Computer guided pre-operative planning and dental implant placement
Abstract
Background: Implants in dentistry are, besides fixed, removable and maxillofacial prosthodontics, one of the reliable possibility to make functional and aesthetic rehabilitation of the edentulism. Surgical and prosthodontic implant complications are often an inattentive consequence of wrong diagnosis, planning, and placement. In this article we present a technique using a highly advanced software program along with a rapid prototyping technology named stereolithography. A planning software for implant placement needs basically the high quality computed tomographic scan of one or both jaws for making accurate preoperative diagnostics and 3D preoperative plan. Later individual drill guide is designed and generated based on both the CT images and the preoperative planning. The patient specific drill guide transfers the virtual planning to the patient’s mouth at time of surgery.
Conclusions: The advantages of computer guided implantology are the better prepared surgery with visualisation of critical anatomic structures, assessment of available bone and data about bone quality, increased confidence for the surgeon, deceased operative time, less frequent use of bone grafts, higher quality of collaboration between specialists and prosthetic lab and better communication with patients. Radiographic examination of the operation field for computer guided planning for implant placement is due to high costs justified as the most important information source on the areas to be implanted.
Downloads
References
Adell R, Eriksson B, Lekholm U, Branemark PI, Jemt T. Longterm follow-up study of osseointegrated implants in the treatment of totally edentulous jaws. Int J Oral Maxillofac Implants 1990; 5: 347–59.
Rode M, Marion L, Kogoj-Rode M. Izkušnje z enosealnimi dentalnimi implantati. Zobozdrav Vestn 1995; 50: 196–9.
Žerdoner D, Rode M. Uporaba dentalnih implantatov F-2 (FRIATEC) v protetični rehabilitaciji. Zdrav Vestn 1997; 66: 433–4.
Ihan-Hren N, Gorjanc M, Kansky AA. Uspešnost vsadkov v brezzobih čeljustih. Zobozdrav Vestn 2002; 57: 9–14.
Mericske-Stern R. Ist Alter eine Barriere für Implantate? Eine kurze Übersicht. Quintessenz 2006; 57: 23–32.
Jacobs R, van Steenberghe D. Radiographic planning and assessment of endosseous oral implant, 1st ed. Berlin: Springer- Verlag, 1998.
Marion L, Rode M, Knez H. Načrtovanje implantno-protetične oskrbe. Zobozdrav Vestn 1995; 50: 191-5.
Jacobs R. Preoperative radiologic planning of implant surgery in compromised patients. Periodontol 2003; 33: 12–25.
Jabero M, Sarment DP. Advanced surgical guidance technology: a review. Implant Dent 2006; 15: 135–42.
Sotošek B. Nekatere novejše rentgenske slikovne metode v maksilofacialnem področju. Zobozdrav Vestn 1988; 43: 129–32.
Longar M, Fidler A. Računalniška tomografija in klasične rentgenske preiskave v stomatologiji. Zobozdrav Vestn 2004; 59: 45–
Hatcher DC, Dial C, Mayorga C. Cone beam CT for pre-surgical assessment of implant sites. J Calif Dent Assoc 2003; 31: 825–33.
Araki K, Maki K, Seki K, Sakamaki K, Harata Y, Sakaino R, Okano T, Seo K. Characteristics of a newly developed dentomaxillofacial X-ray cone beam CT scanner (CB MercuRay): system configuration and physical properties. Dentomaxillofac Radiol 2004; 33: 51–9.
Loubele M, Maes F, Schutyser F, Marchal G, Jacobs R, Suetens P. Assessment of bone segmentation quality of cone-beam CT versus multislice spiral CT: a pilot study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006; 102: 225–34.
Allen F, Smith DG. An assessment of the accuracy of ridge-mapping in planning implant therapy for the anterior maxilla. Clin Oral Implants Res 2000; 11: 34–8.
Jacobs H, Adriansens A, Verstreken K, Stuetens P, Van Steenberghe D. Predictability of a three-dimensional planning system for oral implant surgery. Dentomaxillofacial Radiology 1999; 28: 105–11.
Dixon DR, Morgan R, Hollender LG, Roberts FA, O’Neal RB. Clinical application of spiral tomography in anterior implant placement: case report. J Periodontol 2002; 73: 1202–9.
Šurlan-Popovič K. Radiološka diagnostika cist. In: Ihan-Hren N, ed. Ciste v čeljustih. Zbornik predavanj 11. Čelešnikovi dnevi, strokovni seminar; 2004 Nov 27; Ljubljana. Ljubljana: Klinični center, Klinični oddelek za maksilofacialno in oralno kirurgijo, 2004; 7–9.
