Accuracy of Implant Placement Utilizing 3D Printed and Thermoplastic Surgical Guides: A CBCT-Analysis

The present study aims to compare the accuracy of metal sleeve-free 3D-printed computer-assisted implant surgical guides (MSF group) (n = 10) with metal sleeve-incorporated 3D-printed computer-assisted implant surgical guides (MSI group) (n = 10). Implants of diameter 4.0 mm and 5.0 mm were placed in the left second premolars and bilateral first molars, respectively, using a fully guided system. Closed-form sleeves were used in teeth on the left and open-form sleeves on the right. The weight differences of the surgical guides before and after implant placement, and angular deviations before and after implant placement were measured. Weight differences were compared with Student’s t-tests and angular deviations with Mann–Whitney tests. Cross-sectional views of the insert parts were observed with a scanning electron microscope. Preoperative and postoperative weight differences between the two groups were not statistically significant (p = 0.821). In terms of angular deviations, those along the mesiodistal direction for the left second premolars were significantly lower in the MSF group (p = 0.006). However, those along the mesiodistal direction for the bilateral molars and those along the buccolingual direction for all teeth were not significantly different (p > 0.05). 3D-printed implant surgical guides without metal sleeve inserts enable accurate implant placement without exhausting the guide holes, rendering them feasible for fully guided implant placement.

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CBCT Analysis of Pterygomaxillary Region for Pterygoid Implant Placement - A Radiographic Study

International Journal of Pharmaceutical Research ◽

10.31838/ijpr/2020.12.03.375 ◽

2020 ◽

Vol 12 (03) ◽

Keyword(s):

Radiographic Study ◽

Implant Placement ◽

Cbct Analysis

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Accuracy of implant placement using three different surgical guides

Egyptian Dental Journal ◽

10.21608/edj.2018.79239 ◽

2018 ◽

Vol 64 (4) ◽

pp. 3713-3721

Author(s):

Maha Nagi

Keyword(s):

Implant Placement ◽

Surgical Guides

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Accuracy of Guided Implant Surgery in the Edentulous Jaw Using Desktop 3D-Printed Mucosal Supported Guides

Journal of Clinical Medicine ◽

10.3390/jcm10030391 ◽

2021 ◽

Vol 10 (3) ◽

pp. 391

Author(s):

Rani D’haese ◽

Tom Vrombaut ◽

Geert Hommez ◽

Hugo De Bruyn ◽

Stefan Vandeweghe

Keyword(s):

In Vitro Study ◽

Angular Deviation ◽

Implant Surgery ◽

Implant Position ◽

Surgical Guides ◽

Negative Effect ◽

Bone Level ◽

3D Printed ◽

Implant Alignment

Purpose: The aim of this in vitro study is to evaluate the accuracy of implant position using mucosal supported surgical guides, produced by a desktop 3D printer. Methods: Ninety implants (Bone Level Roxolid, 4.1 mm × 10 mm, Straumann, Villerat, Switzerland) were placed in fifteen mandibular casts (Bonemodels, Castellón de la Plana, Spain). A mucosa-supported guide was designed and printed for each of the fifteen casts. After placement of the implants, the location was assessed by scanning the cast and scan bodies with an intra-oral scanner (Primescan®, Dentsply Sirona, York, PA, USA). Two comparisons were performed: one with the mucosa as a reference, and one where only the implants were aligned. Angular, coronal and apical deviations were measured. Results: The mean implant angular deviation for tissue and implant alignment were 3.25° (SD 1.69°) and 2.39° (SD 1.42°) respectively, the coronal deviation 0.82 mm (SD 0.43 mm) and 0.45 mm (SD 0.31 mm) and the apical deviation 0.99 mm (SD 0.45 mm) and 0.71 mm (SD 0.43 mm). All three variables were significantly different between the tissue and implant alignment (p < 0.001). Conclusion: Based on the results of this study, we conclude that guided implant surgery using desktop 3D printed mucosa-supported guides has a clinically acceptable level of accuracy. The resilience of the mucosa has a negative effect on the guide stability and increases the deviation in implant position.

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Comparison of implant placement accuracy in two different preoperative digital workflows: navigated vs. pilot-drill-guided surgery

International Journal of Implant Dentistry ◽

10.1186/s40729-021-00322-1 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Johannes Spille ◽

Feilu Jin ◽

Eleonore Behrens ◽

Yahya Açil ◽

Jürgen Lichtenstein ◽

...

