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...
Fig. 10. Patient 1—post-operative evaluation of placement accuracy of the implants in the mandible. Green is the planned position; blue is the actual position
Fig. 10. Patient 1—post-operative evaluation of placement accuracy of the implants in the mandible. Green is the planned position; blue is the actual position
Fig. 9. Patient 1—prosthodontic end result 5 months after implant placement
Fig. 9. Patient 1—prosthodontic end result 5 months after implant placement
Fig. 8. Patient 2—intra-oral situation during orthodontic treatment at the age of 14. A temporary crown with bracket is fixed on the dental implant. Eight months after start of orthodontic treatment, the 34 is already close to the planned end position
Fig. 8. Patient 2—intra-oral situation during orthodontic treatment at the age of 14. A temporary crown with bracket is fixed on the dental...
Fig. 7. Patient 2—post-operative orthopantomogram (OPT) at age of 13. Situation 10 months after implant placement. Three months after starting the orthodontic treatment, the 34 is already erected
Fig. 7. Patient 2—post-operative orthopantomogram (OPT) at age of 13. Situation 10 months after implant placement. Three months after starting the orthodontic treatment, the 34 is already erect...
Fig. 6. Patient 1—post-operative orthopantomogram (OPT) at age of 18
Fig. 6. Patient 1—post-operative orthopantomogram (OPT) at age of 18
Fig. 5. he maxilla (left) and mandible (right) with drilling template and metal drilling inserts (Nobel biocare). b Drilling template for the mandible of patient 1. c Implant placement of patient 1. Dental implant placement in the mandible using the virtual developed tooth-supported templates and metal drilling inserts
Fig. 5. a Drilling templates of patient 1. Printed model of the maxilla (l...
Fig. 4. t goal. b Patient 2—virtual set-up of the ultimate implant position. One short dental implant was planned in region 35, based on the location of the mandibular nerve (orange), the impacted 34 (pink) and the bone quality and volume. c Patient 2—virtual set-up of the ultimate prosthetic treatment goal
Fig. 4. a Patient 1—virtual set-up of the ultimate treatment goal. b Patient 2â€...
Fig. 3. e CBCT and intra-oral scan at age of 18. b Patient 2—detailed 3D model of the combined data from the CBCT and intra-oral scan at age of 12
Fig. 3. a Patient 1—detailed 3D model of the combined data from the CBCT and intra-oral scan at age of 18. b Patient 2—detailed 3D model of the combined data from the CBCT and intra-oral scan at age of 12
Fig. 2. uation before start of orthodontic and implant treatment. Eleven permanent teeth (including 2 third molars) were congenitally missing and the 34 is impacted. To erect the 34, orthodontic treatment was desired. Due to the lack of stable anchorages in the third quadrant, it was decided to place one implant at tooth region 35 for orthodontic anchorage and future prosthetics. Due to very lim...
Fig. 1. osed deciduous teeth 55, 54, 65, 74, 75, 84, and 85 and start of orthodontic treatment. Eleven permanent teeth (including 4 third molars) were congenitally missing. b Patient 1—post-orthodontic situation at age of 16. The top of the mandibular processus alveolaris is small (upper). The interdental space at location of the second premolars in the maxilla is 7 and 14 mm at location of t...
Patient
Location implant (tooth nr)
Shoulder
Tip
Axis
X
Y
Z
ED (mm)
...
Filius, M.A.P., Kraeima, J., Vissink, A. et al. Three-dimensional computer-guided implant placement in oligodontia.
Int J Implant Dent 3, 30 (2017). https://doi.org/10.1186/s40729-017-0090-6
Download citation
Received: 27 March 2017
Accepted: 22 June 2017
Published: 08 July 2017
DOI: https://doi.org/10.1186/s40729-017-0090-6
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...
This is not applicable as this research was an evaluation of routine dental care.
Not applicable.
Author Marieke Filius, Joep Kraeima, Arjan Vissink, Krista Janssen, Gerry Raghoebar and Anita Visser state that there are no conflicts of interest.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Correspondence to
Anita Visser.
Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Center Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands
Marieke A. P. Filius, Joep Kraeima, Arjan Vissink, Gerry M. Raghoebar & Anita Visser
Department of Orthodontics, University of Groningen and University Medical Center Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands
K...
The authors like to sincerely thank all co-workers from the Department of Orthodontics, University Center Groningen, The Netherlands, for the potent collaboration during the treatment process.
We also kindly thank native English speaker Jadzia Siemienski for critically reading our manuscript and making suggestions to improve the English.
This research did not receive any specific grant from fund...
Schalk-van der Weide Y, Beemer FA, Faber JA, Bosman F. Symptomatology of patients with oligodontia. J Oral Rehabil. 1994;21:247–61.
Filius MA, Cune MS, Raghoebar GM, Vissink A, Visser A. Prosthetic treatment outcome in patients with severe hypodontia: a systematic review. J Oral Rehabil. 2016;43:373–87.
Shen P, Zhao J, Fan L, et al. Accuracy evaluation of computer-designed surgical guide tem...
(Cone beam) computer tomography
Two-dimensional
Three-dimensional
Euclidian distances
Orthopantomogram
This technical advanced article introduces a fully digitalized workflow for implant planning in complex oligodontia cases. The application of computer-designed surgical templates enables predictable implant placement in oligodontia, where bone quantity and limited interdental spaces can be challenging for implant placement. The stepwise approach described in this technical advanced article provide...
This technical advanced article illustrated the benefit of a full three-dimensional virtual workflow to guide implant placement in oligodontia cases as well as that implants can be reliably placed at the planned positions with the technique proposed.
