Evaluation of the accuracy of a novel surgical guide for flapless dental implant placement for immediate loading in edentulous jaws

Author(s):  
Giovanni de Almeida Prado Di Giacomo ◽  
Patrícia Cury ◽  
Airton Moreira da Silva ◽  
Jorge Vicente Lopes da Silva ◽  
Carlos Eduardo Pompeo Souto ◽  
...  

This study was designed to evaluate the accuracy of a novel computer-designed and selectively laser sintered surgical guide for flapless dental implant placement in the edentulous jaw. Fifty dental implants were placed in 11 patients with at least one totally edentulous jaw. Initially, cone-beam computed tomography (CBCT) was performed in each patient to define the virtual position of the dental implants based on the assessment of bone availability and the proposed dental prosthesis. After virtual planning, 3D surgical guides were printed using selective laser sintering. CBCT was repeated after the surgery, and the pre-and postoperative images were overlapped in the CAD software to compare the planned and actual positions of the dental implants using a one-sample t-test. The mean ± angular standard deviation between the long axes of the planned and final dental implant positions was 4.58 ±2.85 degrees; The linear deviation in the coronal position was  0.87 ± 0.49 mm and  in the apical region of the dental implants was 1.37 ± 0.69 mm. These differences were statistically significant (p <0.001). The proposed modifications reduced the deviations, resulting in an improvement in the technique. We were able to place implants and temporary prostheses using the present protocol, taking into account the differences between the planned and final positions of the dental implants.

Author(s):  
Michelle Carvalho de Sales ◽  
Rafael Maluza Flores ◽  
Julianny da Silva Guimaraes ◽  
Gustavo Vargas da Silva Salomao ◽  
Tamara Kerber Tedesco ◽  
...  

Dental surgeons need in-depth knowledge of the bone tissue status and gingival morphology of atrophic maxillae. The aim of this study is to describe preoperative virtual planning of placement of five implants and to compare the plan with the actual surgical results. Three-dimensional planning of rehabilitation using software programs enables surgical guides to be specially designed for the implant site and manufactured using 3D printing. A patient with five teeth missing was selected for this study. The patient’s maxillary region was scanned with CBCT and a cast model was produced. After virtual planning using ImplantViewer, five implants were placed using a printed surgical guide. Two weeks after the surgical procedure, the patient underwent another CBCT scan of the maxilla. Statistically significant differences were detected between the virtually planned positions and the actual positions of the implants, with a mean deviation of 0.36 mm in the cervical region and 0.7 mm in the apical region. The surgical technique used enables more accurate procedures when compared to the conventional technique. Implants can be better positioned, with a high level of predictability, reducing both operating time and patient discomfort.


2012 ◽  
Vol 83 (4) ◽  
pp. 410-419 ◽  
Author(s):  
Giovanni A. Di Giacomo ◽  
Jorge V. da Silva ◽  
Airton M. da Silva ◽  
Gustavo H. Paschoal ◽  
Patricia R. Cury ◽  
...  

2008 ◽  
Vol 100 (4) ◽  
pp. 323-325 ◽  
Author(s):  
Peter Y.P. Wat ◽  
Edmond H.N. Pow ◽  
Francis S.W. Chau ◽  
Katherine C.M. Leung

Author(s):  
Ting-Mao Sun ◽  
Huey-Er Lee ◽  
Ting-Hsun Lan

The aim of this study was to compare the accuracy of implant placement by using the conventional freehand method, the surgical guide alone, the dental navigation system alone, and the dental navigation system with a surgical guide. The participants were aged 20 years or older and were requiring dental implant surgery according to an assessment made by a dentist between July 2014 and December 2017. A total of 128 dental implants were inserted, 32 dental implants in each group, and participants with similar or identical age (i.e., 20–50 years or 50 years or above) and missing tooth locations were paired for comparison. Accuracy was measured by overlaying the real position in the postoperative Cone Beam Computerized Tomography (CBCT) on the virtual presurgical placement of the implant in a CBCT image. Using the dental navigation system with a surgical guide could help dentists to position implants more accurately. Total, longitudinal, and angular error deviation were significantly different (p < 0.0001). The same level of accuracy could be obtained for the different jaws and tooth positions. The one-way analysis of variance (ANOVA) showed that the total, longitudinal, and angular errors differed significantly (p < 0.0001). A comparison of the four dental implant surgical methods indicated that the combination of a dental implant navigation system and a surgical guide kit achieved the highest accuracy in terms of the different tooth positions and jaws.


