Fig. 9. Scatter diagrams illustrating the distribution of angle deviation of each protocol. a Anterior implants. b Posterior implants
Fig. 9. Scatter diagrams illustrating the distribution of angle deviation of each protocol. a Anterior implants. b Posterior implants
Fig. 8. Box plot diagrams illustrating the distribution of maximum angle deviation of each protocol. a Anterior implants. b Posterior implants
Fig. 8. Box plot diagrams illustrating the distribution of maximum angle deviation of each protocol. a Anterior implants. b Posterior implants
Fig. 7. Scatter diagrams illustrating the distribution of horizontal neck deviation of each protocol. a Anterior implants. b Posterior implants
Fig. 7. Scatter diagrams illustrating the distribution of horizontal neck deviation of each protocol. a Anterior implants. b Posterior implants
Fig. 6. Box plot diagrams illustrating the distribution of maximum horizontal apex deviation of each protocol. a Anterior implants. b Posterior implants
Fig. 6. Box plot diagrams illustrating the distribution of maximum horizontal apex deviation of each protocol. a Anterior implants. b Posterior implants
Fig. 5. Scatter diagrams illustrating the distribution of horizontal neck deviation of each protocol. a Anterior implants. b Posterior implants
Fig. 5. Scatter diagrams illustrating the distribution of horizontal neck deviation of each protocol. a Anterior implants. b Posterior implants
Fig. 4. Box plot diagrams illustrating the distribution of maximum horizontal neck deviation of each protocol. a Anterior implants. b Posterior implants
Fig. 4. Box plot diagrams illustrating the distribution of maximum horizontal neck deviation of each protocol. a Anterior implants. b Posterior implants
Fig. 3. Box plot diagrams illustrating the distribution of vertical deviation of each protocol. a Anterior implants. b Posterior implants
Fig. 3. Box plot diagrams illustrating the distribution of vertical deviation of each protocol. a Anterior implants. b Posterior implants
Fig. 2. a Schematic diagram illustrating the measurement of vertical, horizontal neck, horizontal apex, and angle deviations. b Three forms of horizontal deviation were measured: maximum, mesiodistal, and buccolingual directions
Fig. 2. a Schematic diagram illustrating the measurement of vertical, horizontal neck, horizontal apex, and angle deviations. b Three forms of horizontal deviation we...
Fig. 1. Flowchart summarizing the different phases of the experiment
Fig. 1. Flowchart summarizing the different phases of the experiment
 Vertical implant deviation  Anterior implantPosterior implantp values between anterior and posterior implants FGPGFHFGPGFHMean (mm)0.210.530.300.340.640.49FG = 0.07SD (mm)0.120.520.240.230.370.22PG = 0.27Maximum (mm)0.391.650.810.801.130.80FH = 0.05Minimum (mm)0.090.050.070.040.200.07p valuesAll groups = 0.12All groups = 0.08  Maximum horizontal implant neck deviation Â...
Abduo, J., Lau, D. Accuracy of static computer-assisted implant placement in anterior and posterior sites by clinicians new to implant dentistry: in vitro comparison of fully guided, pilot-guided, and freehand protocols. Int J Implant Dent 6, 10 (2020). https://doi.org/10.1186/s40729-020-0205-3
Download citation
Received: 31 October 2019
Accepted: 21 January 2020
Published: 11 March 2020
DOI:...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
This study was approved by the University of Melbourne Human Research Ethics Committee (1851406.1). The study complied with the Declaration of Helsinki. All participants were aware of the nature of the study and provided their consent prior to the commencement of the study.
Not applicable
Jaafar Abduo, and Douglas Lau declare that they have no competing interests.
Associate Professor in Prosthodontics, Convenor of Postgraduate Diploma in Clinical Dentistry (Implants), Melbourne Dental School, Melbourne University, 720 Swanston Street, Melbourne, VIC, 3010, Australia
Jaafar Abduo
Periodontist, Private Practice, Melbourne University, Melbourne, VIC, Australia
Douglas Lau
You can also search for this author in PubMed Google Scholar
You can also search fo...
