In Vivo Tooth-Supported Implant Surgical Guides Fabricated With Desktop Stereolithographic Printers: Fully Guided Surgery Is More Accurate Than Partially Guided Surgery

Bencharit, Sompop; Staffen, Adam; Yeung, Matthew; Whitley, Daniel; Laskin, Daniel M.; Deeb, George R.

doi:10.1016/j.joms.2018.02.010

Cited by 89 publications

(122 citation statements)

References 19 publications

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“…They concluded the level of surgeon experience affected the accuracy of the implant positioning via a tooth-supported surgical guide. In a similar in vivo study, Bencharit et al [25] also suggested that experience and training may play an important role in guided surgery. Indeed, using a partially guided surgical protocol, the surgeon must understand the treatment plan thoroughly and place the implant freehand.…”

Section: Discussionmentioning

confidence: 89%

In Vitro Accuracy of Static Guided Implant Surgery Measured by Optical Scan: Examining the Impact of Operator Experience

et al. 2020

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Studies examining the effect of operator experience on the accuracy of static guided implant surgery have used postoperative computed tomography (CT) images to measure the error, with inconsistent results. The purpose of this study was to try to clarify this issue by using a measurement method based on the postoperative optical scan. Thirty dentists were divided into an experienced group and an inexperienced group. On a partially edentulous mandibular model in the manikin head, each dentist placed three implants via the stereolithographic (SLA) surgical guide. The implant positions were identified by a desktop scanner and compared with the planned positions using a metrology software program. No statistically significant differences were observed for any of the measured positional and angular deviations of the three implant sites between experienced and inexperienced operators (p > 0.01). All the mean values of deviations of the inexperienced group, except the depth deviation, were less than the experienced group. Implants inserted by dentists under 40 years old had significantly better accuracy than senior doctors in the global deviation at implant apex (p = 0.006). Within the limits of this study, we concluded that operator experience is not a critical factor in achieving the accuracy of guided implant surgery via the tooth-supported SLA surgical guide. Large deviations could occur even with the aid of the SLA surgical guide, and care must be taken to avoid errors for both experienced and inexperienced operators.

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Section: Discussionmentioning

confidence: 89%

In Vitro Accuracy of Static Guided Implant Surgery Measured by Optical Scan: Examining the Impact of Operator Experience

et al. 2020

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“…Advancements in cone‐beam computed tomography (CBCT) and computer‐aided implant treatment planning simplify implant treatment planning and implant guide design . Recent introduction of desktop 3D printing allows clinicians to fabricate implant surgical guides for guided implant surgery in office . Accuracy of implant guides is dependent on the overall dimensional stability of the printed guides as well as the preservation of designed surgical sleeve/tube positioning …”

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confidence: 99%

“…Recent introduction of desktop 3D printing allows clinicians to fabricate implant surgical guides for guided implant surgery in office . Accuracy of implant guides is dependent on the overall dimensional stability of the printed guides as well as the preservation of designed surgical sleeve/tube positioning …”

mentioning

confidence: 99%

Intaglio Surface Dimension and Guide Tube Deviations of Implant Surgical Guides Influenced by Printing Layer Thickness and Angulation Setting

Dalal

Ammoun

Abdulmajeed

et al. 2020

Journal of Prosthodontics

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Purpose:To measure overall intaglio dimensional and tube deviations of implant guides printed at 50 and 100 µm layer thickness at 0°, 45°, and 90°angulation using a stereolithographic (SLA) printer. Materials and Methods: A surgical implant guide design from a subject missing a maxillary right central incisor, used as the original standard tessellation language (STL) were stereolithographically fabricated at each thickness and angulation, 50 and 100 µm layer thickness at 0°, 45°, and 90°angulation (n = 10 each group). The guide was then scanned using cone beam computed tomography. The digital imaging and communications in medicine (DICOM) scanned files were then converted to an STL format. The overall dimensional deviations of the intaglio surface and the positioning of the implant guide tube were then superimposed onto the original designed STL file using best-fitting alignment. A t-test and an F-test as well as ANOVA followed by a post hoc t-test were used to determine statistical significant differences (α = 0.05) for the intaglio surface and guide tube deviation, respectively. Results: The overall intaglio surface discrepancies (µm) printed at 0°, 45°, and 90°w ere 55.07 ± 1.36, 52.39 ± 2.09, and 61.02 ± 15.96 for 50 µm layer; and 98.38 ± 10.55, 84.47 ± 10.61, and 90.26 ± 5 for 100 µm layer with statistically significant differences for both t-test and F-test, p < 0.001. The maximal guide tube linear deviations (µm) printed at 0°, 45°, and 90°were 10.78 ± 3.84, 8.16 ± 3.68, and 12.57 ± 5.39 for 50 µm layer (ANOVA, p = 0.096); and 10.95 ± 5.23, 16.79 ± 4.97, and 22.63 ± 2.81 for 100 µm layer (ANOVA, p < 0.001). The maximal guide tube angular deviations (°) printed at 0°, 45°, and 90°were 1.29 ± 0.30, 0.64 ± 0.13, and 0.56 ± 0.21 for 50 µm layer (ANOVA, p < 0.001); and 1.57 ± 0.29, 0.86 ± 0.14, and 1.02 ± 0.31 for 100 µm layer (ANOVA, p = 0.034). There was a statistical difference in the deviations between 50 and 100 µm layer printing in all printed angulations except at 0°(t-test, p = 0.05, p = 0.03, and p = 0.001 for 0°, 45°, and 90°) and linear deviations (t-test, p < 0.001, p = 0.009, and p = 0.001 for 0°, 45°, and 90°). Conclusion: Printing at 50 µm layer reduces dimensional intaglio deviations in general and reduces tube angular deviations with different angulations of printing. However, the deviations were only ß60 to 100 µm for the intaglio dimension deviations; and ß0.04 to 0.26 mm and ß0.25°to ß2°for tube deviations.Guided implant surgery promises accurate placement of dental implants to ensure optimal esthetics and function of definitive restorations and longevity of osseointegrated implants. 1,2 Advancements in cone-beam computed tomography (CBCT) and computer-aided implant treatment planning simplify implant treatment planning and implant guide design. 3,4 Recent introduction of desktop 3D printing allows clinicians to fabricate implant surgical guides for guided implant surgery in office.

