Abstract:3D printed surgical guides are used for prosthetically-driven oral implant placement. When manufacturing these guides, information regarding suitable printing techniques and materials as well as the necessity for additional, non-printed stock parts such as metal sleeves is scarce. The aim of the investigation was to determine the accuracy of a surgical workflow for oral implant placement using guides manufactured by means of fused deposition modeling (FDM) from a biodegradable and sterilizable biopolymer filam… Show more
“…However, another study using templates from different printers did not demonstrate any significant differences [ 38 ]. In a study on the influence of two different printing materials for templates, no significant differences were found [ 13 ]. An in vitro study by Henprasert et al showed that the fabrication of the template in an additive or subtractive process had no influence on the implant position [ 12 ].…”
Background
An implant prosthesis aims to ensure the best possible rehabilitation of function and esthetics following tooth loss. Template-guided insertion is used to achieve an optimal position of the implant with regard to prosthetic restorability, bone availability, and condition of the surrounding soft tissues. The accuracy of template-guided implant placement is subject to various influencing factors.
The clinically achievable accuracy depending on the macro design of the implant body was investigated in this prospective clinical study.
Material and methods
In this prospective clinical study, 20 implants were placed in 20 patients. The implant had a pronounced conical outer geometry (Conelog ProgressiveLine, Camlog Wimsheim, Germany). Data from a study using an implant with a distinct cylindrical outer geometry were used as a comparison group (Conelog ScrewLine, Camlog, Wimsheim, Germany). The clinically achieved implant position was compared with the planned position.
Results
The evaluation of the two-dimensional deviations in direction resulted in the following mean values (standard deviation) at the shoulder: 0.42 mm (0.33) in the buccolingual direction, 0.27 mm (0.25) in the mesiodistal direction, and 0.68 mm (0.55) in the apicocoronal direction. The mean angular deviation was 4.1° (2.3). The three-dimensional (3D) deviation was 0.94 mm (0.53) at the shoulder and 1.36 mm (0.62) at the apex of the implant.
Significant differences between implants with different macro designs were found in the apicocoronal direction. In connection to this, a significant 3D deviation was found at the implant shoulder.
Conclusions
Significant differences in height were found between the groups. The study had shown that the macro design of an implant has no influence on accuracy in all other directions. Overall, the implants showed a high level of accuracy and a low variation in values. The values were in the range determined by the template-guided insertion system in numerous other investigations. This provides good predictability of prosthetic rehabilitation.
Trial registration
German Register for Clinical Studies (DRKS-ID: DRKS000018939). Date of registration: November 11, 2019.
“…However, another study using templates from different printers did not demonstrate any significant differences [ 38 ]. In a study on the influence of two different printing materials for templates, no significant differences were found [ 13 ]. An in vitro study by Henprasert et al showed that the fabrication of the template in an additive or subtractive process had no influence on the implant position [ 12 ].…”
Background
An implant prosthesis aims to ensure the best possible rehabilitation of function and esthetics following tooth loss. Template-guided insertion is used to achieve an optimal position of the implant with regard to prosthetic restorability, bone availability, and condition of the surrounding soft tissues. The accuracy of template-guided implant placement is subject to various influencing factors.
The clinically achievable accuracy depending on the macro design of the implant body was investigated in this prospective clinical study.
Material and methods
In this prospective clinical study, 20 implants were placed in 20 patients. The implant had a pronounced conical outer geometry (Conelog ProgressiveLine, Camlog Wimsheim, Germany). Data from a study using an implant with a distinct cylindrical outer geometry were used as a comparison group (Conelog ScrewLine, Camlog, Wimsheim, Germany). The clinically achieved implant position was compared with the planned position.
Results
The evaluation of the two-dimensional deviations in direction resulted in the following mean values (standard deviation) at the shoulder: 0.42 mm (0.33) in the buccolingual direction, 0.27 mm (0.25) in the mesiodistal direction, and 0.68 mm (0.55) in the apicocoronal direction. The mean angular deviation was 4.1° (2.3). The three-dimensional (3D) deviation was 0.94 mm (0.53) at the shoulder and 1.36 mm (0.62) at the apex of the implant.
Significant differences between implants with different macro designs were found in the apicocoronal direction. In connection to this, a significant 3D deviation was found at the implant shoulder.
Conclusions
Significant differences in height were found between the groups. The study had shown that the macro design of an implant has no influence on accuracy in all other directions. Overall, the implants showed a high level of accuracy and a low variation in values. The values were in the range determined by the template-guided insertion system in numerous other investigations. This provides good predictability of prosthetic rehabilitation.
Trial registration
German Register for Clinical Studies (DRKS-ID: DRKS000018939). Date of registration: November 11, 2019.
“…Various studies regarding the accuracy of static navigation have identified influencing factors including intraoral positioning and fixation of templates [ 14 ]. The manufacturing process for the drill template can also impact the accuracy of implant placement, as can the materials used [ 15 , 16 , 17 ]. Several studies have reported the influence of different drill sleeves on accuracy [ 18 , 19 , 20 ].…”
The aim of this in vitro study was to determine whether the process chain influences the accuracy of a computer-assisted dynamic navigation procedure. Four different data integration workflows using cone-beam computed tomography (CBCT), conventional impressions, and intraoral digitization with and without reference markers were analyzed. Digital implant planning was conducted using data from the CBCT scans and 3D data of the oral models. The restoration of the free end of the lower jaw was simulated. Fifteen models were each implanted with two new teeth for each process chain. The models were then scanned with scan bodies screwed onto the implants. The deviations between the planned and achieved implant positions were determined. The evaluation of all 120 implants resulted in a mean angular deviation of 2.88 ± 2.03°. The mean 3D deviation at the implant shoulder was 1.53 ± 0.70 mm. No significant differences were found between the implant regions. In contrast, the workflow showed significant differences in various parameters. The position of the reference marker affected the accuracy of the implant position. The in vitro examination showed that precise implantation is possible with the dynamic navigation system used in this study. The results are of the same order of magnitude that can be achieved using static navigation methods. Clinical studies are yet to confirm the results of this study.
“…Three types of computer-generated surgical guides are currently available: supported by teeth, mucosa and bone. Tooth-supported guides are used in cases of partial edentulism [12].…”
Recently, the development of radiology, and software engineering, has led to the development of a new protocol called computer-assisted implantology (CAI) or guided implantology. CT / CBCT scanners allow the dentist to visualize a patients anatomy in 3 dimensions. Define the precise measurement of bone for implant placement, soft tissue thickness, proximity and adjacent root anatomy. The exact location of the maxillary sinuses, and other relevant vital structures such as mandibular canal, mental and incisal foramen canal. Once the images are imported, to the software the clinician can then virtually begin treatment planning. The type and size of the planned implant, its position in the bone, its relationship to the restoration and adjacent teeth and/or implants, and its proximity to vital structures can be determined prior to surgery. Computer-generated surgical drill guides can then be manufactured from the virtual treatment plan.
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