The implants, surgical kits, and guide sleeves were provided by Straumann Australia. This study has been funded by the Kernot Early Career Researcher Award. No financial income for conducting the study was received by the authors.
The authors would also like to thank Mr. Attila Gergely for his technical support in developing the simulated case and the input of the team of Digital Dental Network in designing the guides.
Deeb GR, Allen RK, Hall VP, Whitley D 3rd, Laskin DM, Bencharit S. How accurate are implant surgical guides produced with desktop stereolithographic 3-dimentional printers? J Oral Maxillofac Surgery. 2017;75:2551–9.
Horwitz J, Zuabi O, Machtei EE. Accuracy of a computerized tomography-guided template-assisted implant placement system: an in vitro study. Clin Oral Implants Res. 2009;20:1156–62...
Rungcharassaeng K, Caruso JM, Kan JY, Schutyser F, Boumans T. Accuracy of computer-guided surgery: a comparison of operator experience. J Prosthet Dent. 2015;114:407–13.
Park SJ, Leesungbok R, Cui T, Lee SW, Ahn SJ. Reliability of a CAD/CAM surgical guide for implant placement: an in vitro comparison of surgeons' experience levels and implant sites. Int J Prosthodont. 2017;30:367–9.
Marheine...
Belser UC, Mericske-Stern R, Bernard JP, Taylor TD. Prosthetic management of the partially dentate patient with fixed implant restorations. Clin Oral Implants Res. 2000;11:126–45.
Buser D, Martin W, Belser UC. Optimizing esthetics for implant restorations in the anterior maxilla: anatomic and surgical considerations. Int J Oral Maxillofac Implants. 2004;19:43–61.
Ramaglia L, Toti P, Sbordone...
Three-dimensional
Computer-aided design/computer-aided manufacturing
Cone beam computed tomography
Digital Imaging and Communications in Medicine
Fully guided
Freehand
Pilot-guided
Static computer-assisted implant placement
Surface tessellation language
The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
Within the limitations of the present study, it can be hypothesized that apart from vertical deviation, the FG protocol is more accurate than the PG and FH protocols for all the evaluated variables in the hands of inexperienced clinicians. The PG and FH protocols were generally similar. The FG protocol did not seem to be influenced by the position of the placed implants, while the PG and FH protoc...
For the majority of the evaluated variables, there was a tendency for the posterior implants to suffer from more deviation than anterior implants. This is in accordance with several published reports [5, 21, 22]. Interestingly, implants placed by the FG protocol seemed to be less vulnerable to inaccuracy by changing the implant sites, while the PG and FH protocols showed more horizontal and angle ...
The superior accuracy and the less variation of the FG protocol is most likely related to the control of all the drilling steps and the implant placement via sequential use of precision sleeves. This eliminated the manual orientation and handling of the drills at any stage of drilling or implant placement. In accordance with these observations, Noharet et al. reported a better accuracy of the FG p...
The overall outcome of this study indicates the superiority of the FG protocol in comparison to PG and FH protocols for placing single implants. With the exception of vertical deviation, this was obvious for horizontal neck, horizontal apex, and angle deviations that were closer to the planned implant for the FG protocol than the other protocols. In addition, this superiority was shown for anterio...
In relation to the maximum angle deviation (Fig. 8), the FG protocol had less deviation than the other protocols for anterior (2.42 ± 0.98°) and posterior (2.61 ± 1.23°) implants. The PG (4.65 ± 1.78°) and FH (4.79 ± 2.08°) protocols were similar for anterior implant placement, while the FH protocol seemed more accurate for posterior implants (4.77 ± 2.09°) than the ...
In general, for all the variables, there was a tendency for the FG protocol to yield more accurate implant placement than other protocols (Table 1). In relation to vertical deviation, the PG protocol seemed to be associated with more errors. However, there was no significant difference in vertical deviation among all the protocols. Figure 3 indicates that the PG protocol was associated with deep...
