The marginal bone loss that usually observed around dental implant has been well documented and expected. It has related with self-reaction to the forensic body of each patient as well as the osseointegrated interface. Bone quantity and quality of the implant site may help to define the implant-bone interface, which in turn affects primary stability of the immediate implant placement. Analysis of bone quality prior to surgery provides vital information during treatment planning for dental implant. Additionally, it helps in predicting postsurgical success. The classification of bone quality, however, is difficult to follow clinically, as tactile assessments are subject to the variation among surgeons. Although imaging techniques, such as computed tomography (CT) or cone bean computed tomography (CBCT), are useful to determine bone quality, the exposure to radiation and its precision, are still of concern. This paper reviews common techniques and reference used in dental bone classification as well as the recent reports from histomorphometric analysis and molecular components. It is well acknowledged that clinical awareness of evaluating the amounts of bone surrounding the implant site by appropriate method is critical for a successful outcome.
Background:The accuracy of the implant placement could be advantageous for reducing intra-and postoperative complications. Objectives: This study aimed to present the clinical issues in actual guided surgeries through the examination of the cases of patients that were treated with computer-guided implant surgery and confirm the accuracy of guided surgery by analysing whether the positions before and after the placement matched. Methods: Intra oral structure of each patient, was scanned using an intra oral scanner (Trios 3Shape, United States of America) and merged with the cone-beam computed tomography (CBCT; GiANO, Newtom, Italy) images. Implant placements (CAMLOG, Germany) were planned, regarding the direction and position, using software (Implant Studio TM , Denmark) and placed using the computer-aided design/computer-aided manufacturing (CAD/CAM) guide surgical template. Then, the fabrication of anatomically accurate abutments of the restoration was done using CAD/CAM zirconia. Postoperative CBCTs were recorded and compared with the preoperative using McNemar's test. Result: Mean angular errors between the preoperative planned implant and postoperative placed implant was 4.81 the mean distance errors between the planned and placed implants were 0.43 mm horizontally and 0.68 mm vertically at the implant neck and 0.81 mm horizontally and mm vertically at the implant apex computer-guided implant surgery also offers some advantages over conventional implant surgery from the prosthetic viewpoint. Findings and Conclusion:This technology is expected to continue to develop, with the prediction that all factors contributing to the inaccuracy of guided surgery such as the surgical guide shape, length of metal sleeve and surgical drill, template supporting problem, and scanning method. http://dx.
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