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Takács A, Hardi E, Cavalcante BGN, Szabó B, Kispélyi B, Joób-Fancsaly Á, Mikulás K, Varga G, Hegyi P, Kivovics M. Advancing accuracy in guided implant placement: A comprehensive meta-analysis: Meta-Analysis evaluation of the accuracy of available implant placement Methods. J Dent 2023; 139:104748. [PMID: 37863173 DOI: 10.1016/j.jdent.2023.104748] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [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.
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Affiliation(s)
- Anna Takács
- Department of Community Dentistry, Semmelweis University, Szentkirályi utca 40. 1088 Budapest, Hungary; Centre for Translational Medicine, Semmelweis University, Üllői út 26. 1085 Budapest, Hungary
| | - Eszter Hardi
- Centre for Translational Medicine, Semmelweis University, Üllői út 26. 1085 Budapest, Hungary; Department of Oro-Maxillofacial Surgery and Stomatology, Semmelweis University, Mária utca 52. 1085 Budapest, Hungary
| | - Bianca Golzio Navarro Cavalcante
- Centre for Translational Medicine, Semmelweis University, Üllői út 26. 1085 Budapest, Hungary; Department of Oral Biology, Semmelweis University, Nagyvárad tér 4. 1089 Budapest, Hungary
| | - Bence Szabó
- Centre for Translational Medicine, Semmelweis University, Üllői út 26. 1085 Budapest, Hungary
| | - Barbara Kispélyi
- Centre for Translational Medicine, Semmelweis University, Üllői út 26. 1085 Budapest, Hungary; Department of Prosthodontics, Semmelweis University, Szentkirályi utca 47. 1088 Budapest, Hungary
| | - Árpád Joób-Fancsaly
- Centre for Translational Medicine, Semmelweis University, Üllői út 26. 1085 Budapest, Hungary; Department of Oro-Maxillofacial Surgery and Stomatology, Semmelweis University, Mária utca 52. 1085 Budapest, Hungary
| | - Krisztina Mikulás
- Centre for Translational Medicine, Semmelweis University, Üllői út 26. 1085 Budapest, Hungary; Department of Prosthodontics, Semmelweis University, Szentkirályi utca 47. 1088 Budapest, Hungary
| | - Gábor Varga
- Centre for Translational Medicine, Semmelweis University, Üllői út 26. 1085 Budapest, Hungary; Department of Oral Biology, Semmelweis University, Nagyvárad tér 4. 1089 Budapest, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Üllői út 26. 1085 Budapest, Hungary; Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Szigeti út 12. 7624 Pécs, Hungary; Division of Pancreatic Diseases, Heart and Vascular Center, Semmelweis University, Városmajor utca 68. 1122 Budapest, Hungary
| | - Márton Kivovics
- Department of Community Dentistry, Semmelweis University, Szentkirályi utca 40. 1088 Budapest, Hungary; Centre for Translational Medicine, Semmelweis University, Üllői út 26. 1085 Budapest, Hungary.
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Göçmen G, Bayrakçıoğlu A, Bayram F. Effect of the level of alveolar atrophy on implant placement accuracy in guided surgery for full-arch restorations supported by four implants: an in vitro study. Head Face Med 2023; 19:40. [PMID: 37649094 PMCID: PMC10466718 DOI: 10.1186/s13005-023-00387-w] [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: 04/18/2023] [Accepted: 08/17/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND A fixed screw-retained full-arch restoration supported by four implants is a popular treatment option for edentulous arches. Optimal alignment of implants is quite challenging in extremely atrophied edentulous cases, and a small amount of deviation is expected during guided surgery. This study aimed to compare implant accuracy among edentulous jaws with various levels of atrophy. METHODS Five separate copies of each Cawood and Howell model (III-V) were produced for the maxilla and mandible. A total of 120 implants (30 models). The implant accuracy was assessed based on angular deviations at the base (angle, 3D offset, distal, vestibular, and apical) and tip (3D offset, distal, vestibular, and apical). RESULTS The atrophy level of the jaws had a statistically significant effect on deviation; implants showed greater deviation from the planned location as the atrophy level increased. CONCLUSION Given that implant deviation increased with the degree of atrophy, a greater safety margin from important anatomical structures is recommended when planning implant location for guided surgery in Cawood and Howell V cases.