The vertical deviation was measured by calculating the discrepancy along the long axis of the planned implant at the center of the platform (Fig. 2a). In addition to the magnitude of the deviation, the direction of the error was determined. The horizontal deviations were measured at the neck and the apex of the planned implant. The angle deviation was computed by measuring the angle of the long a...
For all the protocols, straight bone level Straumann dummy implants were planned. The anterior implants were 4.1 × 10 mm, while the posterior implants were 4.8 × 10 mm. The anterior implants were planned to be placed 2 mm subcrestal, while the posterior implants were planned to be placed 1 mm subcrestal.
For the conventional protocols, the clinicians had access to physical intact Ni...
The soft tissue silicone former was removed from the Nissin model to simulate bone anatomy. Subsequently, this model was duplicated with clear resin material mixed with barium sulfate and scanned by a cone beam computed tomography (CBCT) machine to generate cross-sectional DICOM images.
The DICOM images were imported to the implant planning software programs. For the FH protocol, the 2D DICOM ima...
A total of 10 qualified clinicians with a minimum of 3Â years of general practice experience were invited to participate in the study. The number of participants was similar to previously published studies [12, 19], and was confirmed by sample size calculation. A mean horizontal deviation of 1Â mm and an expected standard deviation of 0.75Â mm that were reported from earlier studies [13, 19] were ...
Despite all the advantages of sCAIP protocols, several studies reported that they are still prone to errors and complications [7,8,9, 17, 18]. The FG and PG protocols still require thorough planning and surgical understanding and skills [11]. For multiple implants and long-span edentulous ridges, guided surgery has the advantages of being more reliable, more comfortable for the patient, and more r...
Implant treatment is a growing field in dentistry, and many clinicians aim to increase their scope of practice by including such treatment. One of the main challenges encountered by clinicians new to implant dentistry is the determination and controlling of implant location. It is the consensus that implant placement must be planned to achieve an acceptable position for an ideal restorative outcom...
One of the challenges encountered by clinicians new to implant dentistry is the determination and controlling of implant location. This study compared the accuracy of fully guided (FG) and pilot-guided (PG) static computer-assisted implant placement (sCAIP) protocols against the conventional freehand (FH) protocol for placing single anterior and posterior implants by recently introduced clinicians...
Fig. 9. Scatter diagrams illustrating the distribution of angle deviation of each protocol. a Anterior implants. b Posterior implants
Fig. 9. Scatter diagrams illustrating the distribution of angle deviation of each protocol. a Anterior implants. b Posterior implants
Fig. 8. Box plot diagrams illustrating the distribution of maximum angle deviation of each protocol. a Anterior implants. b Posterior implants
Fig. 8. Box plot diagrams illustrating the distribution of maximum angle deviation of each protocol. a Anterior implants. b Posterior implants
Fig. 7. Scatter diagrams illustrating the distribution of horizontal neck deviation of each protocol. a Anterior implants. b Posterior implants
Fig. 7. Scatter diagrams illustrating the distribution of horizontal neck deviation of each protocol. a Anterior implants. b Posterior implants
Fig. 6. Box plot diagrams illustrating the distribution of maximum horizontal apex deviation of each protocol. a Anterior implants. b Posterior implants
Fig. 6. Box plot diagrams illustrating the distribution of maximum horizontal apex deviation of each protocol. a Anterior implants. b Posterior implants
Fig. 5. Scatter diagrams illustrating the distribution of horizontal neck deviation of each protocol. a Anterior implants. b Posterior implants
Fig. 5. Scatter diagrams illustrating the distribution of horizontal neck deviation of each protocol. a Anterior implants. b Posterior implants
Fig. 4. Box plot diagrams illustrating the distribution of maximum horizontal neck deviation of each protocol. a Anterior implants. b Posterior implants
Fig. 4. Box plot diagrams illustrating the distribution of maximum horizontal neck deviation of each protocol. a Anterior implants. b Posterior implants
Fig. 3. Box plot diagrams illustrating the distribution of vertical deviation of each protocol. a Anterior implants. b Posterior implants
Fig. 3. Box plot diagrams illustrating the distribution of vertical deviation of each protocol. a Anterior implants. b Posterior implants
Fig. 2. a Schematic diagram illustrating the measurement of vertical, horizontal neck, horizontal apex, and angle deviations. b Three forms of horizontal deviation were measured: maximum, mesiodistal, and buccolingual directions
Fig. 2. a Schematic diagram illustrating the measurement of vertical, horizontal neck, horizontal apex, and angle deviations. b Three forms of horizontal deviation we...
