In-vitro study on the accuracy of a simple-design CT-guided stent for dental implants
Identifieur interne : 001E26 ( Pmc/Checkpoint ); précédent : 001E25; suivant : 001E27In-vitro study on the accuracy of a simple-design CT-guided stent for dental implants
Auteurs : Young-June Huh [Corée du Sud] ; Bo-Ram Choi [Corée du Sud] ; Kyung-Hoe Huh [Corée du Sud] ; Won-Jin Yi [Corée du Sud] ; Min-Suk Heo [Corée du Sud] ; Sam-Sun Lee [Corée du Sud] ; Soon-Chul Choi [Corée du Sud]Source :
- Imaging Science in Dentistry [ 2233-7822 ] ; 2012.
Abstract
An individual surgical stent fabricated from computed tomography (CT) data, called a CT-guided stent, would be useful for accurate installation of implants. The purpose of the present study was to introduce a newly developed CT-guided stent with a simple design and evaluate the accuracy of the stent placement.
A resin template was fabricated from a hog mandible and a specially designed plastic plate, with 4 metal balls inserted in it for radiographic recognition, was attached to the occlusal surface of the template. With the surgical stent applied, CT images were taken, and virtual implants were placed using software. The spatial positions of the virtually positioned implants were acquired and implant guiding holes were drilled into the surgical stent using a specially designed 5-axis drilling machine. The surgical stent was placed on the mandible and CT images were taken again. The discrepancy between the central axis of the drilled holes on the second CT images and the virtually installed implants on the first CT images was evaluated.
The deviation of the entry point and angulation of the central axis in the reference plane were 0.47±0.27 mm, 0.57±0.23 mm, and 0.64±0.16°, 0.57±0.15°, respectively. However, for the two different angulations in each group, the 20° angulation showed a greater error in the deviation of the entry point than did the 10° angulation.
The CT-guided template proposed in this study was highly accurate. It could replace existing implant guide systems to reduce costs and effort.
Url:
DOI: 10.5624/isd.2012.42.3.139
PubMed: 23071963
PubMed Central: 3465755
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Research Institute, School of Dentistry, Seoul National University, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region><settlement type="city">Séoul</settlement></placeName><orgName type="university">Université nationale de Séoul</orgName></affiliation></author><author><name sortKey="Yi, Won Jin" sort="Yi, Won Jin" uniqKey="Yi W" first="Won-Jin" last="Yi">Won-Jin Yi</name><affiliation wicri:level="4"><nlm:aff id="A2">Department of Oral and Maxillofacial Radiology, Dental Research Institute and BK21 Craniomaxillofacial Life Science, School of Dentistry, Seoul National University, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du 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June" sort="Huh, Young June" uniqKey="Huh Y" first="Young-June" last="Huh">Young-June Huh</name><affiliation wicri:level="4"><nlm:aff id="A1">Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region><settlement type="city">Séoul</settlement></placeName><orgName type="university">Université nationale de Séoul</orgName></affiliation></author><author><name sortKey="Choi, Bo Ram" sort="Choi, Bo Ram" uniqKey="Choi B" first="Bo-Ram" last="Choi">Bo-Ram Choi</name><affiliation wicri:level="4"><nlm:aff id="A1">Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region><settlement type="city">Séoul</settlement></placeName><orgName type="university">Université nationale de Séoul</orgName></affiliation></author><author><name sortKey="Huh, Kyung Hoe" sort="Huh, Kyung Hoe" uniqKey="Huh K" first="Kyung-Hoe" last="Huh">Kyung-Hoe Huh</name><affiliation wicri:level="4"><nlm:aff id="A1">Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region><settlement type="city">Séoul</settlement></placeName><orgName type="university">Université nationale de Séoul</orgName></affiliation></author><author><name sortKey="Yi, Won Jin" sort="Yi, Won Jin" uniqKey="Yi W" first="Won-Jin" last="Yi">Won-Jin Yi</name><affiliation wicri:level="4"><nlm:aff id="A2">Department of Oral and Maxillofacial Radiology, Dental Research Institute and BK21 Craniomaxillofacial Life Science, School of Dentistry, Seoul National University, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Oral and Maxillofacial Radiology, Dental Research Institute and BK21 Craniomaxillofacial Life Science, School of Dentistry, Seoul National University, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region><settlement type="city">Séoul</settlement></placeName><orgName type="university">Université nationale de Séoul</orgName></affiliation></author><author><name sortKey="Heo, Min Suk" sort="Heo, Min Suk" uniqKey="Heo M" first="Min-Suk" last="Heo">Min-Suk Heo</name><affiliation wicri:level="4"><nlm:aff id="A1">Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region><settlement type="city">Séoul</settlement></placeName><orgName type="university">Université nationale de Séoul</orgName></affiliation></author><author><name sortKey="Lee, Sam Sun" sort="Lee, Sam Sun" uniqKey="Lee S" first="Sam-Sun" last="Lee">Sam-Sun Lee</name><affiliation wicri:level="4"><nlm:aff id="A2">Department of Oral and Maxillofacial Radiology, Dental Research Institute and BK21 Craniomaxillofacial Life Science, School of Dentistry, Seoul National University, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Oral and Maxillofacial Radiology, Dental Research Institute and BK21 Craniomaxillofacial Life Science, School of Dentistry, Seoul National University, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region><settlement type="city">Séoul</settlement></placeName><orgName type="university">Université nationale de Séoul</orgName></affiliation></author><author><name sortKey="Choi, Soon Chul" sort="Choi, Soon Chul" uniqKey="Choi S" first="Soon-Chul" last="Choi">Soon-Chul Choi</name><affiliation wicri:level="4"><nlm:aff id="A1">Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region><settlement type="city">Séoul</settlement></placeName><orgName type="university">Université nationale de Séoul</orgName></affiliation></author></analytic><series><title level="j">Imaging Science in Dentistry</title><idno type="ISSN">2233-7822</idno><idno type="eISSN">2233-7830</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Purpose</title><p>An individual surgical stent fabricated from computed tomography (CT) data, called a CT-guided stent, would be useful for accurate installation of implants. The purpose of the present study was to introduce a newly developed CT-guided stent with a simple design and evaluate the accuracy of the stent placement.</p></sec><sec><title>Materials and Methods</title><p>A resin template was fabricated from a hog mandible and a specially designed plastic plate, with 4 metal balls inserted in it for radiographic recognition, was attached to the occlusal surface of the template. With the surgical stent applied, CT images were taken, and virtual implants were placed using software. The spatial positions of the virtually positioned implants were acquired and implant guiding holes were drilled into the surgical stent using a specially designed 5-axis drilling machine. The surgical stent was placed on the mandible and CT images were taken again. The discrepancy between the central axis of the drilled holes on the second CT images and the virtually installed implants on the first CT images was evaluated.</p></sec><sec><title>Results</title><p>The deviation of the entry point and angulation of the central axis in the reference plane were 0.47±0.27 mm, 0.57±0.23 mm, and 0.64±0.16°, 0.57±0.15°, respectively. However, for the two different angulations in each group, the 20° angulation showed a greater error in the deviation of the entry point than did the 10° angulation.</p></sec><sec><title>Conclusion</title><p>The CT-guided template proposed in this study was highly accurate. It could replace existing implant guide systems to reduce costs and effort.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Branemark, Pi" uniqKey="Branemark P">PI Branemark</name></author><author><name sortKey="Adell, R" uniqKey="Adell R">R Adell</name></author><author><name sortKey="Breine, U" uniqKey="Breine U">U Breine</name></author><author><name sortKey="Hansson, Bo" uniqKey="Hansson B">BO Hansson</name></author><author><name sortKey="Lindstrom, J" uniqKey="Lindstrom J">J Lindstrom</name></author><author><name sortKey="Ohlsson, A" uniqKey="Ohlsson A">A Ohlsson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Israelson, H" uniqKey="Israelson H">H Israelson</name></author><author><name sortKey="Plemons, Jm" uniqKey="Plemons J">JM Plemons</name></author><author><name sortKey="Watkins, P" uniqKey="Watkins P">P Watkins</name></author><author><name sortKey="Sory, C" uniqKey="Sory C">C 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Imaging Sci Dent</journal-id><journal-id journal-id-type="iso-abbrev">Imaging Sci Dent</journal-id><journal-id