- Precision of a 3D Image-guided Implant Surgery and Digital Dental Prosthesis: A Preliminary Report
- Guided Bone Regeneration Using Non-Resorbable Membrane--A Case Report
|Precision of a 3D Image-guided Implant Surgery and Digital Dental Prosthesis: A Preliminary Report=三度空間影像引導植體微創手術與數位義齒的精密度初步評估
|董醒任; Dung, Shing-zeng;
|3D電腦斷層; 影像導引手術; 牙科植體; 3D computed tomography; Image-guided surgery; Dental implants;
|The mainstream of implant therapy in the 21th century is simple, convenient, and minimum invasive. Patient's desire for shorter treatment periods and preservation of the esthetic appearance at all stages of the treatment has stimulated clinicians to explore immediate loading of dental implants. Thorough preoperative planning of implant treatment is the prerequisite for a successful treatment outcome. Clinical examination provided limited information on the width and height of jaw bone and may be improve by CT scan. Spiral CT enables the use of delicate software for accurate three-dimensional (3D) modeling and interactive 3d-based planning and simulation of implant surgery. The purpose of the study was to determine and to compare the precision of 3-D image-guided implant rehabilitation in vitro. Total or partial edentulous resin models were used in this project. A layer of silicon was used to mimic oral mucosa. Precision of 3D image-guided immediate fixed implant restoration was investigated using 4 implants in the edentulous maxilla. The fabrication of the custom- made drilling guide was based on three-dimensional computerized tomography. The installation of the implants was simulated pre-operatively using an adopted 3D-CT planning system. The pre-operative CT was then matched with post-operative ones in order to assess the deviation between the planned and installed implants. Data from the present study found that the differences between planned and final implant positions and axes were mostly acceptable. The match between the planned and achieved implant axes was within 2.2-4.7 degrees; average differences in distance between the planned and achieved positions at the implant shoulder were 0.29-1.16 mm, and at the implant apex, 0.91-1.78 mm. A greater distance between the planned and achieved positions at the implant apex than at the implant head was encountered in all implants. Average differences in depth (distance) between the planned and achieved positions at the implant shoulder were 0.57-1.37 mm, and at the implant apex, 0.53-1.33 mm. While NobelGuide(superscript TM) Software does not allow one to compare planned and actual implant positions and axes, temporary abutment and implant prosthesis were made and inserted immediately following implant placement. The fitness of the implant prosthesis was demonstrated clinically and radiographically. Further long-term clinical studies employing a greater number of patients should be performed to evaluate the real impact of the stereolithographic surgical guide on implant therapy.