2013 ◽  
Vol 70 (6) ◽  
pp. 586-594 ◽  
Author(s):  
Zoran Vlahovic ◽  
Branko Mihailovic ◽  
Zoran Lazic ◽  
Mileta Golubovic

Background/Aim. Flapless implant surgery has become very important issue during recent years, mostly thanks to computerization of dentistry and software planning of dental implants placements. The aim of this study was to compare flap and flapless surgical techniques for implant placement through radiographic and radiofrequency analyses. Methods. The experiment was made in five domestic pigs. Nine weeks following domestic pigs teeth extraction, implants were placed, on the right side using surgical technique flap, and flapless on the left side. Digital dental Xrays were applied to determine primary dental implant stability quality (ISQ). At certain intervals, not later than three months, the experimental animals were sacrificed, and just before it, control X-rays were applied to measure dental implants stability. Results. Radiographic analysis showed that peri-implant bone resorption in the first 4 weeks following placement implants with flap and flapless surgical techniques was negligible. After the 3 months, mean value of peri-implant bone resorption of the implants placed using flap technique was 1.86 mm, and of those placed using flapless technique was 1.13 mm. In relation to the primary dental implant stability in the first and second week there was an expected decrease in ISQ values, but it was less expressed in the dental implants placed using the flapless technique. In the third week the ISQ values were increased in the dental implants placed by using both techniques, but the increase in flapless implant placement was higher (7.4 ISQ) than in flap implant placement (1.5 ISQ). The upward trend continued in a 4- week period, and after 3 months the dental implant stability values in the implants placed using flap technique were higher than the primary stability for 7.1 ISQ, and in the implants placed using flapless technique were higher comparing to the primary stability for 10.1 ISQ units. Conclusion. Based on the results of radiographic and resonance frequency analyses it can be concluded that the flapless technique in surgical implants placemat, leads to better results.


Polymers ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1236
Author(s):  
Jung-Hwa Lim ◽  
Enkhjargal Bayarsaikhan ◽  
Seung-Ho Shin ◽  
Na-Eun Nam ◽  
June-Sung Shim ◽  
...  

This study evaluated the internal fit and the accuracy of the implant placement position in order to determine how the surface shape of the tooth and the offset influence the accuracy of the surgical guide. The acquired digital data were analyzed in three dimensions using 3D inspection software. The obtained results confirmed that the internal fit was better in the groove sealing (GS) group (164.45 ± 28.34 μm) than the original shape (OS) group (204.07 ± 44.60 μm) (p < 0.001), and for an offset of 100 μm (157.50 ± 17.26 μm) than for offsets of 30 μm (206.48 ± 39.12 μm) and 60 μm (188.82 ± 48.77 μm) (p < 0.001). The accuracy of implant placement was better in the GS than OS group in terms of the entry (OS, 0.229 ± 0.092 mm; GS, 0.169 ± 0.061 mm; p < 0.001), apex (OS, 0.324 ± 0.149 mm; GS, 0.230 ± 0.124 mm; p < 0.001), and depth (OS, 0.041 ± 0.027 mm; GS, 0.025 ± 0.022 mm; p < 0.001). In addition, the entries (30 μm, 0.215 ± 0.044 mm; 60 μm, 0.172 ± 0.049 mm; 100 μm, 0.119 ± 0.050 mm; p < 0.001) were only affected by the amount of offset. These findings indicate that the accuracy of a surgical guide can be improved by directly sealing the groove of the tooth before manufacturing the surgical guide or setting the offset during the design process.


2014 ◽  
Vol 08 (01) ◽  
pp. 100-106 ◽  
Author(s):  
Giovanni Di Giacomo ◽  
Jorge Silva ◽  
Rodrigo Martines ◽  
Sergio Ajzen

ABSTRACT Objective: The aim of this study was to analyze a preliminary method of immediately loading dental implants and a definitive prosthesis based on the computer-aided design/computer-aided manufacturing systems, after 2 years of clinical follow-up. Materials and Methods: The study comprised one patient in good general health with edentulous maxilla. Cone beam computer tomography (CBCT) was performed using a radiographic template. The surgical plan was made using the digital imaging and communications in medicine protocol with ImplantViewer (version 1.9, Anne Solutions, Sao Paulo, SP, Brazil), the surgical planning software. These data were used to produce a selective laser sintering surgical template. A maxilla prototype was used to guide the prosthesis technician in producing the prosthesis. Eight dental implants and a definitive prosthesis were installed on the same day. A post-operative CBCT image was fused with the image of the surgical planning to calculate the deviation between the planned and the placed implants positions. Patient was followed for 2 years. Results: On average, the match between the planned and placed angular deviation was within 6.0 ± 3.4° and the difference in coronal deviation was 0.7 ± 0.3 mm. At the end of the follow-up, neither the implant nor the prosthesis was lost. Conclusions: Considering the limited samples number, it was possible to install the dental implants and a definitive prosthesis on the same day with success.


