scholarly journals Accuracy of Computer-Assisted Template-Based Implant Placement Using Two Different Surgical Templates Designed with or without Metallic Sleeves: A Randomized Controlled Trial

2019 ◽  
Vol 7 (2) ◽  
pp. 41 ◽  
Author(s):  
Marco Tallarico ◽  
Matteo Martinolli ◽  
Yong-Jin Kim ◽  
Fabio Cocchi ◽  
Silvio Mario Meloni ◽  
...  

Purpose: To compare virtual planning accuracy of novel computer-assisted, template-based implant placement techniques, which make use of CAD/CAM stereolithographic surgical templates with or without metallic sleeves. Furthermore, to compare open versus closed sleeves for templates without metallic sleeves. Materials and methods: Any partially edentulous patients requiring at least one implant to be placed according to a computer-assisted template-based protocol were enrolled. Patients were randomized according to a parallel group design into two arms: Surgical template with or without metallic sleeves. Three deviation parameters (angular, horizontal, vertical) were defined to evaluate the discrepancy between the planned and placed implant positions. Results: No implants failed, and no complications were experienced. Forty-one implants were placed using surgical templates with metallic sleeves while 49 implants were placed with a surgical template without metallic sleeves. Of these, 16 implants were placed through open sleeves and 33 through closed sleeves. There was a statistically significant difference in angle (p = 0.0212) and in the vertical plan (p = 0.0073) with lower values for implants placed with a surgical template without metallic sleeves. In the test group, close sleeves were more accurate compared with open sleeves in angle (p = 0.0268) and in horizontal plan (p = 0.0477). Conclusion: With the limitations of the present study, surgical templates without metallic sleeves were more accurate in the vertical plan and angle compared to the conventional template with metallic sleeves. Open sleeves should be used with caution in the molar region only in case of reduced interarch space. Further research is needed to confirm these preliminary results.

2013 ◽  
Vol 24 (4) ◽  
pp. 391-396 ◽  
Author(s):  
Marcelo Michele Novellino ◽  
Newton Sesma ◽  
Dalva Cruz Lagana ◽  
Glais Ferrari

The aim of this study was to evaluate whether the introduction of a device, resulting from the combination of an o'ring attachment with an orthodontic implant (o'ring ortho implant, O'ROI), to affix the surgical template of CAD/CAM-guided implant surgery contribute to minimizing the deviations in the position and inclination of implants at the time of their placement. Ten models simulating bone tissue were fabricated and randomly divided into 2 groups: 5 with the scanning and surgical template of the usual technique, representing the Control Group (C), and 5 with scanning and surgical templates fixed by o'ring ortho implants (O'ROI), representing the Test Group (T). Forty implants measuring 4×11 mm were placed in the groups, using the respective templates. The results were evaluated by the fusion of CT images of the planned and placed implants. The locations and axes were compared. There were no statistically significant differences for the angular (Tukey's test F = 1.06 and p = 0. 3124) and linear (ANOVA F = 2.54 and p = 0.11) deviations. However, the angular values of Group T showed a lower standard deviation in comparison with those of Group C. The use of o'ring ortho implants (O'ROI) is able to minimize the angular and linear deviation of implants at the time of their placement.


2006 ◽  
Vol 20 (2) ◽  
pp. 172-177 ◽  
Author(s):  
Fabiana Ozaki ◽  
Claudio Mendes Pannuti ◽  
Ana Vitória Imbronito ◽  
Wellington Pessotti ◽  
Luciana Saraiva ◽  
...  

The aim of this randomised, double blind controlled trial was to verify the efficacy of a herbal dentifrice on the reduction of plaque and gingivitis. Forty eight volunteers with established gingivitis were randomly assigned to either a test group (herbal dentifrice) or positive control group (dentifrice with triclosan and fluoride). The dentifrices were distributed in plain white tubes by an independent pharmacy, which revealed the contents of each tube only after the experimental period. Plaque and gingivitis assessments were carried out on baseline and after 28 days of product use. All examinations were conducted by the same calibrated investigator. Subjects were instructed to brush their teeth three times daily using their assigned dentifrice for 28 days. There was a significant reduction in plaque levels in both the test and control groups. However, there was no significant difference between the groups. A significant reduction in gingivitis was observed in both groups, although there was no significant difference between them. No adverse reactions were reported. The authors concluded that both dentifrices were effective in reducing plaque and gingivitis in subjects with established gingivitis.


