally located or if the implants show a high angular deviation.
Collapse
|
32
|
Spille J, Jin F, Behrens E, Açil Y, Lichtenstein J, Naujokat H, Gülses A, Flörke C, Wiltfang J. Comparison of implant placement accuracy in two different preoperative digital workflows: navigated vs. pilot-drill-guided surgery. Int J Implant Dent 2021; 7:45. [PMID: 33928447 PMCID: PMC8085150 DOI: 10.1186/s40729-021-00322-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 03/17/2021] [Indexed: 11/15/2022] Open
Abstract
Background The aim of the study is to evaluate the accuracy of a new implant navigation system on two different digital workflows. Methods A total of 18 phantom jaws consisting of hard and non-warping plastic and resembling edentulous jaws were used to stimulate a clinical circumstance. A conventional pilot-drill guide was conducted by a technician, and a master model was set by using this laboratory-produced guide. After cone beam computed tomography (CBCT) and 3D scanning of the master models, two different digital workflows (marker tray in CBCT and 3D-printed tray) were performed based on the Digital Imaging Communication in Medicine files and standard tessellation language files. Eight Straumann implants (4.1 mm × 10 mm) were placed in each model, six models for each group, resulting in 144 implant placements in total. Postoperative CBCT were taken, and deviations at the entry point and apex as well as angular deviations were measured compared to the master model. Results The mean total deviations at the implant entry point for MTC (marker tray in CBCT), 3dPT (3d-printed tray), and PDG (pilot-drill guide) were 1.024 ± 0.446 mm, 1.027 ± 0.455 mm, and 1.009 ± 0.415 mm, respectively, and the mean total deviations at the implant apex were 1.026 ± 0.383 mm, 1.116 ± 0.530 mm, and 1.068 ± 0.384 mm. The angular deviation for the MTC group was 2.22 ± 1.54°. The 3dPT group revealed an angular deviation of 1.95 ± 1.35°, whereas the PDG group showed a mean angular deviation of 2.67 ± 1.58°. Although there were no significant differences among the three groups (P > 0.05), the navigation groups showed lesser angular deviations compared to the pilot-drill-guide (PDG) group. Implants in the 3D-printed tray navigation group showed higher deviations at both entry point and apex. Conclusions The accuracy of the evaluated navigation system was similar with the accuracy of a pilot-drill guide. Accuracy of both preoperative workflows (marker tray in CBCT or 3D-printed tray) was reliable for clinical use.
Collapse
Affiliation(s)
- Johannes Spille
- Christian Albrechts University, Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105, Kiel, Germany.
| | - Feilu Jin
- Department of oral and Maxillofacial Surgery, School of Medicine, 2nd Affiliated Hospital of Zhejiang University, Hangzhou, Zhejiang, China
| | - Eleonore Behrens
- Christian Albrechts University, Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105, Kiel, Germany
| | - Yahya Açil
- Christian Albrechts University, Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105, Kiel, Germany
| | - Jürgen Lichtenstein
- Christian Albrechts University, Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105, Kiel, Germany
| | - Hendrik Naujokat
- Christian Albrechts University, Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105, Kiel, Germany
| | - Aydin Gülses
- Christian Albrechts University, Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105, Kiel, Germany
| | - Christian Flörke
- Christian Albrechts University, Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105, Kiel, Germany
| | - Jörg Wiltfang
- Christian Albrechts University, Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105, Kiel, Germany
| |
Collapse
|
33
|
Ramezanzade S, Keyhan SO, Tuminelli FJ, Fallahi HR, Yousefi P, Lopez-lopez J. Dynamic-Assisted Navigational System in Zygomatic Implant Surgery: A Qualitative and Quantitative Systematic Review of Current Clinical and Cadaver Studies. J Oral Maxillofac Surg 2021; 79:799-812. [DOI: 10.1016/j.joms.2020.10.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 10/07/2020] [Accepted: 10/07/2020] [Indexed: 02/06/2023]
|
34
|
Zubizarreta-Macho Á, Valle Castaño S, Montiel-Company JM, Mena-Álvarez J. Effect of Computer-Aided Navigation Techniques on the Accuracy of Endodontic Access Cavities: A Systematic Review and Meta-Analysis. Biology (Basel) 2021; 10:212. [PMID: 33802134 DOI: 10.3390/biology10030212] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/25/2021] [Accepted: 03/06/2021] [Indexed: 02/07/2023]
Abstract
The present systematic review and meta-analysis aims to determine the effect of computer-aided navigation techniques on the accuracy of endodontic access cavities. MATERIALS AND METHODS A systematic literature review and meta-analysis of clinical studies, based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations, was performed that evaluated the root canal location rate of computer-aided navigation techniques applied to endodontic access cavities. Four different databases were used to consult the literature: PubMed-Medline, Scopus, Cochrane, and Web of Science. After discarding duplicate articles and applying inclusion criteria, 14 articles were selected for qualitative analysis and 13 for quantitative analysis. RESULTS the root canal location success rate started at 98.1% (CI: 95.7-100%) of the cases performed through a computer-aided navigation technique. The prediction interval ranged from 93.3% to 100%. The meta-analysis did not detect heterogeneity between the combined studies (Q-test = 17.3; p = 0.185; I2 = 25%). No statistically significant differences were found between computer-aided static navigation techniques (success rate: 98.5%) and computer-aided dynamic navigation techniques (success rate: 94.5%) (Q test = 0.57; p = 0.451), nor between in vitro studies (success rate: 96.2%) and in vivo studies (success rate: 100%) (Q test = 2.53; p-value = 0.112). An odds success ratio of 13.1 (CI: 95%; 3.48, 49.1) encourages the use of computer-aided navigation techniques over conventional endodontic access cavity procedures. CONCLUSIONS the endodontic access cavities created using static and dynamic computer-aided navigation techniques are highly accurate in locating the root canal system.
