Accuracy Evaluation of a Stereolithographic Surgical Template for Dental Implant Insertion Using 3D Superimposition Protocol
Identifieur interne : 002E14 ( Pmc/Curation ); précédent : 002E13; suivant : 002E15Accuracy Evaluation of a Stereolithographic Surgical Template for Dental Implant Insertion Using 3D Superimposition Protocol
Auteurs : Corina Marilena Cristache [Roumanie] ; Silviu Gurbanescu [Roumanie]Source :
- International Journal of Dentistry [ 1687-8728 ] ; 2017.
Abstract
of this study was to evaluate the accuracy of a stereolithographic template, with sleeve structure incorporated into the design, for computer-guided dental implant insertion in partially edentulous patients.
Sixty-five implants were placed in twenty-five consecutive patients with a stereolithographic surgical template. After surgery, digital impression was taken and 3D inaccuracy of implants position at entry point, apex, and angle deviation was measured using an inspection tool software. Mann–Whitney
Mean (and standard deviation) of 3D error at the entry point was 0.798 mm (±0.52), at the implant apex it was 1.17 mm (±0.63), and mean angular deviation was 2.34 (±0.85). A statistically significant reduced 3D error was observed at entry point
The surgical template used has proved high accuracy for implant insertion. Within the limitations of the present study, the protocol for comparing a digital file (treatment plan) with postinsertion digital impression may be considered a useful procedure for assessing surgical template accuracy, avoiding radiation exposure, during postoperative CBCT scanning.
Url:
DOI: 10.1155/2017/4292081
PubMed: 28555157
PubMed Central: 5438863
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Accuracy Evaluation of a Stereolithographic Surgical Template for Dental Implant Insertion Using 3D Superimposition Protocol</title><author><name sortKey="Cristache, Corina Marilena" sort="Cristache, Corina Marilena" uniqKey="Cristache C" first="Corina Marilena" last="Cristache">Corina Marilena Cristache</name><affiliation wicri:level="1"><nlm:aff id="I1">Faculty of Midwifery and Medical Assisting, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania</nlm:aff><country xml:lang="fr">Roumanie</country><wicri:regionArea>Faculty of Midwifery and Medical Assisting, “Carol Davila” University of Medicine and Pharmacy, Bucharest</wicri:regionArea></affiliation></author><author><name sortKey="Gurbanescu, Silviu" sort="Gurbanescu, Silviu" uniqKey="Gurbanescu S" first="Silviu" last="Gurbanescu">Silviu Gurbanescu</name><affiliation wicri:level="1"><nlm:aff id="I2">“Carol Davila” University of Medicine and Pharmacy and Private Practice, Bucharest, Romania</nlm:aff><country xml:lang="fr">Roumanie</country><wicri:regionArea>“Carol Davila” University of Medicine and Pharmacy and Private Practice, Bucharest</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">28555157</idno><idno type="pmc">5438863</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5438863</idno><idno type="RBID">PMC:5438863</idno><idno type="doi">10.1155/2017/4292081</idno><date when="2017">2017</date><idno type="wicri:Area/Pmc/Corpus">002E14</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002E14</idno><idno type="wicri:Area/Pmc/Curation">002E14</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">002E14</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Accuracy Evaluation of a Stereolithographic Surgical Template for Dental Implant Insertion Using 3D Superimposition Protocol</title><author><name sortKey="Cristache, Corina Marilena" sort="Cristache, Corina Marilena" uniqKey="Cristache C" first="Corina Marilena" last="Cristache">Corina Marilena Cristache</name><affiliation wicri:level="1"><nlm:aff id="I1">Faculty of Midwifery and Medical Assisting, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania</nlm:aff><country xml:lang="fr">Roumanie</country><wicri:regionArea>Faculty of Midwifery and Medical Assisting, “Carol Davila” University of Medicine and Pharmacy, Bucharest</wicri:regionArea></affiliation></author><author><name