ABSTRACT
@#Rehabilitation and reconstruction of atrophic edentulous predicament represents significant challenges for implant dentists due to the anatomical conditions of the edentulous jaw. Implant-supported fixed complete dental prostheses represent a scientifically and clinically validated treatment for recovering patients, masticatory function and esthetic effect. However, the highly demanding implant surgical techniques and complex rehabilitation procedures for immediate functional reconstruction make it difficult to achieve the desired treatment outcomes. The application of digital and CAD/CAM technology in various stages of the treatment process is logical for patients and dentists. This article summarizes the workflow of digital-assisted implantation with immediate functional reconstruction of atrophic edentulous combined with a clinical case. Digital-assisted diagnosis, design, implantation, immediate reconstruction and final rehabilitation can optimize the implant surgery and immediate rehabilitation workflow, improve the accuracy of implant-supported immediate functional reconstruction, reduce the demand for a large amount of bone graft, and achieve higher patient satisfaction. The “prosthetic-oriented, begin with the end in mind” concept of edentulous jaw implant prosthetics can accurately and efficiently restore the patient,s beauty and chewing function in a minimally invasive manner, and is worthy of clinical promotion.
ABSTRACT
BACKGROUND: Conventional implantation at anterior aesthetic region is difficult to achieve ideal three-dimensional position, and needs high implantation accuracy. OBJECTIVE: To evaluate the clinical application effect of three-dimensional printed digital guide technology in anterior dental implant. METHODS: Eighty-six cases of dental implants were divided into two groups. Control group (n=43, 52 implants) received conventional dental implantation. Trial group (n=43, 52 implants) received implantation under three-dimensional printed digital guides. The accuracy of the three-dimensional position of the implants was measured. The modified plaque index, modified bleeding index, probing depth and the satisfaction of patients with implant denture were measured at 6 months after implantation. RESULTS AND CONCLUSION: (1) The errors of vertical and horizontal directions at the top and the root after implantation in the trial group were significantly fewer than those in the control group (P < 0.05). (2) The modified plaque index, modified bleeding index, and probing depth in the trial group were significantly lower than those in the control group (P < 0.05). (3) The satisfaction of patients in the trial group was 98% (42/43), which was higher than 86% (37/43) in the control group. (4) In summary, three-dimensional printed digital guide plate used in dental implant dentures can improve the three-dimensional position accuracy after implantation and improve the postoperative clinical effect.
ABSTRACT
Dental implants have become the main choice for patients to fill in their missing teeth. A precise placement is the basis for a functional and aesthetic restoration. A digital surgical guide is a carrier that transfers the preoperative plan of dental implants to the actual surgery. This paper provides some references that can help clinicians improve the accuracy of implant surgery by stating the development, classification, advantages and disadvantages, and factors that affect the accuracy of digital guides.
Subject(s)
Humans , Computer-Aided Design , Dental Implantation, Endosseous , Dental Implants , Esthetics, Dental , Imaging, Three-Dimensional , Patient Care Planning , Surgery, Computer-AssistedABSTRACT
Objective@#To evaluate the clinical effect of a digital whole-process surgical guide for immediate implantation in the molar area. @*Methods @#Twenty-six patients with molar extraction plans were accepted for preoperative CBCT and model construction. Computer software was used to design the ideal three-dimensional position of the implant. The control group of 13 patients underwent immediate implantation with a free hand operation, whereas the experimental group of 13 patients underwent preparation and implant insertion under the guidance of a surgical guide. Bone grafting was performed, and a good initial stability was achieved. After 5 to 6 months, osseointegration was achieved, and the final restoration was delivered. After surgery, the accuracy of the three-dimensional position of the implants was measured, and at the 6 month return visit, the modified Plaque Index (mPLI), modified Sulcular Bleeding Index (mSBI) and probing depth (PD) were measured. @*Results @# In the control group and experimental group, the vertical errors at the top of the implants were 1.246 ± 0.072 mm and 0.628 ± 0.046 mm (t = 26.078, P < 0.001), respectively, and the horizontal errors were 1.563 ± 0.086 mm and 0.546 ± 0.056 mm (t = 35.813, P < 0.001), respectively; and the vertical errors at the root of the implants were 1.352 ± 0.042 mm and 0.532 ± 0.030 mm (t = 57.021, P < 0.001), respectively, and the horizontal errors were 1.645 ± 0.076 mm and 0.625 ± 0.072 mm (t = 35.086, P < 0.001), respectively. For the experimental group, the mPLI value was 0.923 ± 0.760, the mSBI value was 0.846 ± 0.689, and the PD value was 3.460 ± 0.713 mm, which were significantly lower than those of the control group. For the control group, the mPLI value was 1.769 ± 0.927 (t = 2.546, P = 0.018), the mSBI value was 1.692 ± 0.947 (t = 22.605, P = 0.016) and the PD value was (4.579 ± 0.475) mm (t = 4.709, P < 0.001). @*Conclusion@#A digital surgical guide plate can increase the precision of immediate implantation and the peri-implant health in the molar area.