Fig. 1. Flowchart summarizing the different phases of the experiment
Fig. 1. Flowchart summarizing the different phases of the experiment
 Vertical implant deviation  Anterior implantPosterior implantp values between anterior and posterior implants FGPGFHFGPGFHMean (mm)0.210.530.300.340.640.49FG = 0.07SD (mm)0.120.520.240.230.370.22PG = 0.27Maximum (mm)0.391.650.810.801.130.80FH = 0.05Minimum (mm)0.090.050.070.040.200.07p valuesAll groups = 0.12All groups = 0.08  Maximum horizontal implant neck deviation Â...
Abduo, J., Lau, D. Accuracy of static computer-assisted implant placement in anterior and posterior sites by clinicians new to implant dentistry: in vitro comparison of fully guided, pilot-guided, and freehand protocols. Int J Implant Dent 6, 10 (2020). https://doi.org/10.1186/s40729-020-0205-3
Download citation
Received: 31 October 2019
Accepted: 21 January 2020
Published: 11 March 2020
DOI:...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
This study was approved by the University of Melbourne Human Research Ethics Committee (1851406.1). The study complied with the Declaration of Helsinki. All participants were aware of the nature of the study and provided their consent prior to the commencement of the study.
Not applicable
Jaafar Abduo, and Douglas Lau declare that they have no competing interests.
Associate Professor in Prosthodontics, Convenor of Postgraduate Diploma in Clinical Dentistry (Implants), Melbourne Dental School, Melbourne University, 720 Swanston Street, Melbourne, VIC, 3010, Australia
Jaafar Abduo
Periodontist, Private Practice, Melbourne University, Melbourne, VIC, Australia
Douglas Lau
You can also search for this author in PubMed Google Scholar
You can also search fo...
The implants, surgical kits, and guide sleeves were provided by Straumann Australia. This study has been funded by the Kernot Early Career Researcher Award. No financial income for conducting the study was received by the authors.
The authors would also like to thank Mr. Attila Gergely for his technical support in developing the simulated case and the input of the team of Digital Dental Network in designing the guides.
Deeb GR, Allen RK, Hall VP, Whitley D 3rd, Laskin DM, Bencharit S. How accurate are implant surgical guides produced with desktop stereolithographic 3-dimentional printers? J Oral Maxillofac Surgery. 2017;75:2551–9.
Horwitz J, Zuabi O, Machtei EE. Accuracy of a computerized tomography-guided template-assisted implant placement system: an in vitro study. Clin Oral Implants Res. 2009;20:1156–62...
Rungcharassaeng K, Caruso JM, Kan JY, Schutyser F, Boumans T. Accuracy of computer-guided surgery: a comparison of operator experience. J Prosthet Dent. 2015;114:407–13.
Park SJ, Leesungbok R, Cui T, Lee SW, Ahn SJ. Reliability of a CAD/CAM surgical guide for implant placement: an in vitro comparison of surgeons' experience levels and implant sites. Int J Prosthodont. 2017;30:367–9.
Marheine...
Belser UC, Mericske-Stern R, Bernard JP, Taylor TD. Prosthetic management of the partially dentate patient with fixed implant restorations. Clin Oral Implants Res. 2000;11:126–45.
