Comparison of the Accuracy of Implant Position Using Surgical Guides Fabricated by Additive and Subtractive Techniques

Henprasert, Pantip; Dawson, Deborah V.; El‐Kerdani, Tarek; Song, Xuan; Couso‐Queiruga, Emilio; Holloway, Julie A.

doi:10.1111/jopr.13161

Cited by 78 publications

(46 citation statements)

References 73 publications

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“…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]. In contrast, Abduo and Lau demonstrated that templates produced through subtractive manufacturing led to more precise results [39].…”

Section: Discussionmentioning

confidence: 99%

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Does the macro design of an implant affect the accuracy of template-guided implantation? A prospective clinical study

Schnutenhaus

Edelmann²,

Rudolph

2021

Int J Implant Dent

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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.

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Section: Discussionmentioning

confidence: 99%

“…The manufacturing process for the drilling template can have an impact on the accuracy of the implant placement. Several studies have reported the influence of additive printing and subtractive processes, as well as of the materials used in these processes [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Does the macro design of an implant affect the accuracy of template-guided implantation? A prospective clinical study

Schnutenhaus

Edelmann²,

Rudolph

2021

Int J Implant Dent

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“…Clinically sufficient accuracy and prosthetically predictable results can be achieved using this procedure [ 11 , 14 ]. Numerous studies on guided implant placement have attempted to determine the factors that affect the accuracy of the procedure, including different manufacturing methods or different materials used for drilling jigs [ 15 , 16 , 17 ]. Different drilling sleeves [ 18 , 19 , 20 ], as well as the intraoral positioning and fixation of the jigs [ 21 ], can influence accuracy.…”

Section: Introductionmentioning

confidence: 99%

Accuracy of Computer-Assisted Dynamic Navigation in Implant Placement with a Fully Digital Approach: A Prospective Clinical Trial

Edelmann¹,

Wetzel²,

Knipper³

et al. 2021

JCM

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Background: This prospective clinical study aimed to investigate a possible deviation between the digitally planned implant position and the position achieved using dynamic navigation. The aim of the study was to establish clinical effectiveness and precision of implantation using dynamic navigation. Methods: Twenty consecutive patients received an implant (iSy-Implantat, Camlog, Wimsheim, Germany). One screw implant was placed in one jaw with remaining dentition of at least six teeth. The workflow was fully digital. Digital implant planning was conducted using cone-beam computed tomography (CBCT) and an intraoral scan of the actual condition. Twenty implants were subsequently placed using a dynamic computer-assisted procedure. The clinical situation of the implant position was recorded using an intraoral scan. Using these data, models were produced via 3D printing, and CBCTs of these models were made using laboratory analogs. Deviations of the achieved implant position from the planned position were determined using evaluation software. Results: The evaluation of 20 implants resulted in a mean angle deviation of 2.7° (95% CI 2.2–3.3°). The 3D deviation at the implant shoulder was 1.83 mm (95% CI 1.34–2.33 mm). No significant differences were found for any of the parameters between the implantation in the upper or lower jaw and an open or flapless procedure (p-value < 0.05). Conclusion: The clinical trial showed that sufficiently precise implantation was possible with the dynamic navigation system used here. Dynamic navigation can improve the quality of implant positioning. In particular, the procedure allows safe positioning of the implants in minimally invasive procedures, which usually cannot be performed freehand in this form. A clinical benefit and effectiveness can be determined from the results.

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“…An implant planning software allows to import acquired radiographical and surface data and to visualize the final outcome, thereby facilitating to define the ideal implant site according to a virtual set-up and the anatomical characteristics of the patient [8,9]. Based on the virtually planned implant position, a surgical drilling guide can be manufactured, e.g., by 3D printing [10,11] and adapted to the clinical workflow without a typical learning curve [12]. Printing technology based on computer aided design and manufacturing (CAD-CAM) allows to create objects by adding consecutive layers [13].…”

Section: Introductionmentioning

confidence: 99%

How Accurate Is Oral Implant Installation Using Surgical Guides Printed from a Degradable and Steam-Sterilized Biopolymer?

Pieralli

Spies

Hromadnik

et al. 2020

JCM

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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 filament. Furthermore, the potential benefit of metal sleeve inserts should be assessed. A surgical guide was designed for the installation of two implants in the region of the second premolar (SP) and second molar (SM) in a mandibular typodont model. For two additive manufacturing techniques (stereolithography [SLA]: reference group, FDM: observational group) n = 10 surgical guides, with (S) and without (NS) metal sleeves, were used. This resulted in 4 groups of 10 samples each (SLA-S/NS, FDM-S/NS). Target and real implant positions were superimposed and compared using a dedicated software. Sagittal, transversal, and vertical discrepancies at the level of the implant shoulder, apex and regarding the main axis were determined. MANOVA with posthoc Tukey tests were performed for statistical analyses. Placed implants showed sagittal and transversal discrepancies of <1 mm, vertical discrepancies of <0.6 mm, and axial deviations of ≤3°. In the vertical dimension, no differences between the four groups were measured (p ≤ 0.054). In the sagittal dimension, SLA groups showed decreased deviations in the implant shoulder region compared to FDM (p ≤ 0.033), whereas no differences in the transversal dimension between the groups were measured (p ≤ 0.054). The use of metal sleeves did not affect axial, vertical, and sagittal accuracy, but resulted in increased transversal deviations (p = 0.001). Regarding accuracy, biopolymer-based surgical guides manufactured by means of FDM present similar accuracy than SLA. Cytotoxicity tests are necessary to confirm their biocompatibility in the oral environment.

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Comparison of the Accuracy of Implant Position Using Surgical Guides Fabricated by Additive and Subtractive Techniques

Cited by 78 publications

References 73 publications

Does the macro design of an implant affect the accuracy of template-guided implantation? A prospective clinical study

Does the macro design of an implant affect the accuracy of template-guided implantation? A prospective clinical study

Accuracy of Computer-Assisted Dynamic Navigation in Implant Placement with a Fully Digital Approach: A Prospective Clinical Trial

How Accurate Is Oral Implant Installation Using Surgical Guides Printed from a Degradable and Steam-Sterilized Biopolymer?

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