Accuracy of Computer-assisted Template-based Implant Placement Using Conventional Impression and Scan of a Physical Stone Model Or Intra-oral Scanning- a Randomized Controlled Trial
Accuracy of Computer-assisted Template-based Implant Placement Using Conventional Impression and Scan of a Physical Stone Model Or Intra-oral Scanning- a Randomized Controlled Trial

Author: Erta Xhanari

Publisher:

Published: 2017

Total Pages:

ISBN-13:

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Purpose: To compare accuracy and complications of computer-assisted template-based implant placement using conventional impression and scan of a physical stone model or intra-oral scanning to rehabilitate partial edentulous patients.u2028Materials and methods: Any partially edentulous patients with at least five residual teeth, requiring at least one implant to be planned on three-dimensional (3D) cone beam computed tomography (CBCT) scan according to a computer-assisted template-based protocol were enrolled. Patients were randomised according to a parallel group design into two arms: intraoral digital impression (fully digital group) or conventional impression and scan model (conventional group). Implants were placed flapless or with a minimally invasive flap and conventionally loaded after 5 months. Outcome measures were: implant and prosthetic success, complications, accuracy, and peri-implant marginal bone loss. Three deviation parameters (angular, horizontal, vertical) were defined to evaluate the discrepancy between the planned and placed implant positions. Results were compared using a mixed-model repeated-measures analysis of variance (u03b1=0.05).Results: Twenty patients (11 females and 9 males; mean age 45.4 years old) were randomised to the fully digital group (10 patients with 28 implants) or conventional group (10 patients with 29 implants). No patients dropped out. No implant or prosthesis failed up to 1 year after loading. One implants in the fully digital group was placed free-hand due to limited inter-arch space. No other complications were experienced during follow-up. Difference between groups were not statistically significant (p = 0.999). The mean error in angle was 2.32u00b11.44u00b0 (range 0.3u20135.0u00b0; 95% CI 1.17 to 2.23u00b0) in the fully digital group and 2.10u00b11.18u00b0 (range 0.3u20135.8u00b0; 95% CI 1.52 to 2.38u00b0) in the conventional group (P=0.550); in the horizontal plan (mesio-distal), the mean error was 0.52u00b10.30 mm (range 0.1u20131.10 mm; 95% CI 0.39 to 0.61 mm) in the fully digital group and 0.44u00b10.26 mm (range 0.1u20130.9 mm; 95% CI 0.30 to 0.50 mm) in the conventional group (P=0.279); in the vertical plan (apico-coronal), the mean error was 0.58u00b10.44 mm (range 0.0u20131.6 mm; 95% CI 0.44 to 0.76u00b0) in the fully digital group and 0.46u00b10.34 mm (range 0.0u20131.2 mm; 95% CI 0.28 to 0.52u00b0) in the conventional group (P=0.250). One year after loading, the mean marginal bone loss was 0.14u00b10.12 mm (range -0.1u20130.4 mm; 95% CI 0.11 to 0.19 mm) in the fully digital group and 0.18u00b10.13 mm (range -0.1u20130.6 mm; 95% CI 0.15 to 0.25 mm). The difference was not statistically significant (P = 0.2942).Conclusions: With the limitations of the present trial, intraoral digital impressions showed similar results compared to conventional impression and scan model. Digital impression may be a viable option for the rehabilitation of partial edentulous patients when computer-guided template-assisted implant placement is used.

Accuracy of Computer-assisted Template-based Implant Placement Using Conventional Impression and Scan Model Or Digital Impression- a Randomized Controlled Trial
Accuracy of Computer-assisted Template-based Implant Placement Using Conventional Impression and Scan Model Or Digital Impression- a Randomized Controlled Trial

Author: Tallarico Marco

Publisher:

Published: 2017

Total Pages:

ISBN-13:

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Aim: To compare early implant failure, template-related complications, and virtual planning accuracy of computer-assisted template-based implant placement using conventional impression and scan model or digital impression using conventional impression and scan model or digital impression to rehabilitate partial edentulous patients using flapless or mini-flap procedures and immediate loading.u2028Materials and methods: Any partially edentulous patients requiring at least 1 implant to be plan on three-dimensional (3D) cone beam computed tomography (CBCT) scans using a dedicated software were enrolled in the trial. Patients were randomised according to a parallel group design into two arms: intraoral digital impression (fully digital group) versus conventional impression and scan model (control group). Implants were to be placed flapless and loaded immediately, if inserted with a torque over 35 Ncm, with reinforced provisional prostheses. Three deviation parameters (horizontal, vertical, and angular) were defined and calculated between the planned and placed implant positions and analyzed statistically. Results were compared using a mixed-model repeated-measures analysis of variance (u03b1=0.05).Results: Twelve patients were randomised to the fully digital group (6 patients with 17 implants) and control group (6 patients with 20 implants). The mean error in angle was 2.56u00b11.52u00b0 (range 0.3u20135.0u00b0) in the fully digital group and 2.18u00b11.41u00b0 (range 0.3u20135.8u00b0) in the control group (P=0.519); in the horizontal plan (mesio-distal), the mean error was 0.57u00b10.32 mm (range 0.1u20131.1 mm) in the fully digital group and 0.43u00b10.26 mm (range 0.1u20130.9 mm) in the control group (P=0.249); in the vertical plan (apico-coronal), the mean error was 0.67u00b10.51 mm (range 0.0u20131.6 mm) in the fully digital group and 0.43u00b10.32 mm (range 0.0u20131.2 mm) in the control group (P=0.180).Conclusions: With the limitation of the present randomized controlled trial, intraoral digital impression may be a viable option to conventional impression and scan model for the rehabilitation of partial edentulous patients by using computer-guided template-assisted implant placement.

Accuracy of Full Digital Workflow for Dental Implants Insertion in Partially Edentulous Patients
Accuracy of Full Digital Workflow for Dental Implants Insertion in Partially Edentulous Patients

Author: Burlibasa M

Publisher:

Published: 2017

Total Pages:

ISBN-13:

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Background: Static computer-aided implant surgery is a predictable and widely accepted procedure, its accuracy being within the clinical acceptable range in the majority of clinical situations. Usually the 3D model of the bone and surrounding structures is obtained via cone beam computed tomography (CBCT) and the patientu2019s oral condition can be acquired conventionally and then digitalized using a desktop scanner - partially digital workflow (DW) or digitally with the aid of an intraoral scanner - full DW.The aim of the present pilot study is to compare the accuracy of a full digital workflow to partially digital workflow for a limited edentulous space (1 to 3 dental units) using an inspection tool software. Null hypothesis tested: full digital WF is more accurate comparing to partially DW.Materials and methods: The study was conducted in accordance with ethical principles including the World Medical Association Declaration of Helsinki, approved by the University Bioethical Committee, registered (ClinicalTrials.gov Identifier: NCT03814655) and written consent of each subject was obtained.Patients with Kennedy Class III partially edentulism, good general health, acceptance of dental implant treatment, acceptance of pre-operative CBCT, not requiring bone graft, not limited mouth opening were included.The full DW included: intraoral scan of the partially edentulous site, antagonists and occlusion registration, CBCT with radiopaque customized tray placed over the partially edentulous arch; merging files in R2 Gate planning software (Megagen, Korea), implant placement and digital scanning of implants position (.stl u2013 Stereolithography file).In the partially DW, digital impression was replaced with a conventional impression and poured casts are scanned with a desktop scanner.Results: 20 patients were enrolled in this prospective, pilot study and 38 implants were inserted using tooth-supported surgical templates and a flapless technique. Neither complications nor unexpected events occurred during implants insertion.22 implants were inserted using full DW. Inserted and planned implant position were compared using Geomagic Qualify 2013 software (3D Systems,USA).The mean 3D errors of implant positioning for the two insertion protocols were: 0.62mm (u00b10.42) entry point, 0.98mm (u00b10.73) at the implant apex, 2.1 (u00b10.35) angular deviation for full DW, respectively 0.68(u00b10.57), 1.02mm (u00b10.43) and 2.4 (u00b10.22) for partially DW. The t test for implant position showed no statistically significant differences (p > .05) in accuracy between full DW and partially DW, rejecting the null hypothesis tested.Conclusions and clinical implications: Within the limits of the present pilot study, the surgical template used has proved high accuracy for implant insertion, both in full and partially DW.The results of this study suggest that a full digital workflow for computer-guided implant surgery in partially edentulous patients is a reliable method and could be used in clinical situations.