Collapse
|
35
|
Jorba-García A, González-Barnadas A, Camps-Font O, Figueiredo R, Valmaseda-Castellón E. Accuracy assessment of dynamic computer-aided implant placement: a systematic review and meta-analysis. Clin Oral Investig 2021; 25:2479-2494. [PMID: 33635397 DOI: 10.1007/s00784-021-03833-8] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 02/05/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVES To assess the accuracy of dynamic computer-aided implant surgery (dCAIS) systems when used to place dental implants and to compare its accuracy with static computer-aided implant surgery (sCAIS) systems and freehand implant placement. MATERIALS AND METHODS An electronic search was made to identify all relevant studies reporting on the accuracy of dCAIS systems for dental implant placement. The following PICO question was developed: "In patients or artificial models, is dental implant placement accuracy higher when dCAIS systems are used in comparison with sCAIS systems or with freehand placement? The main outcome variable was angular deviation between the central axes of the planned and final position of the implant. The data were extracted in descriptive tables, and a meta-analysis of single means was performed in order to estimate the deviations for each variable using a random-effects model. RESULTS Out of 904 potential articles, the 24 selected assessed 9 different dynamic navigation systems. The mean angular and entry 3D global deviations for clinical studies were 3.68° (95% CI: 3.61 to 3.74; I2 = 99.4%) and 1.03 mm (95% CI: 1.01 to 1.04; I2 = 82.4%), respectively. Lower deviation values were reported in in vitro studies (mean angular deviation of 2.01° (95% CI: 1.95 to 2.07; I2 = 99.1%) and mean entry 3D global deviation of 0.46 mm (95% CI: 0.44 to 0.48 ; I2 = 98.5%). No significant differences were found between the different dCAIS systems. These systems were significantly more accurate than sCAIS systems (mean difference (MD): -0.86°; 95% CI: -1.35 to -0.36) and freehand implant placement (MD: -4.33°; 95% CI: -5.40 to -3.25). CONCLUSION dCAIS systems allow highly accurate implant placement with a mean angular of less than 4°. However, a 2-mm safety margin should be applied, since deviations of more than 1 mm were observed. dCAIS systems increase the implant placement accuracy when compared with freehand implant placement and also seem to slightly decrease the angular deviation in comparison with sCAIS systems. CLINICAL RELEVANCE The use of dCAIS could reduce the rate of complications since it allows a highly accurate implant placement.
Collapse
Affiliation(s)
- Adrià Jorba-García
- Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Albert González-Barnadas
- Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,IDIBELL Institute, Barcelona, Spain
| | - Octavi Camps-Font
- Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,IDIBELL Institute, Barcelona, Spain
| | - Rui Figueiredo
- Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain. .,IDIBELL Institute, Barcelona, Spain. .,Facultat de Medicina i Ciències de la Salut, Campus de Bellvitge, Universitat de Barcelona (UB), Pavelló de Govern, 2a Planta, Despatx 2.9, C/Feixa Llarga s/n, E-08907 L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Eduard Valmaseda-Castellón
- Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,IDIBELL Institute, Barcelona, Spain
| |
Collapse
|
36
|
Wei SM, Zhu Y, Wei JX, Zhang CN, Shi JY, Lai HC. Accuracy of dynamic navigation in implant surgery: A systematic review and meta-analysis. Clin Oral Implants Res 2021; 32:383-393. [PMID: 33540465 DOI: 10.1111/clr.13719] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 12/17/2020] [Accepted: 01/20/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To assess the accuracy of dynamic computer-assisted implant surgery. MATERIALS AND METHODS An electronic search up to March 2020 was conducted using PubMed, Embase, and the Cochrane Central Register of Controlled Trial to identify studies using dynamic navigation in implant surgery, and additional manual search was performed as well. Clinical trials and model studies were selected. The primary outcome was accuracy. A single-arm meta-analysis of continuous data was conducted. Meta-regression was utilized for comparison on study design, guidance method, jaw, and systems. RESULTS Ten studies, four randomized controlled trials (RCT) and six prospective studies, met the inclusion criteria. A total of 1,298 drillings and implants were evaluated. The meta-analysis of the accuracy (five clinical trials and five model studies) revealed average global platform deviation, global apex deviation, and angular deviation were 1.02 mm, 95% CI (0.83, 1.21), 1.33 mm, 95% CI (0.98, 1.67), and 3.59°, 95% CI (2.09, 5.09). Meta-regression shown no difference between model studies and clinical trials (p = .295, 0.336, 0.185), drilling holes and implant (p = .36, 0.279, 0.695), maxilla and mandible (p = .875, 0.632, 0.281), and five different systems (p = .762, 0.342, 0.336). CONCLUSION Accuracy of dynamic computer-aided implant surgery reaches a clinically acceptable range and has potential in clinical usage, but more patient-centered outcomes and socio-economic benefits should be reported.