journal-id-type="publisher-id">ISD</journal-id><journal-title-group><journal-title>Imaging Science in Dentistry</journal-title></journal-title-group><issn pub-type="ppub">2233-7822</issn><issn pub-type="epub">2233-7830</issn><publisher><publisher-name>Korean Academy of Oral and Maxillofacial Radiology</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">23071963</article-id><article-id pub-id-type="pmc">3465755</article-id><article-id pub-id-type="doi">10.5624/isd.2012.42.3.139</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Article</subject></subj-group></article-categories><title-group><article-title>In-vitro study on the accuracy of a simple-design CT-guided stent for dental implants</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Huh</surname><given-names>Young-June</given-names></name><xref ref-type="aff" rid="A1"></xref></contrib><contrib contrib-type="author"><name><surname>Choi</surname><given-names>Bo-Ram</given-names></name><xref ref-type="aff" rid="A1"></xref></contrib><contrib contrib-type="author"><name><surname>Huh</surname><given-names>Kyung-Hoe</given-names></name><xref ref-type="aff" rid="A1"></xref></contrib><contrib contrib-type="author"><name><surname>Yi</surname><given-names>Won-Jin</given-names></name><xref ref-type="aff" rid="A2">*</xref></contrib><contrib contrib-type="author"><name><surname>Heo</surname><given-names>Min-Suk</given-names></name><xref ref-type="aff" rid="A1"></xref></contrib><contrib contrib-type="author"><name><surname>Lee</surname><given-names>Sam-Sun</given-names></name><xref ref-type="aff" rid="A2">*</xref></contrib><contrib contrib-type="author" corresp="yes"><name><surname>Choi</surname><given-names>Soon-Chul</given-names></name><xref ref-type="aff" rid="A1"></xref></contrib></contrib-group><aff id="A1">Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea.</aff><aff id="A2"><label>*</label>Department of Oral and Maxillofacial Radiology, Dental Research Institute and BK21 Craniomaxillofacial Life Science, School of Dentistry, Seoul National University, Seoul, Korea.</aff><author-notes><corresp>Correspondence to: Prof. Soon-Chul Choi. Department of Oral and Maxillofacial Radiology, School of Dentistry, Seoul National University, 28 Yeongeon-dong, Jongno-gu, Seoul 110-768, Korea. Tel) 82-2-2072-2622, Fax) 82-2-744-3919, <email>raychoi@snu.ac.kr</email></corresp></author-notes><pub-date pub-type="ppub"><month>9</month><year>2012</year></pub-date><pub-date pub-type="epub"><day>21</day><month>9</month><year>2012</year></pub-date><volume>42</volume><issue>3</issue><fpage>139</fpage><lpage>146</lpage><history><date date-type="received"><day>20</day><month>3</month><year>2012</year></date><date date-type="rev-recd"><day>01</day><month>6</month><year>2012</year></date><date date-type="accepted"><day>16</day><month>6</month><year>2012</year></date></history><permissions><copyright-statement>Copyright © 2012 by Korean Academy of Oral and Maxillofacial Radiology</copyright-statement><copyright-year>2012</copyright-year><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc/3.0"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/3.0">http://creativecommons.org/licenses/by-nc/3.0</ext-link>) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><sec><title>Purpose</title><p>An individual surgical stent fabricated from computed tomography (CT) data, called a CT-guided stent, would be useful for accurate installation of implants. The purpose of the present study was to introduce a newly developed CT-guided stent with a simple design and evaluate the accuracy of the stent placement.</p></sec><sec><title>Materials and Methods</title><p>A resin template was fabricated from a hog mandible and a specially designed plastic plate, with 4 metal balls inserted in it for radiographic recognition, was attached to the occlusal surface of the template. With the surgical stent applied, CT images were taken, and virtual implants were placed using software. The spatial positions of the virtually positioned implants were acquired and implant guiding holes were drilled into the surgical stent using a specially designed 5-axis drilling machine. The surgical stent was placed on the mandible and CT images were taken again. The discrepancy between the central axis of the drilled holes on the second CT images and the virtually installed implants on the first CT images was evaluated.