Additively Manufactured Surgical Implant Guides: A Review

Elliott, Tom; Hamilton, Adam; Griseto, Neil; Gallucci, German O.

doi:10.1111/jopr.13476

Cited by 24 publications

(14 citation statements)

References 84 publications

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“…A variety of methods for creating such 3D-printed surgical guides have evolved over time. FFF uses a melted thermoplastic extruded by the printer head, which is continuously layered on a platform, while in the material jetting process, a carriage jets photopolymers onto a surface, which are then cured with ultraviolet light[ 21 ].…”

Section: Discussionmentioning

confidence: 99%

“…Computer-assisted implant surgery sets the link between virtual planning and surgery, and a digitally planned implant placement has been shown to be significantly more accurate than freehand placement. A high level of accuracy of the surgical guide is needed for the protection of vital structures and a better interaction between the surgeon and the prosthodontist[ 21 ].…”

Section: Introductionmentioning

confidence: 99%

“…The accuracy of the surgical guide depends on a multitude of factors, such as planning, fabrication, and post-processing steps. As implant surgery is an invasive procedure, contamination with microorganism could lead to an infection and consecutively to a poor outcome[ 21 ]. Therefore, accurate transfer of virtual surgical planning to the actual medical situation as well as structural stability after further processing steps, such as steam sterilization, is important in ensuring a material to be usable for application in patients.…”

Section: Introductionmentioning

confidence: 99%

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Steam-sterilized and degradable fused filament fabrication-printed polylactide/ polyhydroxyalkanoate surgical guides for dental implants: Are they accurate enough for static navigation?

Gielisch¹,

Heimes²,

Thiem³

et al. 2022

IJB

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Three-dimensional (3D) printing is a rapidly evolving field and has gained increasing importance in the medical sector. However, the increasing usage of printing materials is accompanied by more wastages. With a rising awareness of the environmental impact of the medical sector, the development of highly accurate and biodegradable materials is of great interest. This study aims to compare the accuracy of polylactide/polyhydroxyalkanoate (PLA/PHA) surgical guides printed by fused filament fabrication and material jetted guides of MED610 in fully guided dental implant placement before and after steam sterilization. Five guides were tested in this study and each was either printed with PLA/PHA or MED610 and either steam-sterilized or not. After implant insertion in a 3D-printed upper jaw model, the divergence between planned and achieved implant position was calculated by digital superimposition. Angular deviation and 3D deviation at the base and the apex were determined. Non-sterilized PLA/PHA guides showed an angle deviation of 0.38 ± 0.53° compared to 2.88 ± 0.75° in sterile guides (P > 0.001), an offset of 0.49 ± 0.21 mm and 0.94 ± 0.23 mm (P < 0.05), and an offset at the apex of 0.50 ± 0.23 mm before and 1.04 ± 0.19 mm after steam sterilization (P < 0.025). No statistically significant difference could be shown for angle deviation or 3D offset at both locations for guides printed with MED610. PLA/PHA printing material showed significant deviations in angle and 3D accuracy after sterilization. However, the reached accuracy level is comparable to levels reached with materials already used in clinical routine and therefore, PLA/PHA surgical guide is a convenient and green alternative.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Steam-sterilized and degradable fused filament fabrication-printed polylactide/ polyhydroxyalkanoate surgical guides for dental implants: Are they accurate enough for static navigation?

Gielisch¹,

Heimes²,

Thiem³

et al. 2022

IJB

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“…In contrast, pilot-drill guidance offered the advantage of improved implant deviation compared to the freehand approach. However, it was still prone to a large angular deviation which could have resulted due to an undesirable mechanical tolerance between the drills and sleeve or accumulative error at the data acquisition, software processing and template manufacturing steps of the digital workflow [ 19 ]. In addition, the findings suggested that experienced practitioners offered higher angular deviation compared to novice practitioners with all the approaches.…”