Keyword(s):

Navigation System ◽

Entry Point ◽

Angular Deviation ◽

Guided Surgery ◽

Implant Placement ◽

Drill Guide ◽

Navigation Group ◽

3D Printed ◽

The Mean ◽

Master Model

Abstract Background The aim of the study is to evaluate the accuracy of a new implant navigation system on two different digital workflows. Methods A total of 18 phantom jaws consisting of hard and non-warping plastic and resembling edentulous jaws were used to stimulate a clinical circumstance. A conventional pilot-drill guide was conducted by a technician, and a master model was set by using this laboratory-produced guide. After cone beam computed tomography (CBCT) and 3D scanning of the master models, two different digital workflows (marker tray in CBCT and 3D-printed tray) were performed based on the Digital Imaging Communication in Medicine files and standard tessellation language files. Eight Straumann implants (4.1 mm × 10 mm) were placed in each model, six models for each group, resulting in 144 implant placements in total. Postoperative CBCT were taken, and deviations at the entry point and apex as well as angular deviations were measured compared to the master model. Results The mean total deviations at the implant entry point for MTC (marker tray in CBCT), 3dPT (3d-printed tray), and PDG (pilot-drill guide) were 1.024 ± 0.446 mm, 1.027 ± 0.455 mm, and 1.009 ± 0.415 mm, respectively, and the mean total deviations at the implant apex were 1.026 ± 0.383 mm, 1.116 ± 0.530 mm, and 1.068 ± 0.384 mm. The angular deviation for the MTC group was 2.22 ± 1.54°. The 3dPT group revealed an angular deviation of 1.95 ± 1.35°, whereas the PDG group showed a mean angular deviation of 2.67 ± 1.58°. Although there were no significant differences among the three groups (P > 0.05), the navigation groups showed lesser angular deviations compared to the pilot-drill-guide (PDG) group. Implants in the 3D-printed tray navigation group showed higher deviations at both entry point and apex. Conclusions The accuracy of the evaluated navigation system was similar with the accuracy of a pilot-drill guide. Accuracy of both preoperative workflows (marker tray in CBCT or 3D-printed tray) was reliable for clinical use.

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In-house 3D-printed surgical guides for osseous lesions of the lower jaw: an experimental study

European Journal of Medical Research ◽

10.1186/s40001-021-00495-w ◽

2021 ◽

Vol 26 (1) ◽

Author(s):

Lukas Postl ◽

Thomas Mücke ◽

Stefan Hunger ◽

Oliver Bissinger ◽

Michael Malek ◽

...

Keyword(s):

Control Group ◽

Head Model ◽

Computer Assisted ◽

3D Printer ◽

Surgical Guide ◽

Surgical Guides ◽

Lower Jaw ◽

Bony Lesion ◽

3D Printed ◽

Phantom Head

Abstract Background The accuracy of computer-assisted biopsies at the lower jaw was compared to the accuracy of freehand biopsies. Methods Patients with a bony lesion of the lower jaw with an indication for biopsy were prospectively enrolled. Two customized bone models per patient were produced using a 3D printer. The models of the lower jaw were fitted into a phantom head model to simulate operation room conditions. Biopsies for the study group were taken by means of surgical guides and freehand biopsies were performed for the control group. Results The deviation of the biopsy axes from the planning was significantly less when using templates. It turned out to be 1.3 ± 0.6 mm for the biopsies with a surgical guide and 3.9 ± 1.1 mm for the freehand biopsies. Conclusions Surgical guides allow significantly higher accuracy of biopsies. The preliminary results are promising, but clinical evaluation is necessary.

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Effects of Groove Sealing of the Posterior Occlusal Surface and Offset of the Internal Surface on the Internal Fit and Accuracy of Implant Placements Using 3D-Printed Surgical Guides: An In Vitro Study

Polymers ◽

10.3390/polym13081236 ◽

2021 ◽

Vol 13 (8) ◽

pp. 1236

Author(s):

Jung-Hwa Lim ◽

Enkhjargal Bayarsaikhan ◽

Seung-Ho Shin ◽

Na-Eun Nam ◽

June-Sung Shim ◽

...

Keyword(s):

In Vitro Study ◽

Internal Surface ◽

Three Dimensions ◽

Surface Shape ◽

Digital Data ◽

Surgical Guide ◽

Implant Placement ◽

Surgical Guides ◽

Internal Fit

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.

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

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-20-00071 ◽

2021 ◽

Author(s):

Giovanni de Almeida Prado Di Giacomo ◽

Patrícia Cury ◽

Airton Moreira da Silva ◽

Jorge Vicente Lopes da Silva ◽

Carlos Eduardo Pompeo Souto ◽

...

Keyword(s):

Dental Implants ◽

Dental Implant ◽

Selective Laser Sintering ◽

Apical Region ◽

Virtual Planning ◽

Surgical Guide ◽

Implant Placement ◽

Surgical Guides ◽

Edentulous Jaws ◽

Edentulous Jaw

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.

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