Comparative evaluation between the “All on Four” and “Four on Pillars” techniques in 3D virtual planning associated with guided surgery on atrophic jaws

Thorough technical knowledge and anatomical understanding are critical for optimal surgical results. The difficulty of complete maxillary surgery can vary significantly depending on the complexity of the anatomy or bone defect. In this work, we analyze and compare two methods of software-guided planning for the manipulation of dental implants, associated with the All on Four (ALL) and Four on pillars (FOUR) techniques used in patients with atrophic maxillae. Forty-two images of totally edentulous patients were analyzed, and surgical planning was performed using both methods. The average area of the Four on pillars technique is 4.9x (p<0.0001) greater than the average area of the All on four technique, this represents a difference of 489%. This means that, for the same force applied by the jaw, we will have a 4.9x smaller pressure, that is, a better distribution of forces on the jaws. It was not possible to notice a statistical difference between the success proportions (p=0.2542), this means that both techniques have a non-different (similar) success proportion. We conclude that the area of the polygon formed in the Four on pillars surgical plan is larger than in the All on four plan and this results in significantly less pressure on the implants. We also concluded that it was not possible to notice a statistical difference between the proportions of success, which shows that there is no technique with successful performance advantages over the other.

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A comparative evaluation of parasymphyseal fracture fixation in edentulous patients performed using dynamic navigation systems and Herbert screws with the conventional two-plate method: A study on models

Journal of Stomatology Oral and Maxillofacial Surgery ◽

10.1016/j.jormas.2021.01.010 ◽

2021 ◽

Author(s):

Umut Demetoglu ◽

Suheyb Bilge

Keyword(s):

Fracture Fixation ◽

Comparative Evaluation ◽

Navigation Systems ◽

Plate Method ◽

Dynamic Navigation ◽

Edentulous Patients

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Full in-Office Guided Surgery with Open Selective Tooth-Supported Templates: A Prospective Clinical Study on 20 Patients

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph15112361 ◽

2018 ◽

Vol 15 (11) ◽

pp. 2361 ◽

Cited By ~ 10

Author(s):

Francesco Mangano ◽

Uli Hauschild ◽

Oleg Admakin

Keyword(s):

Clinical Study ◽

Low Cost ◽

Prospective Clinical Study ◽

3D Printer ◽

Guided Surgery ◽

Operative Complications ◽

Edentulous Patients ◽

One Year ◽

Single Crowns ◽

Surgical Templates

Background: Guided implant surgery appears to have several benefits, such as the possibility of inserting flapless implants in a prosthetically driven manner, avoiding dangerous anatomical structures. However, to date, only a few surgeons routinely use guided surgery in partially edentulous patients. Aim: To present the results obtained with tooth-supported surgical templates characterized by an innovative open design with selective support, and manufactured via a full in-office procedure with a low-cost desktop 3D printer. Methods: Over a two-year period (2016–2018), all partially edentulous patients with one to three missing teeth (in maxilla and/or mandible), referred to a private dental practice for restoration with dental implants, were considered for inclusion in this prospective clinical study. An intraoral scanner (CS 3600®, Carestream Dental) and cone beam computed tomography (CS 9300®, Carestream Dental) were used to acquire the 3D information on the patients. Guided surgery software (SMOP®, Swissmeda) was used to plan the surgeries and to design open, selective, tooth-supported templates that were fabricated with a stereolithographic (SLA) desktop 3D printer (XFAB2000®, DWS). Guided implant surgeries were performed and patients were followed for a period of one year. The study outcomes were fit and stability of surgical templates, duration (time) of surgery, intra and post-operative complications, and implant stability and survival. Results: Twenty (20) partially edentulous patients (9 males, 11 females; mean age 54.4 ± 9.4 years) were included in the study; 28 open, selective, tooth-supported templates were designed with the aim of inserting 38 implants. Among the surgical templates, 24 had optimal fit and stability, three had optimal fit and sufficient stability, and only one had inadequate fit and unsatisfactory stability and was therefore not suitable for clinical use. The average time of the intervention was 15.7 ± 5.2 min per template. No intra-operative complications were reported, but one implant was not stable at placement and had to be removed. In total, 36 implants were restored with 10 two-unit fixed partial prostheses and 16 single crowns. All implants were successfully functioning at one year, even if, in two single crowns, minor prosthetic complications (abutment screw loosening) occurred. Conclusions: Full in-office guided surgery with open, selective, tooth-supported templates seem to represent a clinically predictable surgical procedure to restore partially edentulous patients. Further studies are needed to confirm these positive outcomes.

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Neuronavigation as a Tool for Pre-Surgical Planning in Refractory Epilepsy Surgery

Neuroscience and Neurological Surgery ◽

10.31579/2578-8868/095 ◽

2019 ◽

Vol 5 (2) ◽

pp. 01-10

Author(s):

Carlos Valencia Calderón

Keyword(s):