Section: Discussionmentioning

confidence: 99%

Influence of experience on dental implant placement: an in vitro comparison of freehand, static guided and dynamic navigation approaches

et al. 2022

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Purpose This study aimed to investigate the performance of novice versus experienced practitioners for placing dental implant using freehand, static guided and dynamic navigation approaches. Methods A total of 72 implants were placed in 36 simulation models. Three experienced and three novice practitioners were recruited for performing the osteotomy and implant insertion with freehand, surgical guide (pilot-drill guidance) and navigation (X-Guide, X-Nav technologies) approaches. Each practitioner inserted 4 implants per approach randomly with a 1-week gap to avoid memory bias (4 insertion sites × 3 approaches × 6 practitioners = 72 implants). The performance of practitioners was assessed by comparing actual implant deviation to the planned position, time required for implant placement and questionnaire-based self-confidence evaluation of practitioners on a scale of 1–30. Results The navigation approach significantly improved angular deviation compared with freehand (P < 0.001) and surgical guide (P < 0.001) irrespective of the experience. Surgical time with navigation was significantly longer compared to the freehand approach (P < 0.001), where experienced practitioners performed significantly faster compared to novice practitioners (P < 0.001). Overall, self-confidence was higher in favor of novice practitioners with both guided approaches. In addition, the confidence of novice practitioners (median score = 26) was comparable to that of experienced practitioners (median score = 27) for placing implants with the navigation approach. Conclusions Dynamic navigation system could act as a viable tool for dental implant placement. Unlike freehand and static-guided approaches, novice practitioners showed comparable accuracy and self-confidence to that of experienced practitioners with the navigation approach. Graphical Abstract

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“…The production of guides involves multiple, closely-linked steps, including data collection and integration, design of the implanting plan and guide structure, and manufacturing, and errors in previous steps will accumulate in the final guides (Putra et al, 2022;Rouzé L'Alzit et al, 2022). Factors influencing template accuracy can be roughly divided into three categories: 1) System error: that is, errors generated during CBCT scanning and data conversion, which cannot be controlled by humans; 2) Manufacturing error: related to the type of 3D printer (Zhang et al, 2022) (Table 1), selection of printing materials, use of supporting structures, slicing method and software types (Cho et al, 2021;Elliott et al, 2022;Rubayo, et al, 2021); and 3) Other factors.…”

Section: Research Status On Additive Manufacturing Applications In Im...mentioning

confidence: 99%

Additive manufacturing technologies in the oral implant clinic: A review of current applications and progress

Huang

Wei

2023

Front. Bioeng. Biotechnol.

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Additive manufacturing (AM) technologies can enable the direct fabrication of customized physical objects with complex shapes, based on computer-aided design models. This technology is changing the digital manufacturing industry and has become a subject of considerable interest in digital implant dentistry. Personalized dentistry implant treatments for individual patients can be achieved through Additive manufacturing. Herein, we review the applications of Additive manufacturing technologies in oral implantology, including implant surgery, and implant and restoration products, such as surgical guides for implantation, custom titanium meshes for bone augmentation, personalized or non-personalized dental implants, custom trays, implant casts, and implant-support frameworks, among others. In addition, this review also focuses on Additive manufacturing technologies commonly used in oral implantology. Stereolithography, digital light processing, and fused deposition modeling are often used to construct surgical guides and implant casts, whereas direct metal laser sintering, selective laser melting, and electron beam melting can be applied to fabricate dental implants, personalized titanium meshes, and denture frameworks. Moreover, it is sometimes required to combine Additive manufacturing technology with milling and other cutting and finishing techniques to ensure that the product is suitable for its final application.

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Additively Manufactured Surgical Implant Guides: A Review

Cited by 24 publications

References 84 publications

Steam-sterilized and degradable fused filament fabrication-printed polylactide/ polyhydroxyalkanoate surgical guides for dental implants: Are they accurate enough for static navigation?

Steam-sterilized and degradable fused filament fabrication-printed polylactide/ polyhydroxyalkanoate surgical guides for dental implants: Are they accurate enough for static navigation?

Influence of experience on dental implant placement: an in vitro comparison of freehand, static guided and dynamic navigation approaches

Additive manufacturing technologies in the oral implant clinic: A review of current applications and progress

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