Caldwell CS. Practical incorporation of computed tomography into daily implant treatment planning. Tex Dent J 2005; 122: 343–54.
Lal K, White GS, Morea DN, Wright RF. Use of stereolithographic templates for surgical and prosthodontic implant planning and placement. Part I. The concept. J Prosthodont 2006; 15: 51–8.
Al-Faraje L. The benefits of computer-guided implantology & SurgiGuides in treating patients with advanced alveolar bone resorption. Materialise Head Lines 2003; 5: 1-3. Dosegljivo na: http://WWW.MATERIALISE.COM
Anonymous. The SimPlant and SurgiGuide Process. Materialise Medical 1-25. Dosegljivo na: http://WWW.MATERIALISE.COM
Van Steenberghe D, Naert I, Jacobs R, Quirynen M. Influence of inflammatory reactions vs. occlusal loading on peri-implant marginal bone level. Adv Dent Res 1999; 13: 130–5.
Smet MH. Three-dimensional skeletal visualisation with spiral computed tomography. J Belge Radiol 1998; 81: 23.
Sarment DP, Sukovic P, Clinthorne N. Accuracy of implant placement with a stereolithographic surgical guide. Int J Oral Maxillofac Implants 2003; 18: 571–7.
Sojar V, Stanisavljevič D, Hribernik M, Glušič M, Kreuh D, Velkavrh U, Fius T. Načrtovanje kirurških posegov na jetrih v 3D prostoru navidezne resničnosti. In: Repše S, Stanisavljevič D, eds. Zbornik simpozija Kirurgija jeter in vranice; 2004; Ljubljana. Ljubljana: Kirurška šola, Klinični oddelek za obdominalno kirurgijo, 2004; 14–23.
Tardieu PB, Vrielinck L, Escolano E. Computer-assisted implant placement. A case report: treatment of the mandible. Int J Oral Maxillofac Implants 2003; 18: 599–604.
Mischkowski RA, Zinser MJ, Neugebauer J, Kubler AC, Zoller JE. Comparison of static and dynamic computer-assisted guidance methods in implantology. Int J Comput Dent 2006; 9: 23–35.
Held U, Metzger M, Schmelzeisen R. Das »Teeth-in-an-Hour«-Konzept eine Fallpräsentation. Quintessenz 2005; 56: 1105–9.
Luckey R. Implantatpositionierung mit dem Navigationssystem RoboDent in der Oberkieferprämolarenregion eine retrospektive Analyse. Quintessenz 2006; 57: 229–37.
Pistorius A, Patrosio C, Willershausen B, Mildenberger P, Rippen G. Periodontal probing in comparison to diagnosis by CTscan. Int Dent J 2001; 51: 339–47.
Mol A. Imaging methods in periodontology. Periodontol 2004; 34: 34–48.
Götte H. Implantate: Kugeln zur Lokalisierung von Schnittebenen für transversale Schichtaufnahmen. Quintessenz 2006; 57: 773–8.
Van Steenberghe D, Glauser R, Blomback U, Andersson M, Schutyser F, Pettersson A, Wendelhag I. A computed tomographic scan-derived customized surgical template and fixed prosthesis for flapless surgery and immediate loading of implants in fully edentulous maxillae: a prospective multicenter study. Clin Implant Dent Relat Res 2005; 7 Suppl 1: 111–20.
The Author transfers to the Publisher (Zdravniški vestnik/Slovenian Medical Journal) all economic copyrights following form Article 22 of the Slovene Copyright and Related Rights Act (ZASP), including the right of reproduction, the right of distribution, the rental right, the right of public performance, the right of public transmission, the right of public communication by means of phonograms and videograms, the right of public presentation, the right of broadcasting, the right of rebroadcasting, the right of secondary broadcasting, the right of communication to the public, the right of transformation, the right of audiovisual adaptation and all other rights of the author according to ZASP.
The aforementioned rights are transferred non-exclusively, for an unlimited number of editions, for the term of the statutory
The Author can make use of his work himself or transfer subjective rights to others only after 3 months from date of first publishing in the journal Zdravniški vestnik/Slovenian Medical Journal.
The Publisher (Zdravniški vestnik/Slovenian Medical Journal) has the right to transfer the rights, acquired parties without explicit consent of the Author.
The Author consents that the Article be published under the Creative Commons BY-NC 4.0 (attribution-non-commercial) or comparable licence.