2020 ◽  
Vol 9 (8) ◽  
pp. 2322 ◽  
Author(s):  
Stefano Pieralli ◽  
Benedikt Christopher Spies ◽  
Valentin Hromadnik ◽  
Robert Nicic ◽  
Florian Beuer ◽  
...  

3D printed surgical guides are used for prosthetically-driven oral implant placement. When manufacturing these guides, information regarding suitable printing techniques and materials as well as the necessity for additional, non-printed stock parts such as metal sleeves is scarce. The aim of the investigation was to determine the accuracy of a surgical workflow for oral implant placement using guides manufactured by means of fused deposition modeling (FDM) from a biodegradable and sterilizable biopolymer filament. Furthermore, the potential benefit of metal sleeve inserts should be assessed. A surgical guide was designed for the installation of two implants in the region of the second premolar (SP) and second molar (SM) in a mandibular typodont model. For two additive manufacturing techniques (stereolithography [SLA]: reference group, FDM: observational group) n = 10 surgical guides, with (S) and without (NS) metal sleeves, were used. This resulted in 4 groups of 10 samples each (SLA-S/NS, FDM-S/NS). Target and real implant positions were superimposed and compared using a dedicated software. Sagittal, transversal, and vertical discrepancies at the level of the implant shoulder, apex and regarding the main axis were determined. MANOVA with posthoc Tukey tests were performed for statistical analyses. Placed implants showed sagittal and transversal discrepancies of <1 mm, vertical discrepancies of <0.6 mm, and axial deviations of ≤3°. In the vertical dimension, no differences between the four groups were measured (p ≤ 0.054). In the sagittal dimension, SLA groups showed decreased deviations in the implant shoulder region compared to FDM (p ≤ 0.033), whereas no differences in the transversal dimension between the groups were measured (p ≤ 0.054). The use of metal sleeves did not affect axial, vertical, and sagittal accuracy, but resulted in increased transversal deviations (p = 0.001). Regarding accuracy, biopolymer-based surgical guides manufactured by means of FDM present similar accuracy than SLA. Cytotoxicity tests are necessary to confirm their biocompatibility in the oral environment.


2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Algirdas Puisys ◽  
Viktorija Auzbikaviciute ◽  
Renata Simkunaite-Rizgeliene ◽  
Dainius Razukevicius ◽  
Rokas Linkevicius ◽  
...  

The aim of this case report is to show that bone remineralization around dental implants with a history of peri-implantitis is possible after irritant factors are removed and only conservative treatment is performed. Patient came to the clinic after three years of dental implant placement complaining about swelling, sensitivity and gingiva color changes at the posterior part of the maxilla. During radiographic and intraoral examinations peri-implantitis of the #24 implant site was diagnosed. The surgical treatment method was rejected and performed conservative treatment instead. The outcome is promising; periapical radiographs three months later showed bone remineralization as well as stable bone after 10 years. A key clinical message: Bone remineralization around dental implants with a history of peri-implantitis is possible after irritant factors are removed and conservative treatment performed.


2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Pietro Fusari ◽  
Matteo Doto ◽  
Matteo Chiapasco

Background. Rehabilitation of edentulous jaws with implant-supported prosthesis has become a common practice among oral surgeons in the last three decades. This therapy presents a very low incidence of complications. One of them is the displacement of dental implants into the maxillary sinus. Dental implants, such as any other foreign body into the maxillary sinus, should be removed in order to prevent sinusitis.Methods. In this paper, we report a case of dental implant migrated in the maxillary sinus and removed by means of the bone lid technique.Results and Conclusion. The migration of dental implants into the maxillary sinus is rarely reported. Migrated implants should be considered for removal in order to prevent possible sinusal diseases. The implant has been removed without any complications, confirming the bone lid technique to be safe and reliable.


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