Full mouth rehabilitation with Implant-Guided Surgery and Fixed prosthesis / 대한치과보철학회지

The development of cone beam computerized tomography (CBCT) allows three-dimensional analysis of the patient's anatomy. The surgical guide is a combination of CBCT, computer-aided design/computer-aided manufacturing (CAD/CAM) and implant diagnostics software, which allows well planned prostheses design and ideal implant placement. Guided surgery minimizes possible anatomical damage and allows for more reproducible treatment planning. In this case, the operation time was shortened by using a surgical guide for multiple implants placement in a fully edentulous patient. Immediate loading were performed more easily using preliminary preparation of provisional prosthesis. The patient was satisfied with improved esthetics and chewing function.

Evaluation of the accuracy of two different surgical guides in dental implantology: stereolithography fabricated vs. positioning device fabricated surgical guides / 대한치과보철학회지

PURPOSE: Recently implant surgical guides were used for accurate and atraumatic operation. In this study, the accuracy of two different types of surgical guides, positioning device fabricated and stereolithography fabricated surgical guides, were evaluated in four different types of tooth loss models. MATERIALS AND METHODS: Surgical guides were fabricated with stereolithography and positioning device respectively. Implants were placed on 40 models using the two different types of surgical guides. The fitness of the surgical guides was evaluated by measuring the gap between the surgical guide and the model. The accuracy of surgical guide was evaluated on a pre- and post-surgical CT image fusion. RESULTS: The gap between the surgical guide and the model was 1.4 +/- 0.3 mm and 0.4 +/- 0.3 mm for the stereolithography and positioning device surgical guide, respectively. The stereolithography showed mesiodistal angular deviation of 3.9 +/- 1.6degrees, buccolingual angular deviation of 2.7 +/- 1.5degrees and vertical deviation of 1.9 +/- 0.9 mm, whereas the positioning device showed mesiodistal angular deviation of 0.7 +/- 0.3degrees, buccolingual angular deviation of 0.3 +/- 0.2degrees and vertical deviation of 0.4 +/- 0.2 mm. The differences were statistically significant between the two groups (P<.05). CONCLUSION: The laboratory fabricated surgical guides using a positioning device allow implant placement more accurately than the stereolithography surgical guides in dental clinic.

Surgical stent for dental implant using cone beam CT images / 대한구강악안면방사선학회지

PURPOSE: The purpose of this study is to develop a surgical stent for dental implant procedure that can be easily applied and affordable by using cone beam computerized tomography (CBCT). MATERIALS AND METHODS: Aluminum, Teflon-PFA (perfluoroalkoxy), and acetal (polyoxymethylene plastic) were selected as materials for the surgical stent. Among these three materials, the appropriate material was chosen using the CBCT images. The surgical stent, which could be easily placed into an oral cavity, was designed with chosen material. CBCT images of the new surgical stent on mandible were obtained using Alphard-3030 dental CT system (Asahi Roentgen Co., Ltd., Kyoto, Japan). The point of insertion was prescribed on the surgical stent with the multiplanar reconstruction software of OnDemand3D (CyberMed Inc., Seoul, Korea). Guide holes were made at the point of insertion on the surgical stent using newly designed guide jig. CBCT scans was taken for the second time to verify the accuracy of the newly designed surgical stent. RESULTS: Teflon-PFA showed radiologically excellent image characteristics for the surgical stent. High accuracy and reproducibility of implantation were confirmed with the surgical stent. CONCLUSION: The newly designed surgical stent can lead to the accurate implantation and achieve the clinically predictable result.

Surgical Stent Graft Operation for Chronic Type A Associated with Acute Type B Dissection / 日本心臓血管外科学会雑誌

A 57-year-old female was admitted for severe back pain. CT, aortography and transesophageal echocardiography showed enlargement of the ascending aorta with large entry and dissection of the descending thoracic and abdominal aorta with entry located at the distal arch. She had left leg ischemia due to a narrow true lumen. Using cardiopulmonary bypass with circulatory arrest and cervical perfusion, the ascending aorta and arch were replaced and three cervical vessels were reconstructed. A stent graft was inserted into the descending aorta and anastomosed to the distal end of the graft and native aorta. There were no postoperative complications. Postoperative CT showed no leakage at the stent graft attachment. This surgical stent graft operation for chronic type A and acute type B dissection was a relatively minimal invasive and effective method.