</p></sec><sec><title>Results</title><p>The deviation of the entry point and angulation of the central axis in the reference plane were 0.47±0.27 mm, 0.57±0.23 mm, and 0.64±0.16°, 0.57±0.15°, respectively. However, for the two different angulations in each group, the 20° angulation showed a greater error in the deviation of the entry point than did the 10° angulation.</p></sec><sec><title>Conclusion</title><p>The CT-guided template proposed in this study was highly accurate. It could replace existing implant guide systems to reduce costs and effort.</p></sec></abstract><kwd-group><kwd>Computer-Assisted Diagnosis</kwd><kwd>Dental Implant</kwd><kwd>Tomography, X-Ray Computed</kwd><kwd>In Vitro</kwd></kwd-group></article-meta></front><floats-group><fig id="F1" position="float"><label>Fig. 1</label><caption><p>Plastic plate for determination of a reference plane. For radiographic recognition, 4 metal balls (2 mm in diameter) are inserted in each of the 4 corners of the plate 2 mm away from the edge of the plate.</p></caption><graphic xlink:href="isd-42-139-g001"></graphic></fig><fig id="F2" position="float"><label>Fig. 2</label><caption><p>Implant planning procedure using V-Implant software.</p></caption><graphic xlink:href="isd-42-139-g002"></graphic></fig><fig id="F3" position="float"><label>Fig. 3</label><caption><p>The reference XOY-plane determined on the plastic plate to calculate the relative position and angulation of the virtual implant.</p></caption><graphic xlink:href="isd-42-139-g003"></graphic></fig><fig id="F4" position="float"><label>Fig. 4</label><caption><p>These illustrations show the procedure for the determination of the position and angle of the virtual implant. The insertion point P (x, y) is determined by the crossing point between the axis of the virtual implant and the XOY-plane, and ∠X (Xθ) and ∠Y (Yθ) are defined as the degree from the X- and Y-axis, respectively.</p></caption><graphic xlink:href="isd-42-139-g004"></graphic></fig><fig id="F5" position="float"><label>Fig. 5</label><caption><p>At the insertion points P (x, y), ∠X(Xθ) and ∠Y(Yθ) are calculated automatically by the software.</p></caption><graphic xlink:href="isd-42-139-g005"></graphic></fig><fig id="F6" position="float"><label>Fig. 6</label><caption><p>A. The specially designed 5-axis drill machine. B. By moving and rotating the table of the machine, a guide hole is made reflecting the determined implant axis.</p></caption><graphic xlink:href="isd-42-139-g006"></graphic></fig><fig id="F7" position="float"><label>Fig. 7</label><caption><p>A. The guide hole is shown as the black cylindrical area on the CT image. The virtual implant is placed into the guide hole on the software. B. After confirming the virtually positioned implants to be placed exactly into the guide hole, the position and the angulation of the central axis of the implant are calculated.</p></caption><graphic xlink:href="isd-42-139-g007"></graphic></fig><table-wrap id="T1" position="float"><label>Table 1</label><caption><p>Discrepancy of the insertion point in the X and Y coordinates and the angle for each group</p></caption><graphic xlink:href="isd-42-139-i001"></graphic><table-wrap-foot><fn><p>ΔX and ΔY represent the discrepancy of the entry point in the X and Y coordinates, respectively. ΔXθ and ΔYθ represent the discrepancy of the angle according to the X-axis and Y-axis, respectively. P: perpendicular, B: buccal, L: lingual, M: mesial, D: distal</p></fn></table-wrap-foot></table-wrap></floats-group></pmc><affiliations><list><country><li>Corée du Sud</li></country><region><li>Région capitale de Séoul</li></region><settlement><li>Séoul</li></settlement><orgName><li>Université nationale de Séoul</li></orgName></list><tree><country name="Corée du Sud"><region name="Région capitale de Séoul"><name sortKey="Huh, Young June" sort="Huh, Young June" uniqKey="Huh Y" first="Young-June" last="Huh">Young-June Huh</name></region><name sortKey="Choi, Bo Ram" sort="Choi, Bo Ram" uniqKey="Choi B" first="Bo-Ram" last="Choi">Bo-Ram Choi</name><name sortKey="Choi, Soon Chul" sort="Choi, Soon Chul" uniqKey="Choi S" first="Soon-Chul" last="Choi">Soon-Chul Choi</name><name sortKey="Heo, Min Suk" sort="Heo, Min Suk" uniqKey="Heo M" first="Min-Suk" last="Heo">Min-Suk Heo</name><name sortKey="Huh, Kyung Hoe" sort="Huh, Kyung Hoe" uniqKey="Huh K" first="Kyung-Hoe" last="Huh">Kyung-Hoe Huh</name><name sortKey="Lee, Sam Sun" sort="Lee, Sam Sun" uniqKey="Lee S" first="Sam-Sun" last="Lee">Sam-Sun Lee</name><name sortKey="Yi, Won Jin" sort="Yi, Won Jin" uniqKey="Yi W" first="Won-Jin" last="Yi">Won-Jin Yi</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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