sortKey="Gurbanescu, Silviu" sort="Gurbanescu, Silviu" uniqKey="Gurbanescu S" first="Silviu" last="Gurbanescu">Silviu Gurbanescu</name><affiliation wicri:level="1"><nlm:aff id="I2">“Carol Davila” University of Medicine and Pharmacy and Private Practice, Bucharest, Romania</nlm:aff><country xml:lang="fr">Roumanie</country><wicri:regionArea>“Carol Davila” University of Medicine and Pharmacy and Private Practice, Bucharest</wicri:regionArea></affiliation></author></analytic><series><title level="j">International Journal of Dentistry</title><idno type="ISSN">1687-8728</idno><idno type="eISSN">1687-8736</idno><imprint><date when="2017">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>The aim</title><p>of this study was to evaluate the accuracy of a stereolithographic template, with sleeve structure incorporated into the design, for computer-guided dental implant insertion in partially edentulous patients.</p></sec><sec><title> Materials and Methods</title><p> Sixty-five implants were placed in twenty-five consecutive patients with a stereolithographic surgical template. After surgery, digital impression was taken and 3D inaccuracy of implants position at entry point, apex, and angle deviation was measured using an inspection tool software. Mann–Whitney <italic>U</italic> test was used to compare accuracy between maxillary and mandibular surgical guides. A <italic>p</italic> value < .05 was considered significant.</p></sec><sec><title> Results</title><p> Mean (and standard deviation) of 3D error at the entry point was 0.798 mm (±0.52), at the implant apex it was 1.17 mm (±0.63), and mean angular deviation was 2.34 (±0.85). A statistically significant reduced 3D error was observed at entry point <italic>p</italic> = .037, at implant apex <italic>p</italic> = .008, and also in angular deviation <italic>p</italic> = .030 in mandible when comparing to maxilla.</p></sec><sec><title> Conclusions</title><p> The surgical template used has proved high accuracy for implant insertion. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Int J Dent</journal-id><journal-id journal-id-type="iso-abbrev">Int J Dent</journal-id><journal-id journal-id-type="publisher-id">IJD</journal-id><journal-title-group><journal-title>International Journal of Dentistry</journal-title></journal-title-group><issn pub-type="ppub">1687-8728</issn><issn pub-type="epub">1687-8736</issn><publisher><publisher-name>Hindawi</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">28555157</article-id><article-id pub-id-type="pmc">5438863</article-id><article-id pub-id-type="doi">10.1155/2017/4292081</article-id><article-categories><subj-group subj-group-type="heading"><subject>Clinical Study</subject></subj-group></article-categories><title-group><article-title>Accuracy Evaluation of a Stereolithographic Surgical Template for Dental Implant Insertion Using 3D Superimposition Protocol</article-title></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="false">http://orcid.org/0000-0001-6635-6091</contrib-id><name><surname>Cristache</surname><given-names>Corina Marilena</given-names></name><xref ref-type="aff" rid="I1"><sup>1</sup></xref><xref ref-type="corresp" rid="cor1"><sup>*</sup></xref></contrib><contrib contrib-type="author"><name><surname>Gurbanescu</surname><given-names>Silviu</given-names></name><xref ref-type="aff" rid="I2"><sup>2</sup></xref></contrib></contrib-group><aff id="I1"><sup>1</sup>Faculty of Midwifery and Medical Assisting, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania</aff><aff id="I2"><sup>2</sup>“Carol Davila” University of Medicine and Pharmacy and Private Practice, Bucharest, Romania</aff><author-notes><corresp id="cor1">*Corina Marilena Cristache: <email>corinacristache@gmail.com</email></corresp><fn fn-type="other"><p>Academic Editor: Izzet Yavuz</p></fn></author-notes><pub-date pub-type="ppub"><year>2017</year></pub-date><pub-date pub-type="epub"><day>7</day><month>5</month><year>2017</year></pub-date><volume>2017</volume><elocation-id>4292081</elocation-id><history><date date-type="received"><day>31</day><month>12</month><year>2016</year></date><date date-type="rev-recd"><day>4</day><month>4</month><year>2017</year></date><date date-type="accepted"><day>16</day><month>4</month><year>2017</year></date></history><permissions><copyright-statement>Copyright © 2017 Corina Marilena Cristache and Silviu Gurbanescu.