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Affiliation(s)
- Gökhan Göçmen
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Marmara University, Istanbul, Turkey.
| | - Ahmet Bayrakçıoğlu
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Marmara University, Istanbul, Turkey
| | - Ferit Bayram
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Marmara University, Istanbul, Turkey
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Bittar E, Binvignat P, Villat C, Maurin JC, Ducret M, Richert R. Assessment of guide fitting using an intra-oral scanner: An in vitro study. J Dent 2023; 135:104590. [PMID: 37327983 DOI: 10.1016/j.jdent.2023.104590] [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: 01/01/2023] [Revised: 06/11/2023] [Accepted: 06/13/2023] [Indexed: 06/18/2023] Open
Abstract
OBJECTIVES The aim of this study was to evaluate the capacity of an intra-oral scanner (IOS) to assess the position of an endodontic guide in vitro. METHODS Fourteen extracted human teeth were placed into a maxillary model and scanned using computed tomography and a reference laboratory scanner. An ideal endodontic guide was then created and modified by adding defects of different thicknesses to simulate incorrect positions: 50 μm, 150 μm, 400 μm, and 1000 μm. For each thickness, guides were printed three times and each guide was scanned by three experimented operators using a Trios 4 IOS (3Shape, Copenhagen, Denmark). The 36 scans were compared using a best-fit alignment to the master model without defect to define the accuracy of the method and the positioning error. RESULTS The IOS presented a mean trueness of 1.28 μm (SD= 12.70) and a mean precision of 11.52 μm (SD= 62.17). Considering all sizes of defect, the mean measured position of the endodontic guide was highly correlated (R>0.99) with the expected position. Compared to the ideal guide, there was a mean linear deviation of 46.11 μm (SD= 23.21) and a mean angular deviation of 5.9° (SD= 1.2); this deviation was not influenced by the operator. CONCLUSION The present study found that an IOS had good performance to detect a positioning error of the endodontic guide in vitro. CLINICAL SIGNIFICANCE This new application of IOS has a promising potential in clinical practice to assist practitioners during the fitting of guides.
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Affiliation(s)
- Elias Bittar
- Hospices Civils de Lyon, PAM Odontologie, Lyon 69007, France
| | | | - Cyril Villat
- Hospices Civils de Lyon, PAM Odontologie, Lyon 69007, France; Laboratoire des Multimatériaux et Interfaces, UMR 5615 CNRS/UCBL, Lyon 69008, France
| | - Jean-Christophe Maurin
- Hospices Civils de Lyon, PAM Odontologie, Lyon 69007, France; Laboratoire de Biologie Tissulaire et Ingénierie thérapeutique, UMR 5305 CNRS/UCBL, Lyon 69008, France
| | - Maxime Ducret
- Hospices Civils de Lyon, PAM Odontologie, Lyon 69007, France; Laboratoire de Biologie Tissulaire et Ingénierie thérapeutique, UMR 5305 CNRS/UCBL, Lyon 69008, France
| | - Raphaël Richert
- Hospices Civils de Lyon, PAM Odontologie, Lyon 69007, France; Laboratoire de Mécanique des Contacts et structures, UMR 5259 CNRS/INSA/Univ, Villeurbanne, Lyon 69100 France.
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Egan PF. Special Issue Editorial: Applications of 3D Printing for Polymers. Polymers (Basel) 2023; 15:polym15071638. [PMID: 37050252 PMCID: PMC10097040 DOI: 10.3390/polym15071638] [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: 02/28/2023] [Accepted: 03/21/2023] [Indexed: 03/29/2023] Open
Abstract
Polymer 3D printing is an emerging technology highly relevant in diverse industries, including medicine, electronics, and robotics [...]