Collapse
Affiliation(s)
- Shi-Min Wei
- 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
| | - Yu Zhu
- 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
| | - Jian-Xu Wei
- 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
| | - Chu-Nan Zhang
- 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
| | - Jun-Yu Shi
- 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
- 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
| |
Collapse
|
37
|
Zubizarreta-Macho Á, Castillo-Amature C, Montiel-Company JM, Mena-Álvarez J. Efficacy of Computer-Aided Static Navigation Technique on the Accuracy of Endodontic Microsurgery. A Systematic Review and Meta-Analysis. J Clin Med 2021; 10:jcm10020313. [PMID: 33467707 PMCID: PMC7830386 DOI: 10.3390/jcm10020313] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 01/12/2021] [Accepted: 01/12/2021] [Indexed: 12/22/2022] Open
Abstract
The aim of this systematic review and meta-analysis was to analyze the efficacy of the computer-aided static navigation technique on the accuracy of root apex location in endodontic microsurgery. MATERIAL AND METHODS A systematic literature review and meta-analysis, based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations, of clinical studies that evaluated the apex location rate of the computer-aided static navigation techniques applied to endodontic microsurgery. A total of four databases were consulted in the literature search: Pubmed-Medline, Scopus, Cochrane, and Web of Science. After eliminating duplicated articles and applying the inclusion criteria, seven articles were selected for the qualitative and the quantitative analysis. RESULTS The root apex location success rate stated at 96.8% (confidence interval (CI): 93.0-100%) of the cases performed through a computer-aided static navigation technique. The prediction interval ranges from 91.4% to 100%. The meta-analysis did not detect heterogeneity between the combined studies (Q-test = 6.15; p-value = 0.407; I2 = 2.4%). The computer-aided static navigation techniques showed a root apex location success rate 27 times higher than conventional endodontic microsurgery procedures (Q test = 0.80; p = 0.671; I2 = 0%). Three studies of computer-aided static navigation techniques and control group were compared using a random effects model with the Mantel-Haenszel method with a statistically significant odds success ratio of 27.7, with a 95% confidence interval between 11.3 and 68.1 (z test = 7.23; p < 0.0001). CONCLUSIONS According to in vitro studies analyzed, endodontic microsurgeries performed through computer-aided static navigation techniques show a high precision.
Collapse
Affiliation(s)
- Álvaro Zubizarreta-Macho
- Department of Endodontics, Faculty of Health Sciences, Alfonso X El Sabio University, 28691 Madrid, Spain; (Á.Z.-M.); (C.C.-A.)
| | - César Castillo-Amature
- Department of Endodontics, Faculty of Health Sciences, Alfonso X El Sabio University, 28691 Madrid, Spain; (Á.Z.-M.); (C.C.-A.)
| | - José María Montiel-Company
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain;
| | - Jesús Mena-Álvarez
- Department of Endodontics, Faculty of Health Sciences, Alfonso X El Sabio University, 28691 Madrid, Spain; (Á.Z.-M.); (C.C.-A.)
- Correspondence:
| |
Collapse
|
38
|
Zhou M, Zhou H, Li SY, Zhu YB, Geng YM. Comparison of the accuracy of dental implant placement using static and dynamic computer-assisted systems: an in vitro study. J Stomatol Oral Maxillofac Surg 2020; 122:343-348. [PMID: 33307210 DOI: 10.1016/j.jormas.2020.11.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 10/26/2020] [Accepted: 11/25/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The study aimed to compare the accuracy of implant placement between static and dynamic computer-assisted systems (CAS) in a partially edentulous mandible model. MATERIALS & METHODS A total of 80 implants was placed in mandible models. The implants were placed using either static or dynamic computer-assisted system. Deviations of implant hex, apex and angulation were measured between preoperative planning and postoperative CBCT in planning software. RESULTS The mean deviations of implant hex, apex and angulation in static CAS group were 1.15 ± 0.34 mm, 1.37 ± 0.38 mm and 2.60 ± 1.11 degree, while in dynamic CAS group were 0.40 ± 0.41 mm, 0.34 ± 0.33 mm and 0.97 ± 1.21 degree, respectively. Implant placement with dynamic CAS showed less deviations of shoulder, apex and angulation than with static CAS significantly. CONCLUSIONS The implant accuracy using CAS system could be influenced by the guiding technique.
