Image-guided insertion of dental implants is significantly more accurate than manual insertion. However, the accuracy that can be achieved with manual implantation is sufficient for most clinical situations.
We introduce a method to apply a preoperative 3D plan for inserting dental implants with an assisting medical robot. The treatment plan is based on the 3D visualization of the CT data of the patient's maxilla and mandible, and supplies the location of the implants in the patient's coordinates. The plan is then transferred to the surgical robot's coordinate system. The robot guides the tool, a drill guide. Position, orientation, and depth of the initial drilling is defined with the tool held by the robot while the surgeon drills. The robot assists the dentist, and the optimal treatment plan will be applied directly to the patient.
Because both investigations displayed comparable error intervals, it was concluded that different observers could perform landmark positioning for the same studies.
Various approaches are being pursued to physico-chemically modify the zirconia neck region of dental implants to improve the integration into the surrounding soft tissue. In this study, polished zirconia discs were laser microstructured with periodic cavities and convex waves. These zirconia samples were additionally activated by argon plasma using the kINPen®09. The surface topography was characterized by scanning electron microscopy and the surface wettability by water contact angle. The in vitro study with human gingival fibroblasts (HGF-1) was focused on cell spreading, morphology, and actin cytoskeleton organization within the first 24 h. The laser-induced microstructures were originally hydrophobic (e.g., 60 µm cavities 138.4°), but after argon plasma activation, the surfaces switched to the hydrophilic state (60 µm cavities 13.7°). HGF-1 cells adhered flatly on the polished zirconia. Spreading is hampered on cavity structures, and cells avoid the holes. However, cells on laser-induced waves spread well. Interestingly, argon plasma activation for only 1 min promoted adhesion and spreading of HGF-1 cells even after 2 h cultivation. The cells crawl and grow into the depth of the cavities. Thus, a combination of both laser microstructuring and argon plasma activation of zirconia seems to be optimal for a strong gingival cell attachment.
The techniques of virtual reality keep gaining in importance for medical applications. Many applications are still being developed or are still in the form of a prototype. However, it is already clear that developments in this area will have a considerable effect on the surgeon's routine work.
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