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Affiliation(s)
- Paul F Egan
- Mechanical Engineering, Texas Tech University, Lubbock, TX 79409, USA
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Chen Y, Su B. Investigation on the application of digital guide templates guided dental implantation in China. BMC Oral Health 2023; 23:36. [PMID: 36683029 PMCID: PMC9869612 DOI: 10.1186/s12903-023-02750-4] [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: 10/29/2022] [Accepted: 01/16/2023] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND The aim of this survey is to investigate the application of digital guide templates (DGTs) across China, and the views and attitudes of oral health professionals toward them. METHODS This survey was prepared, distributed, and collected by WJX. Chinese oral health professionals were invited to participate in it. The basic information of respondents, the application of DGTs, and the views and attitudes toward their status quo and development were statistically described. Chi-square test was used to evaluate the correlation between the basic information of respondents and the application of DGTs as well as the views and attitudes toward them. RESULTS A total of 276 questionnaires were collected, of which 273 were identified as valid. 269 (98.5%) respondents were dental clinical workers, 204 (74.7%) were dental clinical implant workers, and 152 (55.7%) had been engaged in the implant industry for more than five years. The chi-square test showed that working years were significantly correlated with the half-guided, tooth-supported, and mucosa-supported DGTs (P < 0.05); and professional backgrounds and working years presented significant differences in the views and attitudes toward the status quo and development of DGTs (P < 0.05). The questionnaires also made a preliminary investigation and evaluation on the factors influencing accuracy, indications, doctors' recommendations and relevant training. CONCLUSION Most respondents held a positive attitude toward the accuracy and development of DGTs. This survey can point out the direction for the improvement of DGTs, and provide a reference for the study of factors affecting implant accuracy, the establishment of a training system, and the understanding of clinicians' current views on DGTs. Trial registration This survey was approved by the Ethics Review Committee of Chenghuaxinguanghua Dental Clinic (Approval NO. CDCIRB-D-2021-201).
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Affiliation(s)
- Yunli Chen
- College of Biomedical Engineering, Sichuan University, Chengdu, 610065, Sichuan Province, China
| | - Baohui Su
- College of Biomedical Engineering, Sichuan University, Chengdu, 610065, Sichuan Province, China.
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Kobe T, Fidler A, Kuralt M, Gašpirc B, Gašperšič R. Retentive design of a small surgical guide for implant surgery: An in-vitro study. J Dent 2023; 128:104384. [PMID: 36470471 DOI: 10.1016/j.jdent.2022.104384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 10/17/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES Instability of the surgical guide is an overlooked factor that can result in a difference between the planned and the actual positions of an implant. Our aim was to compare the stability of the retentive surgical guide (RSG) with a conventional surgical guide (CSG) in an in-vitro experiment. METHODS A platform to evaluate the stability of the surgical guide was designed using 3D-modelling software (Meshmixer 3.5, Autodesk). Imaging data from 15 patients with a single missing tooth were used to plan the virtual implant. Two surgical guides were designed (Blue Sky Plan 4.8, Blue Sky Bio) and 3D printed (Form2, Dental SG resin, Formlabs) for each case: the CSG with the default, predetermined software settings, and the RSG, designed on a dental model with a 0.1-mm undercut and altered production parameters (reduced guide-to-teeth offset of 0.07 mm, reduced guide thickness of 2.3 mm and a retentive clasp in a marginal area). The dental models were reproducibly secured on the testing platform using a digital force gauge, and the surgical guides were positioned. An increasing force of 0.1 N, 1 N, 2.5 N, and 5 N was sequentially applied from the buccal and the oral directions to the surgical guide via a drill handle. For each force, either