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 ...
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 3 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 1 mm and an expected standard deviation of 0.75 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 ...
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 3 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 1 mm and an expected standard deviation of 0.75 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...
Sagheb, K., Schiegnitz, E., Moergel, M. et al. Clinical outcome of alveolar ridge augmentation with individualized CAD-CAM-produced titanium mesh.
Int J Implant Dent 3, 36 (2017). https://doi.org/10.1186/s40729-017-0097-z
Download citation
Received: 15 March 2017
Accepted: 13 July 2017
Published: 26 July 2017
DOI: https://doi.org/10.1186/s40729-017-0097-z
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...
Keyvan Sagheb reports personal fees and grants from Dentsply, Geistlich, and Nobel Biocare outside the submitted work. Eik Schiegnitz reports personal fees and grants from Septodont, Dentsply, Geistlich, and Straumann outside the submitted work. Maximilian Moergel reports grants from Camlog outside the submitted work. Christian Walter reports grants and personal fees from Straumann outside the sub...
Correspondence to
E. Schiegnitz.
K. Sagheb and E. Schiegnitz contributed equally to this work.
Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany
K. Sagheb, E. Schiegnitz, M. Moergel, C. Walter, B. Al-Nawas & W. Wagner
Mediplus, Oral and Maxillofacial Surgery, Private Praxis, Mainz, Germany
C. Walter
You can also search for...
Ali S, Bakry SA, Abd-Elhakam H. Platelet-rich fibrin in maxillary sinus augmentation: a systematic review. The Journal of oral implantology. 2015;41(6):746–53. PubMed PMID: 25536095
Moraschini V, Barboza ES. Effect of autologous platelet concentrates for alveolar socket preservation: a systematic review. Int J Oral Maxillofac Surg. 2015;44(5):632–41. PubMed PMID: 25631334
Torres J, Tamimi F,...
Pieri F, Corinaldesi G, Fini M, Aldini NN, Giardino R, Marchetti C. Alveolar ridge augmentation with titanium mesh and a combination of autogenous bone and anorganic bovine bone: a 2-year prospective study. J Periodontol. 2008;79(11):2093–103. PubMed PMID: 18980518
Proussaefs P, Lozada J. Use of titanium mesh for staged localized alveolar ridge augmentation: clinical and histologic-histomorphom...
von Arx T, Kurt B. Implant placement and simultaneous peri-implant bone grafting using a micro titanium mesh for graft stabilization. Int J Periodontics Restorative Dent. 1998;18(2):117–27. PubMed PMID: 9663090
von Arx T, Kurt B. Implant placement and simultaneous ridge augmentation using autogenous bone and a micro titanium mesh: a prospective clinical study with 20 implants. Clin Oral Implant...
Moraschini V, Poubel LA, Ferreira VF, Barboza ES. Evaluation of survival and success rates of dental implants reported in longitudinal studies with a follow-up period of at least 10 years: a systematic review. Int J Oral Maxillofac Surg. 2015;44(3):377–88. PubMed PMID: 25467739
Al-Nawas B, Kammerer PW, Morbach T, Ladwein C, Wegener J, Wagner W. Ten-year retrospective follow-up study of the TiO...
Within the limitations of this study, being retrospective and having no control group, the results show that individualized CAD-CAM-produced titanium meshes are a safe and predictable procedure for large vertical and horizontal ridge augmentations. The soft tissue covering remains one of the most critical steps using this technique. However, exposure of the mesh does not result in complete loss of...
The results showed that in all 21 augmented sites, a significant ridge augmentation was achieved, with a mean vertical augmentation of 6.5 ± 1.7 mm and a mean horizontal augmentation of 5.5 ± 1.9 mm. To our best knowledge, this is the first study investigating these parameters in individualized CAD-CAM-produced titanium meshes. For conventional titanium meshes, several studies were publish...
In our study, PRF membranes were additionally to collagen membranes used to cover the CAD-CAM mesh. The aim of this clinical approach was to improve and accelerate wound healing. The results with the low exposure rates and the sufficient augmentation heights indicated that these PRF membranes are a promising technique. However, due to low case number in the control group without a PRF membrane, de...