Collapse
Affiliation(s)
- Miao Zhou
- Department of Oral and Maxillofacial Surgery, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Huangshadadao Road 39, 510182, Guangzhou, China
| | - Hui Zhou
- Department of Oral and Maxillofacial Surgery, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Huangshadadao Road 39, 510182, Guangzhou, China; Department of Stomatology, the Eighth People Hospital of Guangzhou, Huayinglu Road 8, 510060, Guangzhou, China
| | - Shu-Yi Li
- Department of Oral and Maxillofacial Surgery, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Huangshadadao Road 39, 510182, Guangzhou, China
| | - Yi-Bo Zhu
- 4th Dental Center of School and Hospital of Stomatology, Peking University, Dongsihuanzhonglu Road 41, 100025, Beijing, China
| | - Yuan-Ming Geng
- Department of Stomatology, Zhujiang Hospital, Southern Medical University, Gongyedadaozhong Road 253, 510282, Guangzhou, China.
| |
Collapse
|
39
|
Tao B, Shen Y, Sun Y, Huang W, Wang F, Wu Y. Comparative accuracy of cone-beam CT and conventional multislice computed tomography for real-time navigation in zygomatic implant surgery. Clin Implant Dent Relat Res 2020; 22:747-755. [PMID: 33112508 DOI: 10.1111/cid.12958] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 09/04/2020] [Accepted: 10/04/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Cone-beam computed tomography (CBCT) and conventional multislice CT (MSCT) are both used in zygomatic implant navigation surgery but the superiority of one technique versus the other remains unclear. PURPOSE This study compared the accuracy of CBCT and MSCT in zygomatic implant navigation surgery by calculating the deviations of implants. MATERIAL AND METHODS Patients with severely atrophic maxillae were classified into two groups according to the use of CBCT- or MSCT-guided navigation system. The entry and apical distance deviation, and the angle deviation of zygomatic implants were measured on fused operation images. A linear effect model was used for analysis, with statistical significance set at P < .05. RESULTS A total of 72 zygomatic implants were inserted as planned in 23 patients. The comparison of deviations in CBCT and MSCT groups showed a mean (± SD) entry deviation of 1.69 ± 0.59 mm vs 2.04 ± 0.78 mm (P = .146), apical deviation of 2 ± 0.68 mm vs 2.55 ± 0.85 (P < .001), and angle deviation of 2.32 ± 1.02° vs 3.23 ± 1.21° (P = .038). CONCLUSION Real-time zygomatic implant navigation surgery with CBCT may result in higher values for accuracy than MSCT.
Collapse
Affiliation(s)
- Baoxin Tao
- Department of Second Dental Center, 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
| | - Yihan Shen
- Department of Second Dental Center, 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
| | - Yuanyuan Sun
- Department of Second Dental Center, 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
| | - Wei Huang
- Department of Oral 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
| | - Feng Wang
- Department of Oral 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
| | - Yiqun Wu
- Department of Second Dental Center, 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
| |
Collapse
|
40
|
Pellegrino G, Ferri A, Cercenelli L, Marcelli E, Marchetti C, Tarsitano A, Ciocca L. 3D planning of ear prosthesis and navigated flapless surgery for craniofacial implants: A pilot study. J Stomatol Oral Maxillofac Surg 2020; 122:391-396. [PMID: 32977038 DOI: 10.1016/j.jormas.2020.09.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 09/13/2020] [Accepted: 09/16/2020] [Indexed: 10/23/2022]
Abstract
New 3D digital technologies can be applied to implant-supported ear prostheses to restore anatomical structures damaged by cancer, dysplasia, or trauma. However, several factors influence the accuracy of implant positioning using a cranial template. This pilot study describes an innovative navigated flapless surgery for craniofacial implants, prosthetically guided by 3D planning of the ear prosthesis. Laser surface scanning of the face allowed for mapping of the healthy ear onto the defect site, and projection of the volume and position of the final prosthesis. The projected ear volume was superimposed on the skull bone image obtained by cone-beam computed tomography (CBCT), performed with the navigation system marker plate positioned in the patient's mouth. The craniofacial implants were fitted optimally to the ear prosthesis. After system calibration, real-time navigated implant placement based on the virtual planning was performed with minimally invasive flapless surgery under local anesthesia. After 3 months of healing, digital impressions of the implants were made, and the digital manufacturing workflow was completed to manufacture the ear prosthesis anchored to the craniofacial implants. The proposed digital method facilitated implant positioning during flapless surgery, improving the ear prosthesis manufacturing process and reducing operation time, patient morbidity, and related costs. This protocol avoids the need for a reference tool fixed in the cranial bone, as is usually required for maxillofacial surgery, and confirmed that surgical navigation is useful for guiding the insertion of craniofacial implants during flapless surgery.
