Computer-guided implant surgery: A critical review of treatment concepts

Meloni, Silvio Mario; Riu, Giacomo De; Lolli, Francesco Maria; Pisano, Milena; Deledda, Alessandro; Frisardi, G; Tullio, Antonio

doi:10.1016/j.ajoms.2013.05.003

Cited by 7 publications

(7 citation statements)

References 41 publications

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“…Within the limitations of this study, mainly the relatively low number of patients treated and short observation period, it can be concluded that according with the literature reviews [25], computer-guided surgery and immediate loading seem to represent a viable option for the immediate rehabilitations of completely edentulous jaws with fixed implant supported restorations.…”

Section: Discussionmentioning

confidence: 96%

Implant Restoration of Edentulous Jaws with 3D Software Planning, Guided Surgery, Immediate Loading, and CAD-CAM Full Arch Frameworks

Meloni

Riu

Pisano

et al. 2013

International Journal of Dentistry

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Purpose. The aim of this study was to analyze the clinical and radiographic outcomes of 23 edentulous jaws treated with 3D software planning, guided surgery, and immediate loading and restored with CAD-CAM full arch frameworks. Materials and Methods. This work was designed as a prospective case series clinical study. Twenty patients have been consecutively rehabilitated with an immediately loaded implant supported fixed full prosthesis. A total of 120 fixtures supporting 23 bridges were placed. 117 out of 120 implants were immediately loaded. Outcome measures were implants survival, radiographic marginal bone levels and remodeling, soft tissue parameters, and complications. Results. 114 of 117 implants reached a 30 months follow-up, and no patients dropped out from the study. The cumulative survival rate was 97.7%; after 30 months, mean marginal bone level was 1.25 ± 0.31 mm, mean marginal bone remodeling value was 1.08 ± 0.34, mean PPD value was 2.84 ± 0.55 mm, and mean BOP value was 4% ± 2.8%. Only minor prosthetic complications were recorded. Conclusion. Within the limitations of this study, it can be concluded that computer-guided surgery and immediate loading seem to represent a viable option for the immediate rehabilitations of completely edentulous jaws with fixed implant supported restorations. This trial is registered with Clinicaltrials.gov NCT01866696.

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Section: Discussionmentioning

confidence: 96%

Implant Restoration of Edentulous Jaws with 3D Software Planning, Guided Surgery, Immediate Loading, and CAD-CAM Full Arch Frameworks

Meloni

Riu

Pisano

et al. 2013

International Journal of Dentistry

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“…The most established application of these advanced techniques in dentistry is guided dental implantation. Based on a predesigned plan and surgical guide, accurate surgery can be achieved in the clinic with precise implant placement [ 10 , 11 ]. Compared with mandibular reconstruction, dental implantation is rather easy, and guided surgery can be realized with more facility.…”

Section: Discussionmentioning

confidence: 99%

“…In China, however, most mandibular reconstruction surgeries are performed by conventional methods, “free hand,” relying mainly on surgeons’ experience, 2D x-ray imaging, and some simple measuring tools [ 7 ]. Decades ago, advanced engineering technology — including medical image processing, computer-aided design (CAD), computer-aided manufacturing (CAM), additive manufacturing (AM, formerly known as rapid prototyping or RP, now widely known as 3D printing), and digital design based directly on a triangular mesh model — has been widely used in medical research [ 8 ], especially in maxillofacial surgery, including orthognathic surgery [ 9 ], dental implants [ 10 , 11 ], apicoectomy [ 12 ], and mandibular reconstruction [ 13 - 15 ]. With these advanced techniques, surgeons can precisely diagnosis the defect in a 3D environment, predesign a surgical plan, and even perform the plan in the clinic with the help of customized tools such as a surgical guide, thereby significantly improving the quality and efficiency of the surgery.…”

Section: Introductionmentioning

confidence: 99%

Technical procedures for template-guided surgery for mandibular reconstruction based on digital design and manufacturing

