Use of Diagnostic and Surgical Stent: A Simplified Approach for Implant Placement

Abstract

Dental implantology has emerged as a practical alternative to traditional prosthodontics. Since the beginning, placement of implant in the bone to achieve a prosthetic solution that fulfils biologic, aesthetic and biomechanical requirements has been a challenge. In the past, implant site and inclination were dictated by residual bone quality. The desire for predictable prosthesis led to the development of prosthetically guided implantology. This concept establishes the correct implant position during the diagnostic stage according to planned definitive restoration. In prosthetically guided implantology where ideal placement of implant is determined by the definitive restoration, use of radiographic and surgical stent in conjunction with dental CT scan can play an important role. A stent is an appliance used for radiographic evaluation during treatment planning for implant placement and during surgical procedures to locate optimal implant placement site. The stent with dental CT scan enables the dental team to identify specific sites of prospective implant surgery and hence determines the optimal position and angulation of implant relative to occlusal load. Aided by stent the surgeon can avoid undesirable implant site preparation and minimize unnecessary osteotomy, resulting in favorable design of prosthesis, reduced surgical trauma, reduced surgical time and increased patient comfort. This case report is an insight into the method of fabrication of simple and cost effective stent for implant placement and its advantages over the other techniques of stent fabrication.

Radiographic Stents and Surgical Stents in Implant Placements: An Overview

“…Initially, the residual bone available and its quality determined the implant position and angulation. [1] Prosthetically guided implantology was eventually developed due to the need for a predictable prosthesis. According to this concept, an accurate position of the implant is established at the diagnostic phase as per the pre-planned final restoration.…”

“…According to this concept, an accurate position of the implant is established at the diagnostic phase as per the pre-planned final restoration. [1] During implant placement surgery, the position and angulation of the implant should be determined in an optimal position, considering the bone contour, the future prosthesis presence of any vital structures in the vicinity of the proposed implant site. One method to achieve an accurate implant position is to use a radiographic stent during the planning of implant treatment and use of surgical stents during surgery.…”

“…[2][3] The use of radiographic template with CBCT for planning implant position and a surgical stent during the surgery can play an important role. [1] Use of surgical stent during surgery can help toprevent implant placement undesirable site, reduce unrequired osteotomy, result in appropriate prosthesis design, reduce the required surgical time and trauma, and increase patient comfort. [1] An inadequate implants position and angulation may make prosthesis fabrication more complex, and worsen the prognosis of the implant by increasing the risk of surgical and prosthetic problems.…”

“…[1] Use of surgical stent during surgery can help toprevent implant placement undesirable site, reduce unrequired osteotomy, result in appropriate prosthesis design, reduce the required surgical time and trauma, and increase patient comfort. [1] An inadequate implants position and angulation may make prosthesis fabrication more complex, and worsen the prognosis of the implant by increasing the risk of surgical and prosthetic problems. It may lead to failure of the implant and will result in additional trauma to the patients, additional time and cost will be required of correction.…”

“…They have suggested a method for fabrication of a simple and cost effective stent for implant placement and its advantages over the other techniques of stent fabrication. [1] Yen-Chen Ku and Yu-Fu Shen (2000) have described a method for fabrication of a radiographic and surgical stent. A vacuum-formed matrix that is usually used in the fabrication of fixed provisional prostheses was used in the fabrication of stents for radiographic examination and in the surgical stage of implant therapy.…”