Collapse
Affiliation(s)
- G Pellegrino
- Department of Biomedical and Neuromotor Science, Alma Mater Studiorum University of Bologna, Via S. Vitale 59, 40125 Bologna, Italy.
| | - A Ferri
- Department of Biomedical and Neuromotor Science, Alma Mater Studiorum University of Bologna, Via S. Vitale 59, 40125 Bologna, Italy.
| | - L Cercenelli
- Department of Experimental Diagnostic and Specialty Medicine - Department of Biomedical and Neuromotor Science, Alma Mater Studiorum University of Bologna, Via Massarenti 9, 40138 Bologna, Italy.
| | - E Marcelli
- Department of Experimental Diagnostic and Specialty Medicine, Alma Mater Studiorum University of Bologna, Via Massarenti 9, 40138 Bologna, Italy.
| | - C Marchetti
- Department of Biomedical and Neuromotor Science, Alma Mater Studiorum University of Bologna, Via Massarenti 9, 40138 Bologna, Italy.
| | - A Tarsitano
- Department of Biomedical and Neuromotor Science, Alma Mater Studiorum University of Bologna, Via Massarenti 9, 40138 Bologna, Italy.
| | - L Ciocca
- Department of Biomedical and Neuromotor Science, Alma Mater Studiorum University of Bologna, Via S. Vitale 59, 40125 Bologna, Italy.
| |
Collapse
|
41
|
Gambarini G, Galli M, Morese A, Stefanelli LV, Abduljabbar F, Giovarruscio M, Di Nardo D, Seracchiani M, Testarelli L. Precision of Dynamic Navigation to Perform Endodontic Ultraconservative Access Cavities: A Preliminary In Vitro Analysis. J Endod 2020; 46:1286-1290. [DOI: 10.1016/j.joen.2020.05.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/09/2020] [Accepted: 05/31/2020] [Indexed: 12/13/2022]
|
42
|
Henprasert P, Dawson DV, El-Kerdani T, Song X, Couso-Queiruga E, Holloway JA. Comparison of the Accuracy of Implant Position Using Surgical Guides Fabricated by Additive and Subtractive Techniques. J Prosthodont 2020; 29:534-541. [PMID: 32147893 DOI: 10.1111/jopr.13161] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2020] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To evaluate the accuracy of implant position using surgical guides fabricated by additive and subtractive techniques. MATERIALS AND METHODS A partially edentulous standardized mandibular implant model with different bone densities and soft tissue was duplicated and a diagnostic wax-up was performed for the #30 area. A reference radiographic guide was fabricated and cone beam computed tomography (CBCT) was made with the reference radiographic guide in place. A surgical guide was designed using BlueSky Plan 4 software and a reference implant was placed in the #30 region. The STL file of the surgical guide was exported and specimens (n = 15) were fabricated by two different techniques: additive (3D printing) and subtractive (milling). The standardized mandibular model was surface-scanned and duplicated with printed dental model resin (n = 30). Each surgical guide was used to place an implant in thirty duplicate printed models. Differences in implant position as compared to the reference were measured from digital scans with scan bodies in place. The angular deviations, differences in depth, coronal and apical deviations were measured using GeoMagic Control X software. Results were analyzed by Wilcoxon-Mann-Whitney test and PERMANOVA (Permutational Multivariate Analysis of Variance). Intraclass correlation was used to assess measurement reproducibility with Bonferroni adjustment for multiple testing as needed (α = 0.05). RESULTS There were no significant differences in accuracy of implant placement using guides fabricated using additive vs subtractive techniques. The mean angular deviations between the reference and actual position of implant in mesio-distal cross-section were 0.780 ± 0.80° for printed group and 0.77 ± 0.72° for the milled group. The differences in bucco-lingual cross-section were 1.60 ± 1.22° in in printed group and 1.77 ± 0.76° in the milled group. The differences in depth (mm) were measured at the top of the scan body at four locations: mesial, distal, buccal and lingual. The mean differences in depth for the group that used printed surgical guides were (mesial) 0.37 ± 0.29 mm, (distal) 0.32 ± 0.23 mm, (buccal) 0.24 ± 0.23 mm, and (lingual) 0.25 ± 0.17 mm. The mean differences in depth for the group that used milled surgical guides were (mesial) 0.51 ± 0.33 mm, (distal) 0.40 ± 0.32 mm, (buccal) 0.22 ± 0.23 mm, and (lingual) 0.23 ± 0.12 mm in those four aspects, respectively. The mean coronal deviation showed 0.32 mm in the printed group and 0.27 mm in the milled group. For the apical deviation, the results of this study showed mean apical deviation 0.84 mm in the printed group and 0.80 mm in the milled group. CONCLUSIONS Results indicate that 3D-printed surgical guides are statistically as accurate as milled guides for guided-implant surgery with the benefits of high accuracy, ease of fabrication, less waste compared to subtractive techniques, and reduction of laboratory time thereby increasing cost-effectiveness.