Buser D, Martin W, Belser UC. Optimizing esthetics for implant restorations in the anterior maxilla: anatomic and surgical considerations. Int J Oral Maxillofac Implants. 2004;19:43–61.
Ramaglia L, Toti P, Sbordone...
Three-dimensional
Computer-aided design/computer-aided manufacturing
Cone beam computed tomography
Digital Imaging and Communications in Medicine
Fully guided
Freehand
Pilot-guided
Static computer-assisted implant placement
Surface tessellation language
The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
Within the limitations of the present study, it can be hypothesized that apart from vertical deviation, the FG protocol is more accurate than the PG and FH protocols for all the evaluated variables in the hands of inexperienced clinicians. The PG and FH protocols were generally similar. The FG protocol did not seem to be influenced by the position of the placed implants, while the PG and FH protoc...
For the majority of the evaluated variables, there was a tendency for the posterior implants to suffer from more deviation than anterior implants. This is in accordance with several published reports [5, 21, 22]. Interestingly, implants placed by the FG protocol seemed to be less vulnerable to inaccuracy by changing the implant sites, while the PG and FH protocols showed more horizontal and angle ...
The superior accuracy and the less variation of the FG protocol is most likely related to the control of all the drilling steps and the implant placement via sequential use of precision sleeves. This eliminated the manual orientation and handling of the drills at any stage of drilling or implant placement. In accordance with these observations, Noharet et al. reported a better accuracy of the FG p...
The overall outcome of this study indicates the superiority of the FG protocol in comparison to PG and FH protocols for placing single implants. With the exception of vertical deviation, this was obvious for horizontal neck, horizontal apex, and angle deviations that were closer to the planned implant for the FG protocol than the other protocols. In addition, this superiority was shown for anterio...
In relation to the maximum angle deviation (Fig. 8), the FG protocol had less deviation than the other protocols for anterior (2.42 ± 0.98°) and posterior (2.61 ± 1.23°) implants. The PG (4.65 ± 1.78°) and FH (4.79 ± 2.08°) protocols were similar for anterior implant placement, while the FH protocol seemed more accurate for posterior implants (4.77 ± 2.09°) than the ...
In general, for all the variables, there was a tendency for the FG protocol to yield more accurate implant placement than other protocols (Table 1). In relation to vertical deviation, the PG protocol seemed to be associated with more errors. However, there was no significant difference in vertical deviation among all the protocols. Figure 3 indicates that the PG protocol was associated with deep...
The vertical deviation was measured by calculating the discrepancy along the long axis of the planned implant at the center of the platform (Fig. 2a). In addition to the magnitude of the deviation, the direction of the error was determined. The horizontal deviations were measured at the neck and the apex of the planned implant. The angle deviation was computed by measuring the angle of the long a...
For all the protocols, straight bone level Straumann dummy implants were planned. The anterior implants were 4.1 × 10 mm, while the posterior implants were 4.8 × 10 mm. The anterior implants were planned to be placed 2 mm subcrestal, while the posterior implants were planned to be placed 1 mm subcrestal.
For the conventional protocols, the clinicians had access to physical intact Ni...
The soft tissue silicone former was removed from the Nissin model to simulate bone anatomy. Subsequently, this model was duplicated with clear resin material mixed with barium sulfate and scanned by a cone beam computed tomography (CBCT) machine to generate cross-sectional DICOM images.
The DICOM images were imported to the implant planning software programs. For the FH protocol, the 2D DICOM ima...
A total of 10 qualified clinicians with a minimum of 3Â years of general practice experience were invited to participate in the study. The number of participants was similar to previously published studies [12, 19], and was confirmed by sample size calculation. A mean horizontal deviation of 1Â mm and an expected standard deviation of 0.75Â mm that were reported from earlier studies [13, 19] were ...