Loading Protocols in Implant Dentistry
Loading Protocols in Implant Dentistry

Author: Daniel Wismeijer

Publisher: Quintessenz Verlag

Published: 2019-09-03

Total Pages: 345

ISBN-13: 1850973458

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Implant dentistry has become a standard option for the rehabilitation of fully and partially edentulous patients. With the ever-increasing number of dentists involved in implant dentistry, it is essential to ensure that their treatment methods follow the highest standard. The ITI Treatment Guide series, a compendium of evidence-based implant-therapy techniques in daily practice, is written by renowned clinicians and provides a comprehensive overview of various therapeutic options. Using an illustrated step-by-step approach, the ITI Treatment Guide shows practitioners how to manage different clinical situations, with the emphasis on sound diagnostics, evidence-based treatment concepts, and predictable treatment outcomes. The second volume of the ITI Treatment Guide is devoted to the restoration of partially dentate patients. Central to this volume of the ITI Treatment Guide are loading protocols available to the clinician and the patient and how they relate to various treatment indications, including both single and multiple missing teeth in the posterior and anterior regions of the mouth. Among potential topics for upcoming volumes are implant placement in extraction sockets, loading protocols in edentulous patients, implant therapy in the esthetic zone in extended edentulous spaces, and many more.

Digital Workflows in Implant Dentistry
Digital Workflows in Implant Dentistry

Author: German O. Gallucci

Publisher: Quintessenz Verlag

Published: 2019-12-16

Total Pages: 521

ISBN-13: 3868674993

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The field of implant dentistry continues to grow both in terms of the number of practitioners placing and restoring implants and in terms of as well as patient demand for successful outcomes in as short a time as possible. The pace of technological changes and new offerings from implant manufacturers and allied industries are equally fast in their attempts to meet these demands, with a frequently bewildering array of potential solutions available to clinicians. This is never more so than in the field of digital dentistry, with hardware and software solutions for diagnosis, imaging, planning, surgery, impression-taking, and the computer-aided design and manufacture of intraoral prostheses. However, we must always remember our responsibility to ensure that our treatments are carried out safely and in the best interests of our patients. This new Volume 11 of the ITI Treatment Guide series continues the successful theme of the previous ten volumes: a compendium of evidence-based methodology in digital techniques and procedures for daily practice. Written by renowned clinicians and supported by contributions from expert practitioners, the ITI Treatment Guide Digital Workflows in Implant Dentistry provides a comprehensive overview of various technological options and their safe clinical application.

Accuracy of Sleeveless Surgical Templates- One-year Randomized Controlled Trial
Accuracy of Sleeveless Surgical Templates- One-year Randomized Controlled Trial

Author: Erta Xhanari

Publisher:

Published: 2017

Total Pages:

ISBN-13:

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BackgroundRecently, surgical templates without metallic sleeves have been designed and introduced in the dental market, with the goal to make guided surgery work-flow faster and easier. Nevertheless, there is still lack of data about their accuracy and predictability.Aim/HypothesisTo compare virtual planning accuracy of novel computer-assisted, template-based implant placement techniques, which make use of CAD/CAM stereolithographic surgical templates with or without metallic sleeves. Furthermore, to compare open versus closed sleeves for templates without metallic sleeves.Materials and MethodsAny partially edentulous patients with at least five teeth in two different quadrant, requiring at least one implant to be placed according to a computer-assisted template-based protocol were enrolled. Patients were randomized according to a parallel group design into two arms: surgical template designed and fabricated with (test group) or without (control group) metallic sleeves. Implants were placed according to the manufacturer's instruction. Immediately after implant placement, three deviation parameters (angular, horizontal, vertical) were defined to evaluate the discrepancy between the planned and placed implant positions. Furthermore, implant and prosthesis survival and success rates were evaluated one-year after loading.ResultsForty-one implants were placed using surgical templates with metallic sleeves while 49 implants were placed with a surgical template without metallic sleeves. Of these, 16 implants were placed through open sleeves and 33 through closed sleeves. There was a statistically significant difference in angle (p = 0.0212) and in the vertical plan (p = 0.0073) with lower values for implants placed with a surgical template without metallic sleeves. In the test group, close sleeves were more accurate compared with open sleeves in angle (p = 0.0268) and in horizontal plan (p = 0.0477). One-year after implant placement, no implant and no prosthesis failed. No major complications were experienced. Two minor prosthetic complications were experienced in the control group versus none in the test group. The difference was not statistically significant (0.2047).Conclusions and Clinical ImplicationsWith the limitations of the present study, surgical templates designed without metallic sleeves were more accurate in the vertical plan and angle compared to the conventional template with metallic sleeves. Open sleeves should be used in the molar region only in case of reduced space. Further researches with longer follow-up are needed to confirm these results.

