Chirurgie implantaire et prothèse guidées et assistées par ordinateur : le flux numérique continu

Pascual, D.; Vaysse, J.

doi:10.1016/j.revsto.2015.11.011

Cited by 3 publications

(1 citation statement)

References 8 publications

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“…As has been previously suggested in orthognathic surgery literature, a workaround to solve this imaging requirement is to artificially install landmarks in a radiographic template or directly on the gingiva to act as a common fiducial reference for the registration procedure [ 43 ]. Currently, radiographic templates could also be CAD designed using the information obtained from intraoral scanning and can be 3D milled or printed thereby eliminating the need for a conventional impression [ 44 ].…”

Section: Resultsmentioning

confidence: 99%

Cone beam computed tomography in implant dentistry: recommendations for clinical use

et al. 2018

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BackgroundIn implant dentistry, three-dimensional (3D) imaging can be realised by dental cone beam computed tomography (CBCT), offering volumetric data on jaw bones and teeth with relatively low radiation doses and costs. The latter may explain why the market has been steadily growing since the first dental CBCT system appeared two decades ago. More than 85 different CBCT devices are currently available and this exponential growth has created a gap between scientific evidence and existing CBCT machines. Indeed, research for one CBCT machine cannot be automatically applied to other systems.MethodsSupported by a narrative review, recommendations for justified and optimized CBCT imaging in oral implant dentistry are provided.ResultsThe huge range in dose and diagnostic image quality requires further optimization and justification prior to clinical use. Yet, indications in implant dentistry may go beyond diagnostics. In fact, the inherent 3D datasets may further allow surgical planning and transfer to surgery via 3D printing or navigation. Nonetheless, effective radiation doses of distinct dental CBCT machines and protocols may largely vary with equivalent doses ranging between 2 to 200 panoramic radiographs, even for similar indications. Likewise, such variation is also noticed for diagnostic image quality, which reveals a massive variability amongst CBCT technologies and exposure protocols. For anatomical model making, the so-called segmentation accuracy may reach up to 200 μm, but considering wide variations in machine performance, larger inaccuracies may apply. This also holds true for linear measures, with accuracies of 200 μm being feasible, while sometimes fivefold inaccuracy levels may be reached. Diagnostic image quality may also be dramatically hampered by patient factors, such as motion and metal artefacts. Apart from radiodiagnostic possibilities, CBCT may offer a huge therapeutic potential, related to surgical guides and further prosthetic rehabilitation. Those additional opportunities may surely clarify part of the success of using CBCT for presurgical implant planning and its transfer to surgery and prosthetic solutions.ConclusionsHence, dental CBCT could be justified for presurgical diagnosis, preoperative planning and peroperative transfer for oral implant rehabilitation, whilst striving for optimisation of CBCT based machine-dependent, patient-specific and indication-oriented variables.

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Section: Resultsmentioning

confidence: 99%

Cone beam computed tomography in implant dentistry: recommendations for clinical use

et al. 2018

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Accuracy of different types of surgical guides for dental implant placement