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“…The results showed that the accuracy of in‐office fabricated stereolithographic surgical guides was similar to that of manufacturer‐prepared guides . Another study by Bencharit et al also calculated different direction deviations to compare the accuracy between fully guided surgery and partially guided surgery, which showed that fully guided surgery was more accurate . In these 2 studies, the mesiodistal and buccolingual deviations were not determined by comparing the deviations between planned and postoperative implant positions.…”

mentioning

confidence: 93%

Factors that Influence Direction Deviation in Freehand Implant Placement

Tang

Huang

Liao

et al. 2019

Journal of Prosthodontics

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Purpose: This retrospective study investigates the accuracy of freehand implant placement and whether the factors of presence of an adjacent tooth, implant quadrant, number of missing teeth, and location of the implant site influence direction and angulation deviations. Materials and Methods: According to specific inclusion and exclusion criteria, a total of 112 implants from 75 partially edentulous patients were recruited for this retrospective study. The implants were inserted using a freehand approach by one experienced clinician (right-handed). The full thickness flap was elevated to expose the alveolar bone in the implant surgery, and the implant crown consisted of an all-ceramic restoration retained by cement. The planned implant position was preoperatively determined using implant planning software. The postoperative implant position was determined by analyzing the alignment after optically scanning the dentition using a specifically designed registration model in Geomagic Studio software. The deviations between the planned and postoperative implant positions were then calculated. The outcomes included direction and angulation deviations between the planned and postoperative implant positions. All data were analyzed by ANOVA, Bonferroni correction, regression analysis, and one-sample t-tests conducted using SPSS. Results: The 3D deviations between planned and postoperative implant positions were 1.22 ± 0.63 mm at the entrance point, 1.91 ± 1.17 mm at the apical point, and 7.93 ± 5.56°in angulation. The presence of adjacent teeth influenced deviations in the mesiodistal (F = 4.338, p = 0.006) and buccolingual directions (F = 3.017, p = 0.033) at the entrance point and mesiodistal angulation (F = 7.979, p < 0.001). The quadrant influenced deviation in the buccolingual direction at the apical point (F = 6.093, p = 0.001) and buccolingual angulation (F = 6.457, p < 0.001). The number of missing teeth had no effect on deviations of direction and angulation of implants. The location of the implant site affected the deviation in the buccolingual direction at the entrance point (F = 3.096, p = 0.049) and the mesiodistal direction at the apical point (F = 3.724, p = 0.027). Conclusion: The 3D accuracy of freehand-placed implants could be acceptable in clinical situations. The results showed that the presence of an adjacent tooth and the quadrant and the location of the implant site influenced the direction and angulation deviations of the implant position; however, the factor of number of missing teeth did not.Proper positioning and angulation of implants are vital for acquiring ideal prosthetic outcomes and reconstructing certain occlusal relationships. 1,2 A lack of accuracy can lead to a variety of complications, such as implant dehiscence and damage to vital anatomic structures.Using cone beam computed tomography (CBCT) scans and related computer-aided design/computer-aided manufacturing (CAD/CAM) surgical template techniques, implant insertion can be conducted under the guidance of the preoperative design. 3 N...

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In Vivo Tooth-Supported Implant Surgical Guides Fabricated With Desktop Stereolithographic Printers: Fully Guided Surgery Is More Accurate Than Partially Guided Surgery

Cited by 89 publications

References 19 publications

In Vitro Accuracy of Static Guided Implant Surgery Measured by Optical Scan: Examining the Impact of Operator Experience

In Vitro Accuracy of Static Guided Implant Surgery Measured by Optical Scan: Examining the Impact of Operator Experience

Intaglio Surface Dimension and Guide Tube Deviations of Implant Surgical Guides Influenced by Printing Layer Thickness and Angulation Setting

Factors that Influence Direction Deviation in Freehand Implant Placement

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