Despite all the advantages of sCAIP protocols, several studies reported that they are still prone to errors and complications [7,8,9, 17, 18]. The FG and PG protocols still require thorough planning and surgical understanding and skills [11]. For multiple implants and long-span edentulous ridges, guided surgery has the advantages of being more reliable, more comfortable for the patient, and more r...
Implant treatment is a growing field in dentistry, and many clinicians aim to increase their scope of practice by including such treatment. One of the main challenges encountered by clinicians new to implant dentistry is the determination and controlling of implant location. It is the consensus that implant placement must be planned to achieve an acceptable position for an ideal restorative outcom...
One of the challenges encountered by clinicians new to implant dentistry is the determination and controlling of implant location. This study compared the accuracy of fully guided (FG) and pilot-guided (PG) static computer-assisted implant placement (sCAIP) protocols against the conventional freehand (FH) protocol for placing single anterior and posterior implants by recently introduced clinicians...
Â
Sleeve length
Clearance
Total length
Offset
Error at the apex
− 0.1854
0.0037
0.0453
Â
Error at the neck
− 0.1041
0.0018
Â
0.0461
Table 4 Error at the neck (mm)
Sleeve length (mm)
Clearance (μm)
Offset (mm)
6
7
8
9
10
11
12
13
14
15
16
17
4
50
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.2
0.2
0.2
0.2
80
0.1
0.1
0.1
0.1
0.2
0.2
0.2
0.2
0.2
0.3
0.3
0.3
110
0.1
0.1
0.2
0.2
0.2
0.2
0.3
0.3
0.3
0.4
0.4
0.4
140
0.1
0.2
0.2
0.2
0.3
0.3
0.4
0.4
0.4...
Table 3 Error at the apex (mm) and deviation of implant axis (degrees) for sleeve lengths 6 and 7Â mm
Â
Â
Sleeve length (mm)
Clearance (μm)
Deviation (°)
Total length (mm)
16
17
18
19
20
21
22
23
24
25
26
27
28
29
6
50
0.5
0.1
0.1
0.1
0.1
0.1
0.2
0.2
0.2
0.2
0.2
0.2
0.2
0.2
0.2
80
0.8
0.2
0.2
0.2
0.2
0.2
0.2
0.3
0.3
0.3
0.3...
Table 2 Error at the apex (mm) and deviation of implant axis (°) for sleeve lengths 4 and 5 mm
Â
Sleeve length (mm)
Clearance (μm)
Deviation (degrees)
Total length (mm)
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
4.00
50.00
0.72
0.2
0.2
0.2
0.2
0.2
0.2
0.2
0.2
0.3
0.3
0.3
0.3
0.3
0.3
0.3
0.3
80.00
1.15
0.2
0.3
0.3
0.3
0.3...
Table 1 Range of various maximum permissible errors as calculated in the present study
Â
Â
Axis deviation (°)
Error at the neck (mm)
Error at the apex (mm)
Vertical error at the apex (mm)
Min
0.4
0.1
0.1
0.0
Max
5.9
1.5
2.8
0.1
Â
Figure 2. The various errors in implant positioning
Figure 1. The parameters used for the calculation of the various errors and the deviation of implant axis
Figure 1. The parameters used for the calculation of the various errors and the deviation of implant axis
Abbreviations
3d:
Three dimensional
CAD:
Computer-aided design
CAM:
Computer-aided manufacturing
CBCT:
Cone beam computed tomography
CI:
Confidence interval
CT:
Computed tomography
Dicom:
Digital imaging and communications in medicine
FDM:
Fused deposition modelling
GIS:
Guided implant surgery
SLA:
Stereolithography apparatus
STL...
Discussion
The purpose of a computer designed and computer manufactured (CAD/CAM) surgical guide is to provide the means for an accurate and reliable transfer of the computer-realised virtual treatment plan to the actual surgical field. The availability of the CBCT imaging modality should have led to an explosion of the usage of these guides, since they have been shown to be...
Results
The range of the various maximum permissible errors due to the metal sleeve/osteotomy drill combination is presented in Table 1.