Collapse
Affiliation(s)
- Pantip Henprasert
- Department of Prosthodontics, University of Iowa College of Dentistry, Iowa City, IA
| | - Deborah V Dawson
- Iowa Institute for Oral Health Research, The University of Iowa College of Dentistry & Dental Clinics, Iowa City, IA
| | - Tarek El-Kerdani
- Department of Prosthodontics, University of Iowa College of Dentistry, Iowa City, IA
| | - Xuan Song
- Department of Mechanical and Industrial Engineering, University of Iowa, Iowa City, IA
| | | | - Julie A Holloway
- Department of Prosthodontics, University of Iowa College of Dentistry, Iowa City, IA
| |
Collapse
|
43
|
Sun TM, Lee HE, Lan TH. Comparing Accuracy of Implant Installation with a Navigation System (NS), a Laboratory Guide (LG), NS with LG, and Freehand Drilling. Int J Environ Res Public Health 2020; 17:E2107. [PMID: 32235745 DOI: 10.3390/ijerph17062107] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 03/19/2020] [Accepted: 03/20/2020] [Indexed: 01/08/2023]
Abstract
The aim of this study was to compare the accuracy of implant placement by using the conventional freehand method, the surgical guide alone, the dental navigation system alone, and the dental navigation system with a surgical guide. The participants were aged 20 years or older and were requiring dental implant surgery according to an assessment made by a dentist between July 2014 and December 2017. A total of 128 dental implants were inserted, 32 dental implants in each group, and participants with similar or identical age (i.e., 20–50 years or 50 years or above) and missing tooth locations were paired for comparison. Accuracy was measured by overlaying the real position in the postoperative Cone Beam Computerized Tomography (CBCT) on the virtual presurgical placement of the implant in a CBCT image. Using the dental navigation system with a surgical guide could help dentists to position implants more accurately. Total, longitudinal, and angular error deviation were significantly different (p < 0.0001). The same level of accuracy could be obtained for the different jaws and tooth positions. The one-way analysis of variance (ANOVA) showed that the total, longitudinal, and angular errors differed significantly (p < 0.0001). A comparison of the four dental implant surgical methods indicated that the combination of a dental implant navigation system and a surgical guide kit achieved the highest accuracy in terms of the different tooth positions and jaws.
Collapse
|
44
|
Vinci R, Manacorda M, Abundo R, Lucchina AG, Scarano A, Crocetta C, Muzio LL, Gherlone EF, Mastrangelo F. Accuracy of Edentulous Computer-Aided Implant Surgery as Compared to Virtual Planning: A Retrospective Multicenter Study. J Clin Med 2020; 9:E774. [PMID: 32178392 DOI: 10.3390/jcm9030774] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 02/24/2020] [Accepted: 03/09/2020] [Indexed: 12/16/2022] Open
Abstract
Purpose: To evaluate the accuracy of computer-aided dental implant positions obtained with mucosal-supported templates as compared to Three-Dimensional (3D) planning. Materials and methods: One-hundred implants were inserted into 14 edentulous patients using the All-on-4/6 protocol after surgical virtual planning with RealGUIDE, 3DIEMME, and Geomagic software. After 6 months, three-dimensional neck (V) and apex (S) spatial coordinates of implants and angle inclination displacements as compared to virtual plans were evaluated. Results: The S maxilla coordinates revealed a significant discrepancy between clinical and virtual implant positions (p-value = 0.091). The V coordinates showed no significant differences (p-value = 0.71). The S (p-value = 0.017) and V (p-value = 0.038) mandible coordinates showed significant discrepancies between the clinical and virtual positions of the screws. Implant evaluation showed a 1-mm in average of the horizontal deviation in the V point and a 1.6-mm deviation in the S point. A mean 5° angular global deviation was detected. The multivariate permutation test of the S (p-value = 0.02) confirmed the difference. Greater errors in the mandible were detected as compared to the maxilla, and a higher S discrepancy was found in the posterior jaw compared to the anterior section of both the mandible and maxilla. Conclusions: Computer-aided surgery with mucosal-supported templates is a predictable procedure for implant placement. Data showed a discrepancy between the actual dental implant position as compared to the virtual plan, but this was not statistically significant. However, the horizontal and angle deviations detected indicated that flap surgery should be used to prevent implant positioning errors due to poor sensitivity and accuracy in cases of severe jaw atrophy.
