Utilising the nasal aperture for template stabilisation for guided surgery in the atrophic maxilla

Onclin, Pieter; Kraeima, Joep; Merema, B.J.; Meijer, Henny J. A.; Vissink, Arjan; Raghoebar, Gerry M.

doi:10.1186/s40729-020-00221-x

Cited by 3 publications

(4 citation statements)

References 16 publications

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“…The implant positions were transferred to a surgical template using computer software (3‐Matic Medical 11.0; Materialise, Leuven, Belgium). To ensure optimal stability, the template was bone supported and extended into the nasal aperture 15 . All the participants were treated by the same oral and maxillofacial surgeon (GMR).…”

Section: Methodsmentioning

confidence: 99%

“…To ensure optimal stability, the template was bone supported and extended into the nasal aperture. 15 All the participants were treated by the same oral and maxillofacial surgeon (GMR). All the implants (NobelActive NP 3.5 mm, Nobel Biocare Services AG, Kloten, Switzerland) were placed at crestal bone level using a surgical template and consecutive diameter drill sleeves, following the manufacturer's instructions.…”

Section: Surgical Proceduresmentioning

confidence: 99%

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Two or four implants for maxillary overdentures in edentulous patients: 1‐year results of a randomized controlled trial

Onclin

Speksnijder

Vissink

et al. 2023

Clin Implant Dent Rel Res

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IntroductionMaxillary implant overdenture therapy is a good treatment option for treating patients experiencing problems with their conventional maxillary denture. Retaining the overdenture with four implants and a bar attachment system serves as the current gold standard. However, there is a demand for less costly and less invasive treatment options. The aim of this randomized controlled trial was to compare marginal bone level change (MBLC), implant and overdenture survival, clinical, masticatory, and patient‐related outcomes (PROMs) of maxillary implant overdentures with either two or four implants and a bar attachment system.Materials and MethodsForty edentulous participants were randomly allocated to two groups (n = 20), to receive either two or four implants in the maxilla. After healing, all the participants received an implant overdenture retained by a bar attachment system. All the participants were evaluated 1 and 12 months after overdenture placement. The primary outcome was MBLC. Secondary outcomes were implant and overdenture survival, clinical, masticatory, and PROMs. The outcomes were analyzed using parametric and non‐parametric tests.ResultsMBLC was −0.03 mm in the 2‐implant group and −0.16 mm in the 4‐implant group (p = 0.21). Implant survival was 83.3% in the 2‐implant group and 94.4% in the 4‐implant group (p = 0.03). The median pocket depth change and clinical outcomes were low, and masticatory performance along with PROMs improved in both groups and did not differ significantly between them.ConclusionMaxillary 4‐implant overdentures perform better than maxillary 2‐implant overdentures with a bar attachment system in terms of implant and overdenture survival and therefore remains the gold standard. However, both overdentures perform similarly in terms of MBLC, clinical, masticatory, and PROMs.

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Section: Methodsmentioning

confidence: 99%

Section: Surgical Proceduresmentioning

confidence: 99%

Two or four implants for maxillary overdentures in edentulous patients: 1‐year results of a randomized controlled trial

Onclin

Speksnijder

Vissink

et al. 2023

Clin Implant Dent Rel Res

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“…Translation of the 3D VSP towards the surgical procedure was realized by means of 3D-printed surgical guides (Figure 1). The maxillary bone-supported part included an extension to the nasal aperture to verify correct positioning of the guide [17] and was connected with crosslink arms to the zygomatic bone-supported part. Centered channels in the drill-guides enable insertion of stainless steel milled drill sleeves, which should minimize deviation of the drill trajectories and prevent polyamide particle formation (Figure 2C,D).…”

Section: Guide Designmentioning

confidence: 99%

Three-Dimensional Guided Zygomatic Implant Placement after Maxillectomy

Vosselman

Glas

Merema

et al. 2022

JPM

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Zygomatic implants are used in patients with maxillary defects to improve the retention and stability of obturator prostheses, thereby securing good oral function. Prosthetic-driven placement of zygomatic implants is even difficult for experienced surgeons, and with a free-hand approach, deviation from the preplanned implant positions is inevitable, thereby impeding immediate implant-retained obturation. A novel, digitalized workflow of surgical planning was used in 10 patients. Maxillectomy was performed with 3D-printed cutting, and drill guides were used for subsequent placement of zygomatic implants with immediate placement of implant-retained obturator prosthesis. The outcome parameters were the accuracy of implant positioning and the prosthetic fit of the obturator prosthesis in this one-stage procedure. Zygomatic implants (n = 28) were placed with good accuracy (mean deviation 1.73 ± 0.57 mm and 2.97 ± 1.38° 3D angle deviation), and in all cases, the obturator prosthesis fitted as pre-operatively planned. The 3D accuracy of the abutment positions was 1.58 ± 1.66 mm. The accuracy of the abutment position in the occlusal plane was 2.21 ± 1.33 mm, with a height accuracy of 1.32 ± 1.57 mm. This feasibility study shows that the application of these novel designed 3D-printed surgical guides results in predictable zygomatic implant placement and provides the possibility of immediate prosthetic rehabilitation in head and neck oncology patients after maxillectomy.

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“…The insertion of stainless steel (316 L) milled drill sleeves in the channels should minimize deviation of the drill trajectories. The maxillary bone-supported part included an extension to the nasal aperture to verify good positioning of the guide [14] and was connected with crosslink arms to the zygomatic bone-supported part. In addition, the guide was supplied with holes for temporary fixation with mini screws.…”

Section: Virtual Surgical Planningmentioning

confidence: 99%

Immediate implant-retained prosthetic obturation after maxillectomy based on zygomatic implant placement by 3D-guided surgery: a cadaver study

et al. 2021

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Background The aim of this study was to introduce a complete 3D workflow for immediate implant retained prosthetic rehabilitation following maxillectomy in cancer surgery. The workflow consists of a 3D virtual surgical planning for tumor resection, zygomatic implant placement, and for an implant-retained prosthetic-obturator to fit the planned outcome situation for immediate loading. Materials and methods In this study, 3D virtual surgical planning and resection of the maxilla, followed by guided placement of 10 zygomatic implants, using custom cutting and drill/placement-guides, was performed on 5 fresh frozen human cadavers. A preoperatively digitally designed and printed obturator prosthesis was placed and connected to the zygomatic implants. The accuracy of the implant positioning was obtained using 3D deviation analysis by merging the pre- and post-operative CT scan datasets. Results The preoperatively designed and manufactured obturator prostheses matched accurately the per-operative implant positions. All five obturators could be placed and fixated for immediate loading. The mean prosthetic point deviation on the cadavers was 1.03 ± 0.85 mm; the mean entry point deviation was 1.20 ± 0.62 mm; and the 3D angle deviation was 2.97 ± 1.44°. Conclusions It is possible to 3D plan and accurately execute the ablative surgery, placement of zygomatic implants, and immediate placement of an implant-retained obturator prosthesis with 3D virtual surgical planning.The next step is to apply the workflow in the operating room in patients planned for maxillectomy.

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Utilising the nasal aperture for template stabilisation for guided surgery in the atrophic maxilla

Cited by 3 publications

References 16 publications

Two or four implants for maxillary overdentures in edentulous patients: 1‐year results of a randomized controlled trial

Two or four implants for maxillary overdentures in edentulous patients: 1‐year results of a randomized controlled trial

Three-Dimensional Guided Zygomatic Implant Placement after Maxillectomy

Immediate implant-retained prosthetic obturation after maxillectomy based on zygomatic implant placement by 3D-guided surgery: a cadaver study

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