The vertical and horizontal regeneration of resorbed alveolar ridges remains a challenging surgical procedure, especially in the case of extensive bone atrophy. During the past years, different augmentation techniques have been proposed to restore an adequate bone volume. The aim of this study was to evaluate a technique for ridge augmentation in the maxilla and mandible using an individualized CA...
In the investigated time period, 17 patients received 21 TM augmentations. Fourteen of these patients were women and three men. Mean age at the time of augmentation was 37 ± 15 years (17–64 years). Twelve of the patients were non-smoker, and 5 patients were smoker. In 8 patients, a steady periodontal disease could be detected. Sixty-five percent (n = 11) of the patients presented a thin g...
Cone beam computed tomography (CBCT) of the treated sites was performed before augmentation procedure and 6 months postoperatively at time of reentry. Craniofacial bone and TM showed different radio-opacity, which allowed their easy differentiation on the scans after regulating the brightness and contrast. In our department, two different CBCTs were available (Accuitomo, J. Morita Corporation, Ja...
In a retrospective study, the clinical outcome of an individualized CAD-CAM-produced TM (Yxoss CBR®, Filderstadt, Germany) inserted by experienced surgeons in the Department of Oral and Maxillofacial Surgery of the University Medical Centre Mainz, Germany, between December 2014 and January 2017, was analyzed. Therefore, all patients with this CAD-CAM mesh augmentation and reentry operation for im...
The aim of this clinical study was to present the clinical outcome of individualized CAD-CAM-produced TM in combination with particulate autogenous bone mixed with deproteinized bovine bone mineral (DBBM) used to augment horizontal and/or vertical bony defects in both maxillary and mandibular arches, within a two-stage technique. Furthermore, gained horizontal and vertical bone height and the infl...
Dental implant placement is an effective treatment method for the replacement of lost teeth with high survival rates after long-term follow-up [1,2,3]. However, the long-term success and stability of implants in function are directly correlated with the quality and quantity of the available bone at the prospective implant site [4, 5]. Despite the development of various techniques and augmentation ...
The augmentation of the jaw has been and continues to be a sophisticated therapy in implantology. Modern CAD-CAM technologies lead to revival of old and established augmentation techniques such as the use of titanium mesh (TM) for bone augmentation. The aim of this retrospective study was to evaluate the clinical outcome of an individualized CAD-CAM-produced TM based on the CT/DVT-DICOM data of th...
Sagheb, K., Schiegnitz, E., Moergel, M. et al. Clinical outcome of alveolar ridge augmentation with individualized CAD-CAM-produced titanium mesh.
Int J Implant Dent 3, 36 (2017). https://doi.org/10.1186/s40729-017-0097-z
Download citation
Received: 15 March 2017
Accepted: 13 July 2017
Published: 26 July 2017
DOI: https://doi.org/10.1186/s40729-017-0097-z
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...
Keyvan Sagheb reports personal fees and grants from Dentsply, Geistlich, and Nobel Biocare outside the submitted work. Eik Schiegnitz reports personal fees and grants from Septodont, Dentsply, Geistlich, and Straumann outside the submitted work. Maximilian Moergel reports grants from Camlog outside the submitted work. Christian Walter reports grants and personal fees from Straumann outside the sub...
Correspondence to
E. Schiegnitz.
K. Sagheb and E. Schiegnitz contributed equally to this work.
Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany
K. Sagheb, E. Schiegnitz, M. Moergel, C. Walter, B. Al-Nawas & W. Wagner
Mediplus, Oral and Maxillofacial Surgery, Private Praxis, Mainz, Germany
C. Walter
You can also search for...
Ali S, Bakry SA, Abd-Elhakam H. Platelet-rich fibrin in maxillary sinus augmentation: a systematic review. The Journal of oral implantology. 2015;41(6):746–53. PubMed PMID: 25536095
Moraschini V, Barboza ES. Effect of autologous platelet concentrates for alveolar socket preservation: a systematic review. Int J Oral Maxillofac Surg. 2015;44(5):632–41. PubMed PMID: 25631334
Torres J, Tamimi F,...