2019 ◽  
Vol 41 (5) ◽  
pp. 495-501 ◽  
Author(s):  
Carole Charavet ◽  
Geoffrey Lecloux ◽  
Nastasia Jackers ◽  
Adelin Albert ◽  
France Lambert

Summary Objective The aim of this study was to investigate the effects of piezocision (surgical protocol with sutures) in orthodontic treatment using CAD/CAM (computer-aided design and computer-aided manufacturing) customized orthodontic appliances. Design The study is designed as a parallel group, randomized controlled trial (RCT). Setting University Hospital. Ethical approval The study was approved by the ethic committee of the University Hospital Liege, Belgium. Subjects and methods This RCT was conducted on 24 adult patients requiring orthodontic treatment to release mild overcrowding. Patients were all treated with a customized appliance and randomly assigned by means of sealed envelopes containing group codes to either a test group treated with piezocision or a control group without any further treatment. A blinded orthodontist validated appliance removal or further adjustments based on the model study. Outcome measures The overall treatment time and the time between archwire changes were recorded. Moreover, clinical and radiological features such as tooth resorption, gingival recessions, and the presence of scars were evaluated. Results A total of 24 patients (12 control and 12 test) completed the study. The overall treatment time was significantly shorter in the test group than the control group. Likewise, the time difference between all arch changes was significantly lower when piezocision was performed, except for the first arch at the mandible and the last arches at both maxillae. During the fine-tuning phase, no significant difference was found between the two groups. All periodontal and radiographic parameters remained stable from the start to the end of treatment in both the groups. However, minor scars were found in 66 per cent cases. Limitations This trial was a single-centre trial. Conclusions Piezocision seems to be an effective method to accelerate orthodontic treatment in cases of mild overcrowding. However, the effect was only observed during the alignment phase and a greater efficiency was found in the maxilla. The technique may be contraindicated in patients with a high smile line since the risk of slight scarring exists. Registration ClinicalTrails.gov (Identifier: NCT03406130)


2016 ◽  
Vol 42 (5) ◽  
pp. 391-398 ◽  
Author(s):  
Fawaz Alzoubi ◽  
Nima Massoomi ◽  
Anders Nattestad

The aim of this study is to assess the accuracy of immediately placed implants using Anatomage Invivo5 computer-assisted design/computer-assisted manufacturing (CAD/CAM) surgical guides and compare the accuracy to delayed implant placement protocol. Patients who had implants placed using Anatomage Invivo5 CAD/CAM surgical guides during the period of 2012–2015 were evaluated retrospectively. Patients who received immediate implant placements and/or delayed implant placements replacing 1–2 teeth were included in this study. Pre- and postsurgical images were superimposed to evaluate deviations at the crest, apex, and angle. A total of 40 implants placed in 29 patients were included in this study. The overall mean deviations measured at the crest, apex, and angle were 0.86 mm, 1.25 mm, and 3.79°, respectively. The means for the immediate group deviations were: crest = 0.85 mm, apex = 1.10, and angle = 3.49°. The means for the delayed group deviations were: crest = 0.88 mm, apex = 1.59, and angle = 4.29°. No statistically significant difference was found at the crest and angle; however, there was a statistically significant difference between the immediate and delayed group at the apex, with the immediate group presenting more accurate placements at the apical point than the delayed group. CAD/CAM surgical guides can be reliable tools to accurately place implants immediately and/or in a delayed fashion. No statistically significant differences were found between the delayed and the immediate group at the crest and angle, however apical position was more accurate in the immediate group.


