Clinical Accuracy of Flapless Computer-Guided Surgery for Implant Placement in Edentulous Arches

Abstract

Flapless computer-guided surgery may be a viable treatment option for rehabilitating the edentulous arch.

Trends in Computer-Aided Manufacturing in Prosthodontics: A Review of the Available Streams

“…Materials such as ceramics, metals (base metal alloys and titanium), resins, and waxes can be processed by the existing systems [12, 23, 26]. In addition, computerized technologies are used to plan and idealize surgical implant treatment [27–29]. Due to the precision that can be achieved with the aid of information from 3D digital radiographs, implant dimensions and placement locations can be determined using planning software without violation of critical anatomical features.…”

“…In dentistry, this technique is primarily used to produce surgical implant guides. The accuracy of intraoral implant placement positions has been evaluated to provide an indication of the benefit of surgical implant guides produced by stereolithography and has been found to be in the range of 0.4–2.0 mm, and angulations are in the range of 2–5° [27, 29, 138]. Similarly, extraoral implant placement accuracy was 1.5 mm [139].…”

“…Distortions will also occur in the construction of 3D images from multislice radiographs. Despite this, the discrepancies observed endorse the clinical recommendation that these techniques do not eliminate the importance of surgeon experience, awareness of critical anatomical features, and the maintenance of a safe zone of 2 mm from critical features such as adjacent teeth when planning implant placement [29]. Overall, the accuracy of the surgical guides could be improved by fabricating them to fit the alveolar bone instead of soft tissue and by the use of fixation screws [27, 29].…”

“…Despite this, the discrepancies observed endorse the clinical recommendation that these techniques do not eliminate the importance of surgeon experience, awareness of critical anatomical features, and the maintenance of a safe zone of 2 mm from critical features such as adjacent teeth when planning implant placement [29]. Overall, the accuracy of the surgical guides could be improved by fabricating them to fit the alveolar bone instead of soft tissue and by the use of fixation screws [27, 29]. Nevertheless, a split mouth clinical study revealed that the stereolithography guides allowed for implant placement closer to the planned position than conventionally fabricated guides [28].…”

Acurácia de medidas lineares em softwares de planejamento de implantes sobre imagens de mandibulas atróficas obtidas por tomografias computadorizadas de feixe cônico com diferentes protocolos de aquisição

“…Existem poucas referências na literatura (Lund et al, 2009;Maloney et al, 2011;Oz et al, 2011;Kim G et al, 2012;Gerlach et al, 2013;Santos Jr. et al, 2013;Wood et al, 2013;Vieira et al, 2013;Gaia et al, 2013) A análise da acurácia e reprodutibilidade os software OsiriX foram analisadas por alguns autores (Santos Jr. et al, 2013) recomendando seu uso para diagnóstico planejamento pré-operatório, da mesma forma Kim G et al (2012) As inúmeras propriedades e vantagens do uso de software de análise de imagens e planejamento para reabilitações são descritas na literatura (Worthington et al, 2010), mas a necessidade de maiores estudos comparando estes e suas ferramentas se faz necessária, principalmente em casos extremos e específicos como pacientes com mandíbulas atróficas.…”