Graftless Solutions for the Edentulous Patient
Graftless Solutions for the Edentulous Patient

Author: Saj Jivraj

Publisher: Springer Nature

Published: 2023-07-21

Total Pages: 560

ISBN-13: 3031328477

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This book, designed to meet the needs of clinicians and now in an extensively revised second edition, clearly explains the rationale and technique for the rehabilitation of fully edentulous patients utilizing traditional graftless concepts as well as zygomatic implant strategies when posterior support cannot be achieved by the former means. Considerations relevant to treatment planning and the biomechanics of immediate loading and zygomatic implants are first discussed. The techniques for placement of traditional tilted and zygomatic implants and for immediate loading of a full arch restoration are then described step by step. Detailed information and guidance are also provided on the different materials available for full arch restorations, laboratory aspects of the definitive restoration, maintenance of restorations, and management of prosthetic and surgical complications. The book concludes with a helpful series of clinical cases. Graftless Solutions for the Edentulous Patient is designed particularly for clinicians with experience in placing and restoring dental implants.

The Effect of Digital Implant Analog Design on the Trueness of Implant Analog Position in Additively Manufactured Digital Implant Models
The Effect of Digital Implant Analog Design on the Trueness of Implant Analog Position in Additively Manufactured Digital Implant Models

Author: Severino J. Mata

Publisher:

Published: 2020

Total Pages: 95

ISBN-13:

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Statement of problem. Additively manufactured (AM) digital implant models (DIM) fabricated with 3D-printing technology have become more popular in the recent years, combining the advantages of both digital and analog workflows. They are a physical model on which dentists and laboratory technicians can evaluate and work on restorations for layering and adjustments. Even though 3D-printed DIMs have provided a solution between digital and analog workflows, limited evidence exists regarding the accuracy of the implant analog position on these models. Multiple factors related to the fabrication and accuracy of 3D-printed DIMs have been studied. However, the influence of the digital implant analog design on the accuracy of implant analog positions on 3D-printed models is still unclear and only one study related to this topic has been published. Purpose. To compare the implant analog position trueness between AM DIMs with 3 different digital implant analog designs and conventional implant analog stone casts. The study aimed to evaluate and compare the effect of digital implant analog design and insertion on the trueness of analog position of DIMs compared to a conventional implant stone cast. Materials and Methods. A modified partially edentulous maxillary implant model with a conventional implant replica (Nobel Biocare Implant Replica CC RP) on site #13 was used as the master reference model (MRM). Conventional implant-level vinylpolysiloxane (VPS) impressions of the MRM were made using custom trays with the closed tray impression technique and poured in type IV stone to obtain 12 conventional implant casts (Group A, n=12). A complete-arch implant-level digital scan of the MRM with an implant intraoral scan body (ISB) was made using an intraoral scanner (IOS). The digital scan file was exported to a dental CAD software and used to create 3 different DIM designs for different 3 different DIM analogs: NobelProcera (Group B), Elos Medtech (Group C) and Nt-trading (Group D). DIMs were additively manufactured with a Continuous Liquid Interface Production (CLIP) technology 3D printer and DIM analogs were subsequently inserted into each DIM, obtaining 12 specimens per group (n=12). The MRM and all specimens were digitized with an implant ISB using a laboratory scanner, and all STL files were prepared for measurements. A metrology software was used to measure deviations between the MRM scan file to each specimen file. Linear deviations at strategic points on the ISB were measured at the level of x-, y- and z- directions and 3D linear deviation was calculated. Angular deviations at the buccolingual (BL) and mesiodistal (MD) planes of projection were measured on the ISB. ANOVA and Bonferroni corrected t-tests of pairwise comparisons were conducted for statistical analysis of linear and angular deviations of ISBs on all groups to determine the trueness of implant analog positions. An alpha level of 0.05 was used. Results. A highly statistically significant interaction was found between main effects (groups, points, directions) for linear deviation of implant analog position on models compared to the MRM. Statistically significant differences for linear deviations were found between conventional implant casts and DIMs. On the BL direction for linear deviation, statistically significant differences were found between groups A and D (P