The described full three-dimensional virtual workflow has several advantages. First, the surgeon is pre-operatively better informed about the requir...
The surgical guides fitted well and facilitated implant placement. All implants were placed in the native bone. No dehiscences of the implant surface occurred.
Post-operative orthopantomograms (OPT) of patients 1 and 2 are shown in Figs. 6 and 7. In patient 1, six implants were placed (NobelParallel Conical Connection implants, Nobel Biocare Holding AG, Zürich-Flughafen, Switzerland; Length 8.5...
After raising a mucoperiostal flap, the dental implants were placed using the virtual developed tooth-supported drilling templates using metal inserts (Fig. 5c). It was checked whether no dehiscences of the implant surface were present.
A CBCT (ICat, Image Sciences International, Hatfield, UK; 576 slices, voxel size 0.3 mm, FOV: 11 × 16 cm) was made of two oligodontia patients (for patient details, see Figs. 1 and 2) for implant planning. Detailed patient information was obtained with regard to the nerve position and bone quality and quantity. In addition, a digital intra-oral scan was made to get a detailed 3D image of t...
Oligodontia is the congenital absence of six or more permanent teeth, excluding third molars [1]. The need for oral rehabilitation in patients with oligodontia is high as they often suffer from functional and aesthetic problems due to a high number of missing teeth. Implant-based prosthodontics seem to be favourable to improve oral function and aesthetics in oligodontia [2].
Implant treatment in ...
The aim of computer-designed surgical templates is to attain higher precision and accuracy of implant placement, particularly for compromised cases.
The purpose of this study is to show the benefit of a full three-dimensional virtual workflow to guide implant placement in oligodontia cases where treatment is challenging due compromised bone quantity and limited interdental spaces.
A full, digita...
Â
Figure 10. Patient 1—post-operative evaluation of placement accuracy of the implants in the mandible. Green is the planned position; blue is the actual position
Â
Figure 9. Patient 1—prosthodontic end result 5 months after implant placement
Â
Figure 8. Patient 2—intra-oral situation during orthodontic treatment at the age of 14. A temporary crown with bracket is fixed on the dental implant. Eight months after start of orthodontic treatment, the 34 is already close to the planned end position
Â
Figure 7. Patient 2—post-operative orthopantomogram (OPT) at age of 13. Situation 10 months after implant placement. Three months after starting the orthodontic treatment, the 34 is already erected
Â
Figure 6. Patient 1—post-operative orthopantomogram (OPT) at age of 18
Â
Figure 5. a Drilling templates of patient 1. Printed model of the maxilla (left) and mandible (right) with drilling template and metal drilling inserts (Nobel biocare). b Drilling template for the mandible of patient 1. c Implant placement of patient 1. Dental implant placement in the mandible using the virtual developed tooth-supported templates and metal drilling inserts
Â
Figure 4. a Patient 1—virtual set-up of the ultimate treatment goal. b Patient 2—virtual set-up of the ultimate implant position. One short dental implant was planned in region 35, based on the location of the mandibular nerve (orange), the impacted 34 (pink) and the bone quality and volume. c Patient 2—virtual set-up of the ultimate prosthetic treatment goal
Â
Figure 3. a Patient 1—detailed 3D model of the combined data from the CBCT and intra-oral scan at age of 18. b Patient 2—detailed 3D model of the combined data from the CBCT and intra-oral scan at age of 12
Â
Figure 2 a Patient 2—pre-implant orthopantomogram (OPG) at the age of 12. Situation before start of orthodontic and implant treatment. Eleven permanent teeth (including 2 third molars) were congenitally missing and the 34 is impacted. To erect the 34, orthodontic treatment was desired. Due to the lack of stable anchorages in the third quadrant, it was decided to place one implant at tooth...
Â
Â
Figure 1. a Patient 1—orthopantomogram (OPT) at age of 13. Situation before extraction of the ankylosed deciduous teeth 55, 54, 65, 74, 75, 84, and 85 and start of orthodontic treatment. Eleven permanent teeth (including 4 third molars) were congenitally missing. b Patient 1—post-orthodontic situation at age of 16. The top of the mandibular processus alveolaris is small (upper). T...
Results
Clinical and radiographic assessments
The surgical guides fitted well and facilitated implant placement. All implants were placed in the native bone. No dehiscences of the implant surface occurred.
Post-operative orthopantomograms (OPT) of patients 1 and 2 are shown in Figs. 6 and 7. In patient 1, six implants were placed (NobelParallel Conical Connection implants, Nobel Biocare Ho...
Patient and methods
Implant planning and placement
Pre-implant procedure and 3D planning
A CBCT (ICat, Image Sciences International, Hatfield, UK; 576 slices, voxel size 0.3 mm, FOV: 11 × 16 cm) was made of two oligodontia patients (for patient details, see Figs. 1 and 2) for implant planning. Detailed patient information was obtained with regard to the nerve position and bone quality an...
Introduction
Oligodontia is the congenital absence of six or more permanent teeth, excluding third molars [1]. The need for oral rehabilitation in patients with oligodontia is high as they often suffer from functional and aesthetic problems due to a high number of missing teeth. Implant-based prosthodontics seem to be favourable to improve oral function and aesthetics in oligodontia [2].
Impla...
Three-dimensional computer-guided implant placement in oligodontia
Abstract
Background
The aim of computer-designed surgical templates is to attain higher precision and accuracy of implant placement, particularly for compromised cases.
Purpose
The purpose of this study is to show the benefit of a full three-dimensional virtual workflow to guide implant placement in oligodontia cases where t...