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Objective To compare the operative precision between pioneer drilling guiding and full navigation guiding plates in the flapless immediate implantation. Methods Data of 50 immediate implants, which were implanted from 47 outpatients (50 implants) of Tianjin Stomatological Hospital from 2014 to 2016 were retrospectively analyzed. The patients were conducted on the pioneer drilling guiding system (22 implants) and full navigation guiding sytem (28 implants). The cone beam CT (CBCT) was preliminarily taken and modeled for each patient. All of the patients underwent implant surgery after making guiding plates by three-dimensional reconstruction, simulation planting design and the application of digital rapid prototyping technology. Cavity preparations were made by pioneer drilling and full navigation assisted with planting drills respectively to finish implantation. The post-operative CBCT was taken and performed the three-dimensional reconstruction. The implantation precision guiding by two systems were compared. Results All of the 50 immediate implants were successfully completed with the guiding plates. Implant mucositis appeared in one case after 3 months of temporary repair, and after the targeted therapy, the final repair was finished. The rest cases were finally completed. No implant was loose or fell off. The deviation was less in neck apex and root apex angle in full navigation group than that of pioneer drilling guiding group (P<0.01). But there was no significant difference in axial angle between the two groups after navigation and implantation (P>0.05). Conclusion The digital surgical guiding plates provide nice technical support for the application of the flapless immediate implantation. And the full navigation system has higher precision than that of the pioneer drilling navigation system.
ABSTRACT
Objective To compare the operative precision between pioneer drilling guiding and full navigation guiding plates in the flapless immediate implantation. Methods Data of 50 immediate implants, which were implanted from 47 outpatients (50 implants) of Tianjin Stomatological Hospital from 2014 to 2016 were retrospectively analyzed. The patients were conducted on the pioneer drilling guiding system (22 implants) and full navigation guiding sytem (28 implants). The cone beam CT (CBCT) was preliminarily taken and modeled for each patient. All of the patients underwent implant surgery after making guiding plates by three-dimensional reconstruction, simulation planting design and the application of digital rapid prototyping technology. Cavity preparations were made by pioneer drilling and full navigation assisted with planting drills respectively to finish implantation. The post-operative CBCT was taken and performed the three-dimensional reconstruction. The implantation precision guiding by two systems were compared. Results All of the 50 immediate implants were successfully completed with the guiding plates. Implant mucositis appeared in one case after 3 months of temporary repair, and after the targeted therapy, the final repair was finished. The rest cases were finally completed. No implant was loose or fell off. The deviation was less in neck apex and root apex angle in full navigation group than that of pioneer drilling guiding group (P<0.01). But there was no significant difference in axial angle between the two groups after navigation and implantation (P>0.05). Conclusion The digital surgical guiding plates provide nice technical support for the application of the flapless immediate implantation. And the full navigation system has higher precision than that of the pioneer drilling navigation system.