2015 ◽  
Vol 38 (5) ◽  
pp. E5 ◽  
Author(s):  
Jehuda Soleman ◽  
Florian Thieringer ◽  
Joerg Beinemann ◽  
Christoph Kunz ◽  
Raphael Guzman

OBJECT The authors describe a novel technique using computer-assisted design (CAD) and computed-assisted manufacturing (CAM) for the fabrication of individualized 3D printed surgical templates for frontoorbital advancement surgery. METHODS Two patients underwent frontoorbital advancement surgery for unilateral coronal synostosis. Virtual surgical planning (SurgiCase-CMF, version 5.0, Materialise) was done by virtual mirroring techniques and superposition of an age-matched normative 3D pediatric skull model. Based on these measurements, surgical templates were fabricated using a 3D printer. Bifrontal craniotomy and the osteotomies for the orbital bandeau were performed based on the sterilized 3D templates. The remodeling was then done placing the bone plates within the negative 3D templates and fixing them using absorbable poly-dl-lactic acid plates and screws. RESULTS Both patients exhibited a satisfying head shape postoperatively and at follow-up. No surgery-related complications occurred. The cutting and positioning of the 3D surgical templates proved to be very accurate and easy to use as well as reproducible and efficient. CONCLUSIONS Computer-assisted virtual planning and 3D template fabrication for frontoorbital advancement surgery leads to reconstructions based on standardizedmeasurements, precludes subjective remodeling, and seems to be overall safe and feasible. A larger series of patients with long-term follow-up is needed for further evaluation of this novel technique.


Author(s):  
J. Soleman ◽  
F. Thieringer ◽  
J. Beinemann ◽  
V. Oesch ◽  
C. Kunz ◽  
...  

2016 ◽  
Vol 21 (2) ◽  
pp. 73-80 ◽  
Author(s):  
Bruna de Rezende Marins ◽  
Suy Ellen Pramiu ◽  
Mauro Carlos Agner Busato ◽  
Luiz Carlos Marchi ◽  
Adriane Yaeko Togashi

ABSTRACT Objective: The objective of this study was to clinically and radiographically assess the peri-implant conditions of implants used as orthodontic anchorage. Methods: Two groups were studied: 1) a test group in which osseointegrated implants were used as orthodontic anchorage, with the application of 200-cN force; and 2) a control group in which implants were not subjected to orthodontic force, but supported a screw-retained prosthesis. Clinical evaluations were performed three, six and nine months after prosthesis installation and 1- and 3-year follow-up examinations. Intraoral periapical radiographs were obtained 30 days after surgical implant placement, at the time of prosthesis installation, and one, two and three years thereafter. The results were compared by Kruskal-Wallis test. Results: There was no statistically significant difference in clinical probing depth (p = 0.1078) or mesial and distal crestal bone resorption (p = 0.1832) during the study period. After three years of follow-up, the mean probing depth was 2.21 mm for the control group and 2.39 mm for the test group. The implants of the control group showed a mean distance between the bone crest and implant shoulder of 2.39 mm, whereas the implants used as orthodontic anchorage showed a mean distance of 2.58 mm at the distal site. Conclusion: Results suggest that the use of stable intraoral orthodontic anchorage did not compromise the health of peri-implant tissues or the longevity of the implant.


2015 ◽  
Vol 13 (1) ◽  
pp. 26-32
Author(s):  
Rajan Bhatnagar Bhatnagar ◽  
Aseem Tandon ◽  
Rishi Pokhrel