Pieri F, Corinaldesi G, Fini M, Aldini NN, Giardino R, Marchetti C. Alveolar ridge augmentation with titanium mesh and a combination of autogenous bone and anorganic bovine bone: a 2-year prospective study. J Periodontol. 2008;79(11):2093–103. PubMed PMID: 18980518
Proussaefs P, Lozada J. Use of titanium mesh for staged localized alveolar ridge augmentation: clinical and histologic-histomorphom...
von Arx T, Kurt B. Implant placement and simultaneous peri-implant bone grafting using a micro titanium mesh for graft stabilization. Int J Periodontics Restorative Dent. 1998;18(2):117–27. PubMed PMID: 9663090
von Arx T, Kurt B. Implant placement and simultaneous ridge augmentation using autogenous bone and a micro titanium mesh: a prospective clinical study with 20 implants. Clin Oral Implant...
Moraschini V, Poubel LA, Ferreira VF, Barboza ES. Evaluation of survival and success rates of dental implants reported in longitudinal studies with a follow-up period of at least 10 years: a systematic review. Int J Oral Maxillofac Surg. 2015;44(3):377–88. PubMed PMID: 25467739
Al-Nawas B, Kammerer PW, Morbach T, Ladwein C, Wegener J, Wagner W. Ten-year retrospective follow-up study of the TiO...
Within the limitations of this study, being retrospective and having no control group, the results show that individualized CAD-CAM-produced titanium meshes are a safe and predictable procedure for large vertical and horizontal ridge augmentations. The soft tissue covering remains one of the most critical steps using this technique. However, exposure of the mesh does not result in complete loss of...
The results showed that in all 21 augmented sites, a significant ridge augmentation was achieved, with a mean vertical augmentation of 6.5 ± 1.7 mm and a mean horizontal augmentation of 5.5 ± 1.9 mm. To our best knowledge, this is the first study investigating these parameters in individualized CAD-CAM-produced titanium meshes. For conventional titanium meshes, several studies were publish...
In our study, PRF membranes were additionally to collagen membranes used to cover the CAD-CAM mesh. The aim of this clinical approach was to improve and accelerate wound healing. The results with the low exposure rates and the sufficient augmentation heights indicated that these PRF membranes are a promising technique. However, due to low case number in the control group without a PRF membrane, de...
The vertical and horizontal regeneration of resorbed alveolar ridges remains a challenging surgical procedure, especially in the case of extensive bone atrophy. During the past years, different augmentation techniques have been proposed to restore an adequate bone volume. The aim of this study was to evaluate a technique for ridge augmentation in the maxilla and mandible using an individualized CA...
In the investigated time period, 17 patients received 21 TM augmentations. Fourteen of these patients were women and three men. Mean age at the time of augmentation was 37 ± 15 years (17–64 years). Twelve of the patients were non-smoker, and 5 patients were smoker. In 8 patients, a steady periodontal disease could be detected. Sixty-five percent (n = 11) of the patients presented a thin g...
Cone beam computed tomography (CBCT) of the treated sites was performed before augmentation procedure and 6 months postoperatively at time of reentry. Craniofacial bone and TM showed different radio-opacity, which allowed their easy differentiation on the scans after regulating the brightness and contrast. In our department, two different CBCTs were available (Accuitomo, J. Morita Corporation, Ja...
In a retrospective study, the clinical outcome of an individualized CAD-CAM-produced TM (Yxoss CBR®, Filderstadt, Germany) inserted by experienced surgeons in the Department of Oral and Maxillofacial Surgery of the University Medical Centre Mainz, Germany, between December 2014 and January 2017, was analyzed. Therefore, all patients with this CAD-CAM mesh augmentation and reentry operation for im...
The aim of this clinical study was to present the clinical outcome of individualized CAD-CAM-produced TM in combination with particulate autogenous bone mixed with deproteinized bovine bone mineral (DBBM) used to augment horizontal and/or vertical bony defects in both maxillary and mandibular arches, within a two-stage technique. Furthermore, gained horizontal and vertical bone height and the infl...
