ABSTRACT
BACKGROUND: Computer-aided dental implant placement seems to be useful for placing implants by using a flapless approach. However, evidence supporting such applications is scarce. The aim of this study is to evaluate the accuracy of and complications that arise from the use of selective laser sintering surgical guides for flapless dental implant placement and immediate definitive prosthesis installation. METHODS: Sixty implants and 12 prostheses were installed in 12 patients (four males and eight females; age range: 41 to 71 years). Lateral (coronal and apical) and angular deviations between virtually planned and placed implants were measured. The patients were followed up for 30 months, and surgical and prosthetic complications were documented. RESULTS: The mean ± SD angular, coronal, and apical deviations were 6.53° ± 4.31°, 1.35 ± 0.65 mm, and 1.79 ± 1.01 mm, respectively. Coronal and apical deviations of <2 mm were observed in 82.67% and 58.33% of the implants, respectively. The total complication rate was 34.41%; this rate pertained to complications such as pulling of the soft tissue from the lingual surface during drilling, insertion of an implant that was wider than planned, implant instability, prolonged pain, midline deviation of the prosthesis, and prosthesis fracture. The cumulative survival rates for implants and prostheses were 98.33% and 91.66%, respectively. CONCLUSIONS: The mean lateral deviation was <1.8 mm, and the mean angular deviation was 6.53°. However, 41.67% of the implants had apical deviation >2 mm. The complication rate was 34.4%. Hence, computer-aided dental implant surgery still requires improvement and should be considered as in the developmental stage.
Subject(s)
Computer-Aided Design , Dental Implantation, Endosseous/instrumentation , Immediate Dental Implant Loading/methods , Lasers , Postoperative Complications , Surgery, Computer-Assisted/methods , Adult , Aged , Cone-Beam Computed Tomography/methods , Dental Arch/pathology , Dental Implants , Dental Prosthesis, Implant-Supported , Dental Restoration Failure , Female , Follow-Up Studies , Gingivitis/etiology , Humans , Jaw Relation Record/instrumentation , Male , Middle Aged , Osseointegration/physiology , Pain, Postoperative/etiology , Patient Care Planning , Prospective Studies , Tomography, X-Ray Computed/methods , User-Computer InterfaceABSTRACT
Aim: To evaluate 10 years of experience of use of biomodels at the Department of Oral andMaxillofacial Surgery of the Piracicaba Dental School, University of Campinas (UNICAMP),Brazil, showing the difficulties and importance of using biomodels in a public oral and maxillofacialsurgery service. Methods: The records of all patients treated at the referred Department of Oraland Maxillofacial Surgery between January 2000 and December 2010 were reviewed. Results:Biomodels were used in 63 cases, including pathologies (47%), trauma sequelae (23%),dentofacial deformities (8%), temporomandibular joint anomalies (8%), implant surgery (8%)and maxillofacial prosthesis (6%). These cases were performed in a partnership with RenatoArcher Information of Technology Center CTI, Campinas, Brazil. Conclusions: The partnershipwith CTI enables the use of prototypes for treatment planning of patients of a public health systemusing selective laser sintering, a cheaper prototyping method. The patients can benefit from thistechnology, without any costs for them.
Subject(s)
Health Planning , Technology Assessment, BiomedicalABSTRACT
PURPOSE: To quantify the amount of bone formation in the calvarial region of Wistar rats after craniotomy using bone wax as a haemostatic agent. METHODS: Surgery to produce bilateral, symmetric, full-thickness cranial defects (area: 18 mm(2)) was performed in eight animals. The right side of the cranium remained open and the edges of the left side osseous defect was covered with bone wax. Calvaria were imaged immediately after surgery and 12 weeks postoperatively by computerized tomography. The areas of the bone defects were measured in three-dimensional images using Magics 13.0 (Materialise-Belgic, software CAD). RESULTS: The average amount of bone formation on the left and right side respectively was 4.85 mm(2) and 8.16 mm(2). Statistically significant differences between the amount of bone formation on the left and right sides were seen. CONCLUSIONS: Bone wax significantly diminishes the rate of bone formation in calvarial defects in a rat model.