Collapse
|
45
|
Lopes A, de Araújo Nobre M, Santos D. The Workflow of a New Dynamic Navigation System for the Insertion of Dental Implants in the Rehabilitation of Edentulous Jaws: Report of Two Cases. J Clin Med 2020; 9:jcm9020421. [PMID: 32033089 PMCID: PMC7073768 DOI: 10.3390/jcm9020421] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 01/16/2020] [Accepted: 02/01/2020] [Indexed: 12/19/2022] Open
Abstract
Background: This case series describes the surgical workflow during maxillary full-arch rehabilitations in two patients through the All-on-4 concept (standard and hybrid) assisted by DTX Studio Implant Software planning and X-Guide Navigation. Results: The X-Guide Navigation enabled the drills and implants to be positioned and oriented precisely, allowing the implants to be positioned favorably under the surgical and prosthetic points of view through the avoidance of damage to the maxillary sinus and nasal cavity. Dynamic navigation-assisted surgery provided advantages, including the possibility to modify the implants’ system, length, or location perioperatively. However, it must be underlined that to achieve proficiency with this technology it is necessary to consider a necessary learning curve. Conclusion: The insertion of dental implants assisted by dynamic navigation for maxillary full-arch rehabilitations was considered a safe and predictable procedure. Nevertheless, it can be improved (such as with a simpler fiducial markers protocol), aiming to simplify the procedure.
Collapse
Affiliation(s)
- Armando Lopes
- Implantology Department, Maló Clinic, 1600-042 Lisbon, Portugal; (A.L.); (D.S.)
| | - Miguel de Araújo Nobre
- Research and Development Department, Maló Clinic, 1600-042 Lisbon, Portugal
- Correspondence: ; Tel.: +351-217-228-100
| | - Diogo Santos
- Implantology Department, Maló Clinic, 1600-042 Lisbon, Portugal; (A.L.); (D.S.)
| |
Collapse
|
46
|
Zubizarreta-Macho Á, Muñoz AP, Deglow ER, Agustín-Panadero R, Álvarez JM. Accuracy of Computer-Aided Dynamic Navigation Compared to Computer-Aided Static Procedure for Endodontic Access Cavities: An in Vitro Study. J Clin Med 2020; 9:E129. [PMID: 31906598 DOI: 10.3390/jcm9010129] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 12/30/2019] [Accepted: 12/31/2019] [Indexed: 11/27/2022] Open
Abstract
Purpose: To analyze the accuracy of two computer-aided navigation techniques to guide the performance of endodontic access cavities compared with the conventional access procedure. Materials and Methods: A total of 30 single-rooted anterior teeth were selected, which were randomly distributed into three study groups: Group A—guided performance of endodontic access cavities through computer-aided static navigation system (n = 10) (SN); Group B—guided performance of endodontic access cavities through computer-aided dynamic navigation system (n = 10) (DN); and Group C—manual (freehand) performance of endodontic access cavities (n = 10) (MN). The endodontic access cavities of the SN group were performed with a stereolithography template designed on 3D implant planning software, based on preoperative cone-beam computed tomography (CBCT) and a 3D extraoral surface scan, and endodontic access cavities of the DN group were planned and performed by the dynamic navigation system. After endodontic access cavities were performed, a second CBCT was done, and the degree of accuracy between the planned and performed endodontic access cavities was analyzed using therapeutic planning software and Student’s t-test. Results: Paired t-test revealed no statistically significant differences between SN and DN at the coronal (p = 0.6542), apical (p = 0.9144), or angular (p = 0.0724) level; however, statistically significant differences were observed between the two computer-aided navigation techniques and the MN group at the coronal (p < 0.0001), apical (p < 0.0001), and angular (p < 0.0001) level. Conclusion: Both computer-aided static and dynamic navigation procedures allowed accurate performance of endodontic access cavities.
Collapse
|
47
|
Alkanderi A, Al Sakka Y, Koticha T, Li J, Masood F, Suárez-López Del Amo F. Incidence of nasopalatine canal perforation in relation to virtual implant placement: A cone beam computed tomography study. Clin Implant Dent Relat Res 2019; 22:77-83. [PMID: 31829508 DOI: 10.1111/cid.12852] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 08/20/2019] [Accepted: 09/07/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND The nasopalatine canal (NPC) is of special importance when considering implant therapy in the maxillary central incisors' region. PURPOSE To investigate the incidence of NPC perforation in relation to virtual immediate implant placement. MATERIALS AND METHODS A search through the cone beam computed tomography (CBCT) database of The University of Oklahoma-College of Dentistry was conducted. First, canal related measurements were conducted. Second, digital prosthetic planning was performed. Then, immediate implants were virtually placed and additional measurements were performed. Perforation rate was assessed. Last, data obtained was statistically analyzed. RESULTS A total of 217 scans fulfilled the inclusion criteria. Only 8% of cases showed NPC perforation. The perforation occurred at mid-third of the implant or at the mid and apical third in 33% and 22% of the cases, respectively. A statistically significant association was found between perforation of NPC and bone width palatal to the root of the central incisor (P < .0001) as well as canal angulation (P = .0196). NPC angulation (°) and palatal bone width (mm) predisposed to a higher risk of perforation. Only 27.78% of the perforations could be overcome by the installation of shorter implants. CONCLUSIONS Low incidence of NPC perforation could be expected when immediately placing implants in the maxillary incisor region.