Dental implant placement is an effective treatment method for the replacement of lost teeth with high survival rates after long-term follow-up [1,2,3]. However, the long-term success and stability of implants in function are directly correlated with the quality and quantity of the available bone at the prospective implant site [4, 5]. Despite the development of various techniques and augmentation ...
The augmentation of the jaw has been and continues to be a sophisticated therapy in implantology. Modern CAD-CAM technologies lead to revival of old and established augmentation techniques such as the use of titanium mesh (TM) for bone augmentation. The aim of this retrospective study was to evaluate the clinical outcome of an individualized CAD-CAM-produced TM based on the CT/DVT-DICOM data of th...
Sleeve length
Clearance
Total length
Offset
Error at the apex
− 0.1854
0.0037
0.0453
Error at the neck
− 0.1041
0.0018
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 7 mm
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
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
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
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
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 ...
Figure 6. Figure 6. a–d Von Mises stress distribution on bone. From a to d: L-M, ZL-M, L-V, and ZL-V respectively. The stress concentration occurred in the cortical bone around the neck of the implant. Groups L-M and ZL-M were quite similar and reduced stress
Figure 5. a–d Von Mises stress distribution on abutment. From a to d: L-M, ZL-M, L-V, and ZL-V respectively. Von Mises stresses were relatively similar and concentrated at the coronal part of the abutment in all groups
Figure 5. a–d Von Mises stress distribution on abutment. From a to d: L-M, ZL-M, L-V, and ZL-V respectively. Von Mises stresses were relatively similar and concentrated ...
Figure 4. a–d Von Mises stress distribution on implant. From a to d: L-M, ZL-M, L-V, and ZL-V respectively
Figure 4. a–d Von Mises stress distribution on implant. From a to d: L-M, ZL-M, L-V, and ZL-V respectively
Figure 3. a–d Maximum principal stress distribution on crown restoration. From a to d: L-M, ZL-M, L-V, and ZL-V respectively
Figure 3. a–d Maximum principal stress distribution on crown restoration. From a to d: L-M, ZL-M, L-V, and ZL-V respectively
Figure 2. The graph of the interaction of the materials and restoration design
Group
N
Mean (N)
Standard deviation
Minimum
Maximum
L-M
12
2891.88a
410.12
2079.74
3486.96
L-V
12
2077.37bc
356.59
1220.96
2493.39
ZL-M
12
1750.28c
314.96
1084.36
2163.95
ZL-V
12
2202.55b
503.14
1292.20
2912.81
Material
Young’s modulus (GPa)
Poisson ratio
Reference
E.max CAD
95
0.20
[1]
Vita Suprinity
65
0.23
[2]
Vita VM 11
65
0.23
*
E.max Ceram
64
0.23
[4]
Implant and abutment
114
0.34
[5]
Cortical bone
13.7
0.3
[5]
Spongious bone
1
0.3
[5]
Figure 1. Crown restoration design
Groups
N
Materials
L-M
12
IPS e-max CADIPS e.max CAD glaze
L-V
12
IPS e-max CADe.max Ceram DentinIPS e.max Ceram Glaze
ZL-M
12
Vita SuprinityVita Akzent Plus
ZL-V
12
Vita SuprinityVM-11Vita Akzent Plus
Material
Chemical composition (%)
Coefficient of thermal expansion (10−6 K−1)
Flexural strength (MPa)
Manufacturer
IPS e.max CAD; lithium disilicate glass ceramic (LDS)
SiO2 (57–80), Li2O (11–19), K2O (0–13), P2O5 (0–11), ZrO2 (0–8), ZnO (0–8), Al2O3 (0–5), MgO (0–5), coloring oxides (0–8)
10.2
360
Ivoclar Vivadent
IPS e.max Ceram; low-fusing nan...
Conclusions
Within the limitation of the present study, it can be concluded that the restoration design affected the failure load of ceramics. Monolithic design had a statistically significant effect on the failure load of two different ceramics (LDS > ZLS). Veneer application had opposite effects on two different ceramics which increased the failure load of ZLS and reduced it for LDS witho...
