Virtual implant planning and fully guided implant surgery using magnetic resonance imaging—Proof of principle

Abstract

Objectives To present a workflow of virtual implant planning and guided implant surgery with magnetic resonance imaging (MRI) and virtual dental models without the use of ionizing radiation. Methods Five patients scheduled for implant placement underwent an MR examination at three Tesla using individualized 2D and 3D turbo spin‐echo (TSE) sequences and dedicated head coils. The MRI data and virtual dental models derived from either optical model scans or intraoral scans were imported to a virtual implant planning software (coDiagnostiX, Dental Wings, Montreal, Canada). Virtual prosthetic planning and implant planning were performed regarding the hard and soft tissue anatomy. A drill guide was designed on the virtual dental model using computer‐aided design (CAD) and manufactured in‐house, using a 3D printer (Eden 260V, Stratasys, Eden Prairie, MN, USA). Results The MRI displayed all relevant anatomical structures for dental implant planning such as cortical and cancellous bone, floor of the nasal and maxillary sinus, inferior alveolar nerve and neighboring teeth. The manual alignment of virtual dental models with the MRI was possible using anatomical landmarks. Dental implant planning, CAD/CAM of a drill guide and fully guided implant placement were successfully performed. Conclusions Guided implant surgery is feasible with MRI without ionizing radiation. Further studies will have to be conducted to study the accuracy of the presented protocol and compare it to the current workflow of guided surgery using CBCT.

Magnetic resonance imaging based computer‐guided dental implant surgery—A clinical pilot study

“…MR images displayed all anatomical structures that are relevant for dental implant planning. As has already been demonstrated in other investigations, bone tissue, teeth, and maxillary sinus could be clearly depicted in this study 13,16,23,25 . As the occasional term “black bone MRI” suggests, cortical bone and other tissues with short T 2 * relaxation times including mineralized structures such as teeth initially appear black in T1‐weighted bone sequences and results in an unusual imaging impression compared to the one derived from CBCT or CT.…”

“…As a result, MRI is increasingly becoming the focus of attention as a diagnostic basis for implant planning 23,24 . One recently published case report demonstrates a proof‐of principle of template‐guided implant placement based on MRI 25 . So far, there is no research testing feasibility of this approach with special regards to accuracy of implant placement.…”

Dental MRI: a road beyond CBCT

“…Several attempts have been made to evaluate the reliability of MR imaging in dental implant planning [7,8]. Unlike the current study, however, most of the preceding studies have not assessed the reliability and accuracy of MR-based planning in clinical workflow settings.…”

Use of dental MRI for radiation-free guided dental implant planning: a prospective, in vivo study of accuracy and reliability

“…In prosthetically driven backward planning, however, the implant position is defined within the image dataset and isotropic imaging, as made available by CBCT, is necessary. The feasibility of dental MRI for backward planning has been show very recently in a case series [17]. The reliability and accuracy of dental MRI, however, has not yet been evaluated in a clinical setting.…”