the magnitude of the guide's displacement was captured with an intra-oral scanner (CEREC Omnicam AC, Dentsply Sirona; software version: SW 4.5.2) or the dislodgement of the guide was recorded. Scans were imported for analysis (GOM Inspect 2018, GOM GmbH), and library files of the surgical guides and implants were superimposed as a joined complex. The deviation of the implant's position was calculated from the displacement of the guide's position RESULTS: Three-way repeated measures using ANOVA revealed a more significant guide displacement and virtually projected implant deviation in the CSG group than the RSG group and with increasing force in all the deviation parameters. Both groups showed greater resistance to the displacement with the force applied from the oral direction than the buccal direction. The application of the force in the buccal direction resulted in guide dislodgements of 13% and 0% for the CSG and RSG, respectively. In the oral direction, the dislodgement rates were 33% and 7% for the CSG and RSG, respectively. CONCLUSIONS Within the limitations of this study, the retentive design increased the stability of the surgical guide and, consequently, the accuracy of the virtually projected implants in comparison to the conventional surgical guide designed using the default settings. Clinical trials are needed to confirm its advantages in clinical use. CLINICAL SIGNIFICANCE With a simple modification to the design, the surgical guide retention provided greater stability, with smaller deviations under loading; this resulted in improved implant precision parameters without requiring additional materials or software. Further studies are needed to assess the clinical feasibility of this surgical guide with improved retention and function.
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Li B, Wang P, Xu H, Gu R, Han X, Bai D, Xue C. Effects of offset design on the accuracy of bracket placement with a guided bonding device. J Orofac Orthop 2022:10.1007/s00056-022-00424-4. [PMID: 36102945 DOI: 10.1007/s00056-022-00424-4] [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: 04/11/2022] [Accepted: 08/01/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND This study aimed to evaluate the effects of offset design on the accuracy of bracket placement for computer-aided design and computer-aided manufacturing (CAD/CAM)-guided bonding devices (GBDs) in vitro. METHODS Eight dental models were selected. Seven types of GBDs were designed and three-dimensionally (3D) printed for each model, including one without any offset and the other six with translation offsets (TF) and expansion offsets (EF) of 0.05, 0.10, and 0.15 mm, respectively. After the brackets were bonded on the models using the different GBDs in vitro, linear and angular deviations of the bracket positions were evaluated. RESULTS In total, 56 GBDs were printed, and 784 brackets were bonded using the GBDs. No misfit between the dentitions and the devices was found during the bonding process. With increasing offset, more brackets were gingivally positioned with the frequencies ranging from 61.61 to 76.79% for the TF groups and from 58.93 to 78.57% for the EF groups. The vertical deviations of the brackets increased from 0.100 to 0.168 mm and from 0.117 to 0.150 mm in the TF and the EF group, respectively, as offset increased. No statistically significant difference was found in the vertical deviation between most of the TF and EF groups with the same offset value (p > 0.05). With respect to angulation, the mean absolute deviations were 0.881, 1.083, and 1.029° in the 0.05-mm, 0.10-mm, and 0.15-mm EF groups, respectively, which were greater than those in the corresponding TF groups (0.799, 0.847, and 0.806°). Similarly, with increasing offset, the mean absolute deviations for rotation in the EF groups (0.847, 0.998, and 1.138°) were greater than those in the TF groups (0.853, 0.946, and 0.896°). Compared with the 0.15-mm TF group, greater angulations (p < 0.05) and rotations (p < 0.01) were found in the 0.15-mm EF group. CONCLUSIONS Offset designs influenced the precision of vertical bracket placement with GBDs. Due to the smaller deviations in angulation and rotation of bracket placement, TF is preferred over EF for GBDs. Moreover, the differences between TF and EF also need to be considered in the design of other dental CAD/CAM devices.