Zheng et al. compared the stress distribution of the same veneering ceramic on different cores and concluded that the zirconia core was clearly different from other materials with higher tensile stresses at the veneer core interface because the increasing differences between the elasticity modulus of the core and the veneer transmitted higher stress concentrations to the cores. Con...
Veneer application provided additional strength to the ZLS crowns in contrast to the LDS crowns. The higher failure load of the veneered ZLS crowns (2202.55 N; group L-V 2077.37 N) may be associated with the higher flexural strength of the veneering porcelain VM-11 (100 MPa; emax Ceram 90 MPa). These veneered groups had a statistically significant difference from the monoli...
Similar results were presented in a study of Traini et al. as it was concluded that ZLS was comparable to that of existing zirconia-based ceramics and was suitable for oral function even in the posterior regions. In the literature, there have been few studies on this ceramic and a limited number of them include the failure load of the material. In one of these studi...
In literature, it has been stated that the failure load of LDS crowns was higher than veneered zirconia and could be comparable with metal ceramic systems. Doğan et al. evaluated the fracture strength of different CAD/CAM-manufactured crowns and concluded that the monolithic LDS crowns had the highest fracture resistance. Present study confirmed as monolithic LDS crowns demonstrated so satisfying...
Discussion
Implant-supported restorations have been accepted as an alternative treatment for the rehabilitation of edentulous spaces. Despite the high success rates, implant failures are inevitable and classified as early or late implant failures. Late implant failures are observed after prosthetic restoration which is primarily related to biomechanical complications. Since occlusal loads are t...
Results
Descriptive analysis (mean, standard deviation (SD), minimum, maximum) of the groups is presented in Table 4.
Group L-M exhibited the highest failure load values (2891.88 N ± 410.12 N), and the lowest values were observed in group ZL-M (1750.28 N ± 314.96 N). Two-way ANOVA indicated a statistically significant difference between materials and veneering technique (p = 0.00 < ...
Statistical analysis
The statistical analysis was performed with SPSS 24.0 (SPSS Inc, Chicago, USA). The Kolmogorov–Smirnov normality test was used to evaluate whether the data distribution of the groups was normal. The homogeneity of the variances was analyzed by Levene’s test. Since test results indicated that data distribution of the groups was normal and the variances were homogenous,...
All crowns were subjected to a combination firing that included crystallization and glaze firing according to each manufacturer’s guidelines in the ceramic furnace (Vita Vacumat 6000 M, Vita Zahnfabrik, Bad Sackingen, Germany).
For veneered restorations, the design mode was changed to “split,” and the core was constructed in 0.6-mm thickness. In group L-V (n = 12), e.max ...
Methods
Preparation of test groups
This study tested the current glass ceramic ZLS by comparing LDS with monolithic and conventional veneering techniques in implant-supported crowns: group L-M: lithium disilicate ceramic (monolithic), group L-V: lithium disilicate ceramic (conventional veneering), group ZL-M: zirconia-reinforced lithium silicate ceramic (monolithic), group ZL-V: zirconia-reinf...
Background
Implants have been successfully used to replace missing teeth for many years. Notwithstanding the high success rates, complications such as screw loosening and/or fracture, prosthesis fracture, and even implant fracture are inevitable. The reasons of the complication may be related to decreased proprioception and low tactile sensitivity which makes implant-supported crowns more susc...
Abstract
Background
Present study compared the failure load of CAD/CAM-manufactured implant-supported crowns and the stress distribution on the prosthesis-implant-bone complex with different restoration techniques.
Methods
The materials were divided into four groups: group L-M: lithium disilicate ceramic (LDS, monolithic), group L-V: LDS ceramic (veneering), group ZL-M: zirconia-reinforced l...
Berita yang masih relatif baru di jagat kedokteran gigi Internasional menyebutkan, Nobel Biocare memperkenalkan produk baru berupa ekspansi CAD/ CAM. Berbeda dari CAD/ CAM versi-versi yang terdahulu, teknologi CAD/ CAM versi baru ini telah diperluas sehingga menawarkan fleksibilitas dan konektivitas. Perkenalan produk baru ini dilakukan pada tanggal 23-24 Februari dalam acara Chicago Dental Societ...