Collapse
Affiliation(s)
- Aaeshah Alkanderi
- Department of Periodontics, University of Oklahoma Health Sciences Center, College of Dentistry, Oklahoma City, Oklahoma
| | - Yacoub Al Sakka
- Department of Periodontics, University of Oklahoma Health Sciences Center, College of Dentistry, Oklahoma City, Oklahoma.,Division of Prosthodontics, University of Oklahoma Health Sciences Center, College of Dentistry, Oklahoma City, Oklahoma
| | - Tapan Koticha
- Department of Periodontics, University of Oklahoma Health Sciences Center, College of Dentistry, Oklahoma City, Oklahoma
| | - Ji Li
- College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Farah Masood
- Department of Oral Diagnosis & Radiology, University of Oklahoma Health Science Center, College of Dentistry, Oklahoma City, Oklahoma
| | - Fernando Suárez-López Del Amo
- Department of Periodontics, University of Oklahoma Health Sciences Center, College of Dentistry, Oklahoma City, Oklahoma
| |
Collapse
|
48
|
Mediavilla Guzmán A, Riad Deglow E, Zubizarreta-Macho Á, Agustín-Panadero R, Hernández Montero S. Accuracy of Computer-Aided Dynamic Navigation Compared to Computer-Aided Static Navigation for Dental Implant Placement: An In Vitro Study. J Clin Med 2019; 8:E2123. [PMID: 31810351 DOI: 10.3390/jcm8122123] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 11/28/2019] [Accepted: 11/28/2019] [Indexed: 12/28/2022] Open
Abstract
Aim: To analyze the accuracy capability of two computer-aided navigation procedures for dental implant placement. Materials and Methods: A total of 40 dental implants were selected, which were randomly distributed into two study groups, namely, group A, consisting of those implants that were placed using a computer-aided static navigation system (n = 20) (guided implant (GI)) and group B, consisting of those implants that were placed using a computer-aided dynamic navigation system (n = 20) (navigation implant (NI)). The placement of the implants from group A was performed using surgical templates that were designed using 3D implant-planning software based on preoperative cone-beam computed tomography (CBCT) and a 3D extraoral surface scan, and the placement of group B implants was planned and performed using the dynamic navigation system. After placing the dental implants, a second CBCT was performed and the degree of accuracy of the planning and placement of the implants was analyzed using therapeutic planning software and Student’s t-test. Results: The paired t-test revealed no statistically significant differences between GI and NI at the coronal (p = 0.6535) and apical (p = 0.9081) levels; however, statistically significant differences were observed between the angular deviations of GI and NI (p = 0.0272). Conclusion: Both computer-aided static and dynamic navigation procedures allow accurate implant placement.
Collapse
|
49
|
Gambarini G, Galli M, Stefanelli LV, Di Nardo D, Morese A, Seracchiani M, De Angelis F, Di Carlo S, Testarelli L. Endodontic Microsurgery Using Dynamic Navigation System: A Case Report. J Endod 2019; 45:1397-1402.e6. [DOI: 10.1016/j.joen.2019.07.010] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 06/29/2019] [Accepted: 07/01/2019] [Indexed: 01/12/2023]
|
50
|
Abstract
Background This study evaluated the operating performance of an implant navigation system used by dental students and dentists of prosthodontic background with varying levels of experience. A surgical navigation system and optical tracking system were used, and dentists’ accuracies were evaluated in terms of differences between the positions of actually drilled holes and those of the holes planned using software before surgeries. Methods The study participants were 5 dental students or dentists who had studied in the same university and hospital but had different experience levels regarding implants. All participants were trained in operating the AqNavi system in the beginning of the study. Subsequently, using 5 pairs of dental models, each participant drilled 5 implant holes at 6 partially edentulous positions (11, 17, 26, 31, 36, and 47). In total, each participant conducted 30 drilling tests. Results In total, 150 tests among 5 dentists at 6 tooth positions (11, 17, 26, 31, 36, and 47) were conducted. Although a comparison of the tests revealed significant differences in the longitudinal error (P < .0001) and angular error (P = .0011), no significant difference was observed in the total error among the dentists. Conclusions A relatively long operating time was associated with relatively little implant experience. Through the dental navigation system, dental students can be introduced to dental implant surgery earlier than what was possible in the past. The results demonstrated that the operational accuracy of the dental implant navigation system is not restricted by participants’ implant experience levels. The implant navigation system assists the dentist in the ability to accurately insert the dental implant into the correct position without being affected by his/her own experience of implant surgery.
Collapse
Affiliation(s)
- Ting-Mao Sun
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, 100 Shin-Chuan 1st Road, Sanmin District, Kaohsiung, 80708, Taiwan
| | - Huey-Er Lee
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, 100 Shin-Chuan 1st Road, Sanmin District, Kaohsiung, 80708, Taiwan.,Division of Family Dentistry, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ting-Hsun Lan
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, 100 Shin-Chuan 1st Road, Sanmin District, Kaohsiung, 80708, Taiwan. .,Division of Prosthodontics, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
| |
Collapse
|