Subject(s)
Hemostatics/pharmacology , Osteogenesis/drug effects , Palmitates/pharmacology , Skull/surgery , Waxes/pharmacology , Wound Healing/drug effects , Animals , Cephalometry , Disease Models, Animal , Inflammation/pathology , Male , Osteogenesis/physiology , Photomicrography , Rats , Rats, Wistar , Skull/diagnostic imaging , Skull/injuries , Time Factors , Tomography, X-Ray Computed , Wound Healing/physiologyABSTRACT
PURPOSE: To quantify the amount of bone formation in the calvarial region of Wistar rats after craniotomy using bone wax as a haemostatic agent. METHODS: Surgery to produce bilateral, symmetric, full-thickness cranial defects (area: 18 mm²) was performed in eight animals. The right side of the cranium remained open and the edges of the left side osseous defect was covered with bone wax. Calvaria were imaged immediately after surgery and 12 weeks postoperatively by computerized tomography. The areas of the bone defects were measured in three-dimensional images using Magics 13.0 (Materialise-Belgic, software CAD). RESULTS: The average amount of bone formation on the left and right side respectively was 4.85 mm² and 8.16 mm². Statistically significant differences between the amount of bone formation on the left and right sides were seen. CONCLUSIONS: Bone wax significantly diminishes the rate of bone formation in calvarial defects in a rat model.
OBJETIVO: Quantificar a formação óssea da região da calvaria de ratos Wistar submetidos à craniotomia com a utilização de cera de osso como agente hemostático. MÉTODOS: Cirurgia para realizar um defeito ósseo craniano bilateral, simétrico (área: 18 mm²) e com espessura total foi realizado em oito animais. O lado direito do crânio permaneceu aberto e as extremidades do defeito ósseo do lado esquerdo foram recobertas com cera de osso. O crânio foi submetido à avaliação radiológica imediatamente após a cirurgia e 12 semanas após a cirurgia com a utilização de tomografia computadorizada. As áreas dos defeitos ósseos foram medidas através de imagens tridimensionais e utilizando o programa de computador Magics 13.0 (Materialise-Belgic, software CAD). RESULTADOS: A quantidade média de formação óssea no lado esquerdo e direito foi respectivamente de 4.85 mm² e 8.16 mm². Diferença estatisticamente significante foi observada entre o lado direito e esquerdo. CONCLUSÕES: A cera de osso diminuiu significativamente a formação óssea nos defeitos ósseos em modelo animal.
Subject(s)
Animals , Male , Rats , Hemostatics/pharmacology , Osteogenesis/drug effects , Palmitates/pharmacology , Skull/surgery , Waxes/pharmacology , Wound Healing/drug effects , Cephalometry , Disease Models, Animal , Inflammation/pathology , Osteogenesis/physiology , Photomicrography , Rats, Wistar , Skull/injuries , Skull , Time Factors , Tomography, X-Ray Computed , Wound Healing/physiologyABSTRACT
O artigo descreve a técnica de cirurgia guiada sem retalho gengival com carga imediata provisória e subsequente avaliação do posicionamento dos implantes instalados. Material e Métodos: Paciente de 54 anos com maxila e dentula com enxerto bilateral dos seios maxilares. O planejamento cirúrgico foi realizado em software a partir dos dados da Tomografia Computadorizada Conebeam (TCCB). Estes dados foram editados para geração da guia cirúrgica virtual e com a tecnologia de prototipagem rápida foram produzidos dois protótipos. O primeiro da maxila com o arco dental para produção da estrutura da prótese fixa provisória e o segundo da guia cirúrgica, que orientou a fresagem e a colocação de seis implantes. Ao final da cirurgia a prótese provisória foi instalada. As imagens da TCCB pós-operatória foram sobrepostas às imagens do planejamento para mensuração das discrepâncias entre as posições dos implantes pré e pós-operatórios. Resultados: Em 2,5 horas seis implantes e a prótese fixa provisória foram instalados com sucesso. Os desvios médios foram: 0,64mm (OP ± 0,32mm) na região coronal; 1,22mm (OP ± 0,63) na região apical e 4,83 graus (OP ± 1,77) no desvio angular. Conclusão: Neste caso clínico. a técnica proporcionou, com sucesso, a reabilitação com implantes e prótese fixa provisória em carga imediata em 2,5 horas. Os desvios no posicionamento dos implantes estão dentro da variação encontrada na literatura.
The article describes the technique of flapless surgery with immediate load. Methods: The subject was a 54 year-old female patient with edentulous maxilla. Eight months before the surgerya sinus lifting was done with autogenous bone. The surgical planning was made in sof- tware using cone beam computerized tomography (CBCT) data.lt was edited to create two rapid prototype models, one for the maxilla with the dental arc and the other was the surgical guide. The first model was used to produce the temporary prosthesis, and the surgical template guided the drilling and placement of six implants. At the end of the surgery the prosthesis was fixed. The postoperative image was fused with the planning one to measure the linear and angular differences. Results: In two and half hours the implants and the fixed temporary prosthesis were successfully installed. The mean deviations were : 0,64mm (50 ± 0,32mm) in coronal position and 1,22mm (50 ± 0,63) in apex position, and the angular deviations was 4,83 degress (OP ± 1,77). Conclusion: Within a limited sample, this technique ma de the oral rehabilitation in two and hours possible. The deviations found are within the one in the literature.