Drobyshev,

Vaulina,

Redko

et al. 2023

Russian Journal of Dentistry

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Abstract BACKGROUND: Nowadays, the development of three-dimensional (3D) imaging techniques and implant planning software has contributed to a large diffusion of prosthetically guided implant placement. AIM: The aim of this study is to compare virtual planning accuracy of dental implant placement using various surgical templates. MATERIALS AND METHODS: The study involved 24 partially and fully edentulous patients. Patients were randomized according to a parallel group design into four arms: Templates for pilot osteotomy made by 3D-printing (group I), full-guide templates made by 3D-printing (group II), surgical templates for pilot osteotomy made by milling (group III) and full-guide templates made by milling (group IV). The accuracy of dental implant position was assessed by comparing the planned and actual position of the implants according to pre- and postoperative computed tomography (CT). Three mean deviation parameters (angular, at the neck position, at the apex position) were defined to evaluate the discrepancy between the planned and placed implant positions. RESULTS: The best results were obtained in Group III, where dental implant placement was performed using milled surgical templates for pilot osteotomy, the mean angular deviation, deviation at the neck and deviation at the apex of the implant were 4.013.21⁰, 0.380.23 mm, 0.560.51 mm respectively (p0.001 for all). In the group where milled surgical templates were used for the full guided osteotomy, the mean angular deviation was 5.665.38⁰, deviations at the implant neck and apex were 0.730.71 mm, 0.680.67 mm, respectively (p 0.001 for all), which demonstrates high accuracy of implant placement within the "safety zone". In groups I and II, where templates made by 3D printing were used, lower accuracy scores were obtained. In the group for pilot osteotomy, the mean angular deviation was 7.715.94⁰, the mean deviation at the neck was 1.021.07 mm, the mean deviation at the apex of the implant was 1.401.69 mm (p0.001 for all). In the group, for full guided osteotomy, the mean angular deviation, deviations at the neck and at the apex of the implant were 6.46.21⁰, 0.580.45 mm, 0.830.80 mm respectively (p0.001 for all). CONCLUSIONS: Dental implant placement with the use of surgical templates makes it possible to achieve a high accuracy of the implant position. Milled surgical templates are more accurate than 3D-printed templates for dental implants, which allows us to introduce surgical templates made by milling into clinical practice in order to improve the quality of dental care.

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Computer-Guided Osteotomy with Simultaneous Implant Placement and Immediately Loaded Full-Arch Fixed Restoration: A Case Report

Todaro

Cerri²,

Isola

et al. 2023

Prosthesis

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Aim: This case report aims to illustrate a clinical protocol that allows for the rehabilitation of patients requiring extensive osteotomy, simultaneous implant placement, and full-arch, screwed-in prosthetics in one session. This protocol allows for the improvement of the aesthetics and functionality of the fixed implant-supported prosthesis through the preoperative planning of all surgical procedures, including osteotomy, and of the prosthesis through the application of 3D-printing technology for the creation of surgical templates and prostheses. Methods: This case report concerns a 72-year-old patient, ASA1, who, following diagnosis, the establishment of a treatment plan, and the provision of informed consent, opted for an immediate, full-arch rehabilitation of the lower arch. The digital planning stage started with the correct positioning of the fixtures. The proper bone levels were found and used to guide the creation of the provisional screwed-in prothesis. Two templates with the same supports (landmarks/pins) were then 3D-printed: a positioning template, including a slit to assist the surgeon during the osteotomy, and a surgery template to assist the surgeon during the implants’ positioning. A screwed-in prosthesis encased in resin C&B MFH (NEXTDENT®, Soesterberg, The Netherlands) was delivered. Minimal occlusal adjustments were performed. Results: In a single clinical session, through careful planning and the pre-operative 3D printing of a prosthesis, a temporary implant-supported prosthetic rehabilitation was possible in a case that required an extended osteotomy. Clinically, the correspondence between the virtual design phase and the final realization was consistent. At a functional level, the provisional prosthesis required minimal occlusal adjustments and the DVO values obtained in the immediate post-operative period were found to be comparable to those of the virtual design. By planning the final position of the bone and the implants in advance, it was possible to deliver a full-arch prothesis with proper implant emergence, occlusal vertical dimensions, and occlusal relationship. Conclusion: This fully digital protocol allows the clinician to preview and plan the osteotomy and implant surgery as well as the delivery of the temporary, immediately loaded, complete, fixed prosthesis in patients who are candidates for post-extraction surgery with the need for severe osteotomy.

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Chirurgie implantaire et prothèse guidées et assistées par ordinateur : le flux numérique continu

Cited by 3 publications

References 8 publications

Cone beam computed tomography in implant dentistry: recommendations for clinical use

Cone beam computed tomography in implant dentistry: recommendations for clinical use

Accuracy of different types of surgical guides for dental implant placement

Computer-Guided Osteotomy with Simultaneous Implant Placement and Immediately Loaded Full-Arch Fixed Restoration: A Case Report

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