Concerning the error at the apex, two reference tables were reported (Tables 2 and 3). In these tables, the deviation of the implant axis was also tabulated. A separate table (Table 4) tabulated the error at the neck.
Multiple regression ...
Based on the geometric analysis of the problem in hand, an algorithm was developed and implemented in C programming language. The purpose of this program was to readily and accurately compute the following maximum positioning errors, permissible by the different sleeve/drill/guide properties (Fig. 2):
1. Deviation of the implant axis in degrees,
2. Error at the neck in mm,
2. Er...
Methods
For the estimation of the errors in implant positioning due to the properties of the metal sleeve/osteotomy drill combination, four parameters are necessary: (1) sleeve length, (2) clearance (space between the bur and the sleeve), (3) implant length, and (4) offset (distance of the lip of the metal sleeve to the neck of the implant) (Figs. 1 and 2).
Definitions
Basic...
Background
Computer-aided designed and computer-aided manufactured (CAD/CAM) implant surgical guides are long recommended to reliably transfer a virtual treatment plan to the surgical field. The 3d-printed guide stands a basic part of a process commonly referred to as guided implant surgery (GIS). The outcome of this process has been shown to be relatively accurate, even when th...
CAD/CAM implant surgical guides: maximum errors in implant positioning attributable to the properties of the metal sleeve/osteotomy drill combination
Â
Abstract
Background
The purpose of this study is to provide the relevant equations and the reference tables needed for calculating the maximum errors in implant positioning attributed to the properties of the mechanical parts of any CAD/CAM ...
BMP-2/ACS7
bone morphogenetic protein 2/ absorbable collagen sponge 7, protein morfogenetik tulang 2/ spons kolagen terabsorbsi 7
CAD/CAM
computer-aided design/computer-aided manufacturing, desain terbantu komputer/ manufaktur terbantu komputer
CBCT
cone beam computerized tomography, tomografi terkomputerisasi cahya kerucut
CBR
customized bone...
Simpulan
Laporan kasus ini menyajikan struktur kisi titanium tersesuai baru yang spesifik pasien, yang cocok untuk membentuk dan membangun kembali tulang cacat dalam situasi anatomi yang kompleks. Hasil klinis dan histologis menunjukkan protokol ini sebagai prosedur yang berhasil dan dapat diprediksi untuk membangun kembali tulang cacat yang menderita atrofi. Penelitian lebih lanjut diperlukan un...
Wedharan
Dalam laporan kasus ini, struktur kisi tersesuai spesifik pasien digunakan untuk augmentasi horizontal dan vertikal pada rahang bawah posterior. Struktur itu menawarkan kecocokan yang persis pas dan stabilitas yang tinggi setelah fiksasi sekrup seperti yang telah terbukti dalam penelitian terbaru untuk jala-jala yang telah dibentuk dulu sebelumnya. Jala yang tersesuai memperpendek durasi...
Weton
Sesuai permintaan pasien, penutupan celah interdental diperlukan untuk meningkatkan weton kosmetik dan fungsional. Oleh karena itu, penempatan implant diperlukan. Pilihan perawatan alternatif seperti prostetik konvensional (jembatan #27 sampai #30 dan #31) harus berurusan dengan berbagai macam stabilitas mekanik dan dapat membuat berkurangnya stabilitas mekanik. Dalam kasus ini, gigi poster...
Bahan dan Metode
Peserta
Seorang wanita saras berusia 61 tahun tanpa sejarah medis menunjukkan segmen yang sangat atrofi dari mandibula posterior kanan bawah (# 29 dan # 28). Defisit vertikal dan transversal yang signifikan, serta situasi jaringan lunak yang menantang, membuat penempatan implant yang fungsional dan estetis tidak bisa dilakukan (Gambar 1 dan 2).
Gambar 1. Tampilan klinis cacat...