Liu

Hui

et al. 2014

BioMed Eng OnLine

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BackgroundThe occurrence of mandibular defects caused by tumors has been continuously increasing in China in recent years. Conversely, results of the repair of mandibular defects affect the recovery of oral function and patient appearance, and the requirements for accuracy and high surgical quality must be more stringent. Digital techniques — including model reconstruction based on medical images, computer-aided design, and additive manufacturing — have been widely used in modern medicine to improve the accuracy and quality of diagnosis and surgery. However, some special software platforms and services from international companies are not always available for most of researchers and surgeons because they are expensive and time-consuming.MethodsHere, a new technical solution for guided surgery for the repair of mandibular defects is proposed, based on general popular tools in medical image processing, 3D (3 dimension) model reconstruction, digital design, and fabrication via 3D printing. First, CT (computerized tomography) images are processed to reconstruct the 3D model of the mandible and fibular bone. The defect area is then replaced by healthy contralateral bone to create the repair model. With the repair model as reference, the graft shape and cutline are designed on fibular bone, as is the guide for cutting and shaping. The physical model, fabricated via 3D printing, including surgical guide, the original model, and the repair model, can be used to preform a titanium locking plate, as well as to design and verify the surgical plan and guide. In clinics, surgeons can operate with the help of the surgical guide and preformed plate to realize the predesigned surgical plan.ResultsWith sufficient communication between engineers and surgeons, an optimal surgical plan can be designed via some common software platforms but needs to be translated to the clinic. Based on customized models and tools, including three surgical guides, preformed titanium plate for fixation, and physical models of the mandible, grafts for defect repair can be cut from fibular bone, shaped with high accuracy during surgery, and fixed with a well-fitting preformed locking plate, so that the predesigned plan can be performed in the clinic and the oral function and appearance of the patient are recovered. This method requires 20% less operating time compared with conventional surgery, and the advantages in cost and convenience are significant compared with those of existing commercial services in China.ConclusionsThis comparison between two groups of cases illustrates that, with the proposed method, the accuracy of mandibular defect repair surgery is increased significantly and is less time-consuming, and patients are satisfied with both the recovery of oral function and their appearance. Until now, more than 15 cases have been treated with the proposed methods, so their feasibility and validity have been verified.

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“…The number of patients with TMDs is increasing, probably due to psychological tension in modern society [ 1 ]. According to well-accepted psychophysiological concepts, occlusal problems and emotional stress are the most serious aetiological factors [ 2 – 7 ]. However, the causes of TMD are far more complex.…”

Section: Introductionmentioning

confidence: 99%

Arthrocentesis and Temporomandibular Joint Disorders: Clinical and Radiological Results of a Prospective Study

Riu

Stimolo

Meloni

et al. 2013

International Journal of Dentistry

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Purpose. We evaluated the efficacy of arthrocentesis in the treatment of temporomandibular joint (TMJ) disorders. Material and Methods. In this prospective clinical case series, 30 consecutive patients with TMJ disorders underwent arthrocentesis using saline and sodium hyaluronate injections. Outcome measures were TMJ pain, maximum mouth opening (MMO), joint noises, and anatomical changes in the TMJ architecture. Patients were evaluated using cone-beam computed tomography (CBCT) and magnetic resonance imaging (MRI) at the beginning of treatment and 60 days after the last arthrocentesis. Pretreatment and posttreatment clinical parameters were compared using paired and unpaired t-tests, and McNemar's test was used to evaluate CBCT and MRI changes (P < 0.05). Results. At 1-year follow-up examinations, visual analogue scale scores indicated that pain was reduced significantly and mean postoperative MMO was increased significantly. CBCT findings showed no significant change, and MRI showed only slight reductions in inflammatory signs. Conclusions. Within the limitations of this study, we can conclude that arthrocentesis is a simple, minimally invasive procedure with a relatively low risk of complications and significant clinical benefits in patients with TMJ disorders. This trial is registered with NCT01903512.

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Computer-guided implant surgery: A critical review of treatment concepts

Cited by 7 publications

References 41 publications

Implant Restoration of Edentulous Jaws with 3D Software Planning, Guided Surgery, Immediate Loading, and CAD-CAM Full Arch Frameworks

Implant Restoration of Edentulous Jaws with 3D Software Planning, Guided Surgery, Immediate Loading, and CAD-CAM Full Arch Frameworks

Technical procedures for template-guided surgery for mandibular reconstruction based on digital design and manufacturing

Arthrocentesis and Temporomandibular Joint Disorders: Clinical and Radiological Results of a Prospective Study

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