Epilepsy Surgery ◽

Surgical Planning ◽

Refractory Epilepsy ◽

Surgical Experience ◽

Surgical Time ◽

Cross Sectional ◽

Guided Surgery ◽

Image Guided ◽

Eloquent Areas ◽

High Incidence

Summary Epilepsy is one of the most frequent chronic neurological pathologies, with high incidence and prevalence worldwide. A third of these patients are resistant to treatment, which is known as refractory epilepsy. Most of these patients suffer epilepsy secondary to epileptogenic lesions, where the surgery is the only treatment that could cure epilepsy. The goal of epilepsy surgery is to remove the epileptogenic area with preservation of eloquent areas, and here the surgical experience, the neuroimaging technology and the availability of image-guided surgery systems known as a neuronavigator plays a key role. Objectives: To demonstrate the usefulness of neuronavigation in pre-surgical planning and in the surgery of refractory epilepsy. Method: A cross-sectional and analytical descriptive study was conducted based on 47 surgeries performed (12 resective, 32 palliative and 3 diagnostic) in patients with refractory epilepsy and mean age of 9.93 years (SD 4.1). In 27 patients (57.44%) the neuronavigator was used. In the group of patients operated with neuronavigation, the surgical time decreased by 47.17 minutes (p = 0.022), the amount of bleeding by 111.41 milliliters (p = 0.011) and the days of hospitalization by 6.68 days (p = 0.005), compared with the group operated without neuronavigation. Complications in the neuronavigation group were 29.63% compared to 65% in the group operated without neuronavigation (p = 0.034). Conclusions: In our series, the use of the neuronavigator in the planning and development of the surgery had a significant impact by reducing the amount of bleeding lost, the surgical time, the days of hospitalization, and the post-surgical complications.

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Virtual planning and guided surgery in fibular free-flap mandibular reconstruction: A 29-case series

European Annals of Otorhinolaryngology Head and Neck Diseases ◽

10.1016/j.anorl.2016.01.009 ◽

2016 ◽

Vol 133 (3) ◽

pp. 175-178 ◽

Cited By ~ 30

Author(s):

D. Culié ◽

O. Dassonville ◽

G. Poissonnet ◽

J.-C. Riss ◽

J. Fernandez ◽

...

Keyword(s):

Free Flap ◽

Case Series ◽

Mandibular Reconstruction ◽

Virtual Planning ◽

Guided Surgery ◽

Fibular Free Flap

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Comparative Evaluation of Colony Forming Units of Candida After Using Plain and Probiotic Added Denture Adhesive in Completely Edentulous Patients: A Randomised Crossover Trial

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2019/40070.12908 ◽

2019 ◽

Author(s):

Tamanna Chhabra ◽

Vandana Shah ◽

Rajesh Sethuraman

Keyword(s):

Comparative Evaluation ◽

Crossover Trial ◽

Denture Adhesive ◽

Colony Forming Units ◽

Edentulous Patients

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The use of Computer Guided Implant Surgery in Oral Rehabilitation: A Literature Review

World Journal of Dentistry ◽

10.5005/jp-journals-10015-1259 ◽

2014 ◽

Vol 5 (1) ◽

pp. 60-63

Author(s):

Mateus Rodrigues Tonetto ◽

Matheus Coelho Bandéca ◽

Vinicius Ibiapina Mascarenhas ◽

Lívia Jacovassi Tavares ◽

Lara Maria Ferreira Mendes

Keyword(s):

Literature Review ◽

Dental Implants ◽

Preoperative Planning ◽

Cone Beam ◽

Prosthetic Rehabilitation ◽

Oral Rehabilitation ◽

Virtual Planning ◽

Implant Surgery ◽

Guided Surgery ◽

High Resolution Images

ABSTRACT The virtual planning of dental implants is a technology that brings many benefits to practitioners and patients who undergo a prosthetic rehabilitation. The cone beam computed tomography (CBCT) produces high-resolution images allowing to implant a breakthrough in preoperative planning, making planning more accurate. The virtually guided surgery is a surgery planned based computers in a 3D anatomical model of the patient and transferred to the surgical procedure through guides built especially for this purpose. The objective of this study is to report the current concepts in the literature on virtually guided surgery, emphasizing its applicability, indications and benefits in prosthetic rehabilitation with dental implants. Thus, it was concluded that the technique of guided surgery represents an advance in the field of implantology significantly decreasing errors, bringing good results postoperative and increasing predictability of the results, one technique suitable for various cases. How to cite this article Mascarenhas VI, de Molon RS, Tavares LJ, Mendes LMF, Tonetto MR, Bandeca MC. The use of Computer Guided Implant Surgery in Oral Rehabilitation: A Literature Review. World J Dent 2014;5(1):60-63.

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Virtual Planning of a Complex Three-Part Bimaxillary Osteotomy

Case Reports in Dentistry ◽

10.1155/2017/8013874 ◽

2017 ◽

Vol 2017 ◽

pp. 1-5

Author(s):

Chiara Di Blasio ◽

Marilena Laura Anghinoni ◽

Alberto Di Blasio

Keyword(s):

Ct Scan ◽

Laser Scanning ◽

New Technologies ◽

Maxillofacial Surgery ◽

Virtual Planning ◽

Optical Scanning ◽

Dentofacial Deformity ◽

Maxillary Surgery ◽

Bimaxillary Surgery ◽

Complex Surgical Procedures

In maxillofacial surgery, every patient presents special problems requiring careful evaluation. Conventional methods to study the deformities are still reliable, but the advent of tridimensional (3D) imaging, especially computed tomography (CT) scan and laser scanning of casts, created the opportunity to better understanding the skeletal support and the soft tissue structures. Nowadays, virtual technologies are increasingly employed in maxillofacial surgery and demonstrated precision and reliability. However, in complex surgical procedures, these new technologies are still controversial. Especially in the less frequent cases of three-part maxillary surgery, the experience is limited, and scientific literature cannot give a clear support. This paper presents the case of a young patient affected by a complex long face dentofacial deformity treated by a bimaxillary surgery with three-part segmentation of the maxilla. The operator performed the surgical study completely with a virtual workflow. Pre- and postoperative CT scan and optical scanning of plaster models were collected and compared. Every postoperatory maxillary piece was superimposed with the presurgical one, and the differences were examined in a color-coded map. Only mild differences were found near the osteotomy lines, when the bony surface and the teeth demonstrated an excellent coincidence.

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