Pendahuluan
Untuk beberapa pasien, implan gigi bukan pilihan jika tanpa augmentasi tulang horizontal atau tulang vertikal. Cacat tulang alveolar dapat dirawat dengan berbagai teknik regenerasi tulang termasuk cangkok tulang blok, regenerasi tulang terpandu (GBR), pemisahan punggungan gusi, dan osteogenesis gangguan, serta prosedur augmentasi dasar sinus di rahang atas.
Jala titanium sudah banyak...
Marcus Seiler, DDS1; Peer W. Kämmerer, MD, DDS, PhD, MA2; Michael Peetz, PhD3; Amely G. Hartmann, DDS1
1 Department of Oral and Maxillofacial Surgery, Private Practice, Filderstadt, Jerman.
2 Department of Oral and Maxillofacial Surgery, University Medical Center of the Johannes Gutenberg University, Mainz, Jerman.
3 Dental Campus, Zürich, Swiss.
Â
Korespondensi:
 * P...
References
Misch CM. Comparison of intraoral donor sites for onlay grafting prior to implant placement. Int J Oral Maxillofac Implants. 1997;12:767–776.
Hammerle CH, Karring T. Guided bone regeneration at oral implant sites. Periodontology 2000. 1998;17:151–175.
Simion M, Baldoni M, Zaffe D. Jawbone enlargement using immediate implant placement associated with a split-crest techniq...
Acknowledgments
The authors thank patients, nurses, and physicians for their support with patients' material and reports. Moreover, the authors thank all of our colleagues for helpful discussions. The authors thank Prof Dr Christoph Hämmerle, University of Zürich, for histologic examinations.
The authors declare that they have no competing interests. M.S. developed the methodology (owner of pa...
BMP-2/ACS7
bone morphogenetic protein 2/ absorbable collagen sponge 7
CAD/CAM
computer-aided design/computer-aided manufacturing
CBCT
cone beam computerized tomography
CBR
customized bone regeneration
DICOM
digital imaging and communication in medicine
GBR
guided bone regeneration
3DP
three-dimensional printing
Conclusion
This case report presents a novel patient-specific customized lattice structure made of titanium, which is suitable for shaping and rebuilding a bone defect in complex anatomic situations. Clinical and histologic results demonstrated this protocol as a successful and predictable procedure for rebuilding an atrophied bone defect. Further studies are needed to evaluate the effects and be...
Discussion
In this case report, a customized patient-specific lattice structure was used for horizontal and vertical augmentation in the posterior mandible. It offered a precise fit and high stability after screw fixation as already proven in recent studies for preformed meshes. A customized mesh shortens duration of surgery and offers all benefits of reduced time for intervention and improved su...
Results
According to the patient's request, a closure of the interdental gap was necessary to improve the cosmetic and functional outcome. Therefore, an implant placement was required. Alternative treatment options such as conventional prosthetics (bridge #27 to #30 and #31) would have to deal with a wide range and may result in reduced mechanical stability. In this case, the posterior teeth (#30...
Materials and Methods
Participant
A 61-year-old healthy woman without any medical history showed a highly atrophied segment of the right lower posterior mandible (#29 and #28). The significant vertical and transversal deficit, as well as the challenging soft tissue situation, made a functionally and esthetically satisfying implant placement impossible (Figures 1 and 2).
Figure 1. Clinical app...
Introduction
For some patients, dental implants would not be an option without horizontal or vertical bone augmentation. Alveolar bone defects may be treated with various bone regeneration techniques including block bone graft, guided bone regeneration (GBR), ridge splitting, and distraction osteogenesis, as well as sinus floor augmentation procedures in the upper jaw.
Titanium meshes have been...
Marcus Seiler, DDS1; Peer W. Kämmerer, MD, DDS, PhD, MA2; Michael Peetz, PhD3; Amely G. Hartmann, DDS1
1 Department of Oral and Maxillofacial Surgery, Private Practice, Filderstadt, Germany.
2 Department of Oral and Maxillofacial Surgery, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.
3 Dental Campus, Zürich, Switzerland.
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Correspondence:...