Introduction: In present scenario when lesser time is being devoted to basic medical sciences, and at the same time knowledge and concepts required to be mastered by medical undergraduates increasing exponentially, structured modules and software have a potential role to play. Embryology in particular can be a subject for such modules owing to its complex dynamics and even less proportion of time available to master it. This study evaluates if supplementing traditional methods with computer-aided instruction improve students' understanding of human embryology. Methods: The study was conducted during revision sessions before university examinations. Subjects of study were first year medical undergraduates (n=128), divided into two equal groups by simple randomization. Demographic data and prior academic performance of students were collected from student profile register. Revision sessions for control group were conducted using traditional methods and for test group CAL module was used. Students were evaluated by pre and post-tests consisting of 50 multiple choice answers questions each and each question fetched 0.5 marks. Independent sample t test was used for comparison of means. Opinion of students and instructors were collected using anonymous questionnaire under heads of subject-interest, appropriateness of CAL module as teaching materials, overall satisfaction and its possible effectiveness as self-learning module. Results: Two groups showed no statistical difference in terms of sex ratio, age and prior academic performance. Pre-test showed no significant difference in mean scores of two groups, mean post-test scores on the other hand were significantly greater in test group as compared to the control group. Most of the students and instructors involved in the study graded the CAL-module as ‘excellent’. Conclusions: The study shows that traditional teaching methods supplemented with CAL module improves the understanding of developmental anatomy in medical undergraduates. Use of this module as a self-study material requires further evaluations.doi:  http://dx.doi.org/10.3126/mjsbh.v13i1.12997


2016 ◽  
Vol 21 (1) ◽  
pp. 89-100 ◽  
Author(s):  
Francisco Vale ◽  
Jessica Scherzberg ◽  
João Cavaleiro ◽  
David Sanz ◽  
Francisco Caramelo ◽  
...  

Objective: In this case report, the feasibility and precision of tridimensional (3D) virtual planning in one patient with craniofacial microsomia is tested using Nemoceph 3D-OS software (Software Nemotec SL, Madrid, Spain) to predict postoperative outcomes on hard tissue and produce CAD/CAM (Computer Aided Design/Computer Aided Manufacturing) surgical splints. Methods: The clinical protocol consists of 3D data acquisition of the craniofacial complex by cone-beam computed tomography (CBCT) and surface scanning of the plaster dental casts. The ''virtual patient'' created underwent virtual surgery and a simulation of postoperative results on hard tissues. Surgical splints were manufactured using CAD/CAM technology in order to transfer the virtual surgical plan to the operating room. Intraoperatively, both CAD/CAM and conventional surgical splints are comparable. A second set of 3D images was obtained after surgery to acquire linear measurements and compare them with measurements obtained when predicting postoperative results virtually. Results: It was found a high similarity between both types of surgical splints with equal fitting on the dental arches. The linear measurements presented some discrepancies between the actual surgical outcomes and the predicted results from the 3D virtual simulation, but caution must be taken in the analysis of these results due to several variables. Conclusions: The reported case confirms the clinical feasibility of the described computer-assisted orthognathic surgical protocol. Further progress in the development of technologies for 3D image acquisition and improvements on software programs to simulate postoperative changes on soft tissue are required.


2017 ◽  
Vol 2017 ◽  
pp. 1-16 ◽  
Author(s):  
Alessandro Cucchi ◽  
Elisabetta Vignudelli ◽  
Simonetta Franco ◽  
Luca Levrini ◽  
Dario Castellani ◽  
...  

Purpose. To evaluate the survival, success, and complication rates of tapered double-lead threads single implants, placed in fresh extraction sockets and healed sites of the posterior jaws. Methods. The enrolled patients were randomly divided into 2 groups: in the test group (TG), all implants were inserted at the time of tooth extraction; in the control group (CG), all implants were placed 3 months after extraction. The implants were followed for a period of 1 to 3 years after loading. The main outcomes were implant survival, complications, and implant-crown success. Results. Ninety-two patients had 97 installed implants (49 in the TG, 48 in the CG). Only two implants failed, in the TG; the survival rates were therefore 95.9% (47/49) and 100% (48/48) for TG and CG, respectively. In the surviving implants, no complications were reported, for an implant-crown success of 100%. Conclusions. Although a significant difference was found in the levels of primary stability between TG and CG, single implants placed in fresh extraction sockets and healed sites of the posterior jaws had similar survival and complication rates. Crestal bone levels and peri-implant bone resorption showed similar values. A longer follow-up period is however required, to confirm these positive outcomes.


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