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Affiliation(s)
- Bin Li
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases; Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Peiqi Wang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases; Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Hui Xu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases; Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Rui Gu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases; Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xianglong Han
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases; Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Ding Bai
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases; Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Chaoran Xue
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases; Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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陈 韵, 苏 葆. [Accuracy of computer-guided oral implant placement and influencing factors]. Sheng Wu Yi Xue Gong Cheng Xue Za Zhi 2022; 39:841-847. [PMID: 36008349 PMCID: PMC10957356 DOI: 10.7507/1001-5515.202110070] [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] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 06/09/2022] [Indexed: 06/15/2023]
Abstract
With the development of computer and digital technology, the application of computer-aided technology has become a new trend in the field of oral implant. Computer-guided oral implant surgery has the advantages of being safer and more accurate than traditional implant surgery, and it can truly realize the concept of restoration-oriented implant. However, computer-guided oral implant surgery has various steps which cause deviations accumulation, so that some clinicians remain sceptical about the accuracy of the technology. Currently, due to the lack of a quantitative system for evaluating the accuracy of computer-guided oral implantation, the implant deviation in each step is still inconclusively in the stage of research and debate. The purpose of this paper is to summarize the advantages and disadvantages, research progress, accuracy and influencing factors of computer-guided oral implantation, aiming to provide a reference for improving implant accuracy and guiding clinical design and surgery.
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Affiliation(s)
- 韵郦 陈
- 四川大学 生物医学工程学院(成都 610065)College of Biomedical Engineering, Sichuan University, Chengdu 610065, P. R. China
| | - 葆辉 苏
- 四川大学 生物医学工程学院(成都 610065)College of Biomedical Engineering, Sichuan University, Chengdu 610065, P. R. China
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Türker H, Aksoy B, Özsoy K. Fabrication of Customized dental guide by stereolithography method and evaluation of dimensional accuracy with artificial neural networks. J Mech Behav Biomed Mater 2022; 126:105071. [PMID: 34998070 DOI: 10.1016/j.jmbbm.2021.105071] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/26/2021] [Accepted: 12/29/2021] [Indexed: 10/19/2022]
Abstract
The present study was investigated the production dental guides by using additive manufacturing stereolithography (SLA) technology, and the dimensional aperture values of the dental guides for dental implant treatment using artificial intelligence technology. The aim of this study is to benefit from artificial neural networks (ANNs) to classify the results obtained from the new production freedom of SLA by changing the existing design concept of dental guides. In the study, the Three Dimensional (3D) anatomical model was designed by using Mimics programme the data obtained from the Cone Beam Computed Tomography (CBCT) images of the patient. Three different dental guide designs were performed using the 3-Matic programme for dental implant treatment on the obtained 3D anatomical model. Dental guide designs and mandible model were produced with a SLA 3D printer, and a data set was created using a 3D scanner. The dimensional aperture values were obtained by performing the 3D registration process between the mandible and dental guides. The data set was analyzed both statistically with Jamovi 2.0.0 software and ANNs. The results showed that the minimum and maximum aperture values obtained from the dental guides were very close to each other, indicating that the guides were compatible with the mandible bone. The statistical results showed that the dimensional aperture values decrease in proportion to the values with minimum arithmetic mean value in the data set, and it was determined that the dental guide-3 was the most suitable model for the mandible. When all test data in the confusion matrix obtained from ten different aritificial neural network models created using ANNs were examined, it was been seen that ANN model-5 was the most successful model with an accuracy rate of 99%.
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Affiliation(s)
- Hasan Türker
- Department of Mechatronics Engineering, Faculty of Technology, Isparta University of Applied Sciences, Isparta, 32100, Turkey
| | - Bekir Aksoy
- Department of Mechatronics Engineering, Faculty of Technology, Isparta University of Applied Sciences, Isparta, 32100, Turkey
| | - Koray Özsoy
- Department of Machine and Metal Technology, Isparta OSB Vocational School, Isparta University of Applied Sciences, Isparta, 32400, Turkey.
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