ABSTRACT
PURPOSE: To describe a chairside method for producing implant guides based solely on digital data and present a first assessment of in vitro accuracy on plaster models. MATERIAL AND METHODS: Twenty-four implants were planned and pilot drillings were performed according to a new protocol, which is based on the registration of CBCT and CAD/CAM data. Chairside-milled one-piece drill guides were used to transfer the virtual plan into reality. Accuracy measurements were acquired. RESULTS: Chairside-milled drill guides were successfully fabricated and accuracy for pilot drillings was between 0.17 and 1.3 mm. CONCLUSION: Within the limits of this experimental study, chairside-milled drill guides are feasible and do not require any preparation before CBCT scanning.
Subject(s)
Computer-Aided Design , Dental Implantation, Endosseous/instrumentation , Dental Implants , Point-of-Care Systems , Composite Resins/chemistry , Computer-Aided Design/standards , Cone-Beam Computed Tomography/methods , Dental Implants/standards , Dental Materials/chemistry , Dental Prosthesis, Implant-Supported , Denture Design , Denture, Partial, Fixed , Equipment Design/standards , Feasibility Studies , Humans , Image Processing, Computer-Assisted/methods , Models, Dental , Patient Care Planning , Point-of-Care Systems/standards , Surgery, Computer-Assisted/standards , User-Computer InterfaceABSTRACT
The greatest key to successful implant therapy is proper placement of the implant in the jaw bone. The key to proper placement is careful preoperative planning. When planning implant treatment, it is important to take the relevant anatomical features and their later prosthetic consequences into account. This is done using a radiographic template of the planned restoration, which until now had to be made by a dental technician. The radiographic template must be inserted in the patient's mouth during radiographic imaging so that the dentist can visualize the prosthetic plan. Implant planning is thus performed according to the backward planning principle. In the novel, fully digital approach to dental implant planning presented here, the prosthetic proposal is designed using computer-aided design software and integrated into a three-dimensional radiograph. This article explains how the technology works and reviews the available data. In addition, the clinical workflows for the SiCAT Optiguide and Sirona Cerec Guide virtual implant planning methods will be described and compared with conventional implant planning methods. Finally, the indications and countraindications for the two methods will be discussed.
Subject(s)
Computer-Aided Design , Cone-Beam Computed Tomography/methods , Dental Implantation, Endosseous/methods , Patient Care Planning , Surgery, Computer-Assisted/methods , Artifacts , Contraindications , Dental Implantation, Endosseous/instrumentation , Dental Impression Technique , Fiducial Markers , Humans , Image Processing, Computer-Assisted/methods , Imaging, Three-Dimensional/methods , Optical Imaging/methods , Patient Selection , Point-of-Care Systems , Software , Stents , User-Computer InterfaceABSTRACT
PURPOSE: Modern implant dentistry requires the application of torque during various treatment steps. This study investigated seven different surgical motors for the accuracy of the applied torque and their reliability. MATERIALS AND METHODS: The following surgical motors were evaluated: Chiropro 980 (Bienair), INTRAsurg 300 and INTRAsurg 500 (KaVo), Osseocare (Nobel Biocare), Surgic XT (NSK), Elcomed SA-200 C (W and H), and Osseo System (XO Dentalcare). The torque was measured during typical surgical and prosthetic procedures using a special load transfer mechanism for a torque gauge. For each setting, 30 measurements were made and means were calculated. RESULTS: The highest percentage shortfall was 20.5% at a set torque of 11.4 Ncm (absolute deviation of -2.4 Ncm). The highest percentage by which a torque was exceeded was 54.6% (absolute deviation of 5.5 Ncm). The lowest value for absolute shortfall was found to be -5.6 Ncm at a set torque of 45 Ncm. The highest absolute exceeded was 15 Ncm at a set torque of 40 Ncm. Potentially problematic torque values were identified in the low-torque-value setting, as the implant position may be changed if a machine driver applies excessive torque to the first-stage healing screw. In addition, in the indication of immediate loading in the high-set-torque group, torque values above the critical value of 50 Ncm may be unwittingly applied while working with a set torque of 40 Ncm. CONCLUSION: For most of the clinically relevant torque settings, precise values were measured, although a few devices delivered potentially problematic torque values for some of the indications.