</copyright-statement><copyright-year>2017</copyright-year><license xlink:href="https://creativecommons.org/licenses/by/4.0/"><license-p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><sec><title>The aim</title><p>of this study was to evaluate the accuracy of a stereolithographic template, with sleeve structure incorporated into the design, for computer-guided dental implant insertion in partially edentulous patients.</p></sec><sec><title> Materials and Methods</title><p> Sixty-five implants were placed in twenty-five consecutive patients with a stereolithographic surgical template. After surgery, digital impression was taken and 3D inaccuracy of implants position at entry point, apex, and angle deviation was measured using an inspection tool software. Mann–Whitney <italic>U</italic> test was used to compare accuracy between maxillary and mandibular surgical guides. A <italic>p</italic> value < .05 was considered significant.</p></sec><sec><title> Results</title><p> Mean (and standard deviation) of 3D error at the entry point was 0.798 mm (±0.52), at the implant apex it was 1.17 mm (±0.63), and mean angular deviation was 2.34 (±0.85). A statistically significant reduced 3D error was observed at entry point <italic>p</italic> = .037, at implant apex <italic>p</italic> = .008, and also in angular deviation <italic>p</italic> = .030 in mandible when comparing to maxilla.</p></sec><sec><title> Conclusions</title><p> The surgical template used has proved high accuracy for implant insertion. Within the limitations of the present study, the protocol for comparing a digital file (treatment plan) with postinsertion digital impression may be considered a useful procedure for assessing surgical template accuracy, avoiding radiation exposure, during postoperative CBCT scanning.</p></sec></abstract></article-meta></front><floats-group><fig id="fig1" orientation="portrait" position="float"><label>Figure 1</label><caption><p>Planned implant insertion in R2GATE® software.</p></caption><graphic xlink:href="IJD2017-4292081.001"></graphic></fig><fig id="fig2" orientation="portrait" position="float"><label>Figure 2</label><caption><p>The stereolithographic surgical guide utilized in all cases had the guide sleeve incorporated in the design, eliminating the need for additional insertion of metal guide sleeves. All surgical drills used had 3 parts: the stopper part, the guide part, and the drilling part [<xref rid="B19" ref-type="bibr">19</xref>]. Stopper and guide parts are identical for all drills and especially designed for R2Gate® surgical template. Drilling part varies in length and diameter according to the drilling protocol.</p></caption><graphic xlink:href="IJD2017-4292081.002"></graphic></fig><fig id="fig3" orientation="portrait" position="float"><label>Figure 3</label><caption><p>(a) Surgical template applied over the edentulous area and adjacent teeth. (b) Second drill used for flapless implant site preparation.</p></caption><graphic xlink:href="IJD2017-4292081.003"></graphic></fig><fig id="fig4" orientation="portrait" position="float"><label>Figure 4</label><caption><p>Implant insertion with hand ratchet. The ratchet connector has six green vertical landmarks (corresponding to implant hex) and a horizontal reference line. In order to reproduce the planned implant position, the horizontal reference line should match with the upper border and the green vertical landmark with the window of the surgical template.</p></caption><graphic xlink:href="IJD2017-4292081.004"></graphic></fig><fig id="fig5" orientation="portrait" position="float"><label>Figure 5</label><caption><p>Digital impression of the implants after screwing the scan abutment.</p></caption><graphic xlink:href="IJD2017-4292081.005"></graphic></fig><fig id="fig6" orientation="portrait" position="float"><label>Figure 6</label><caption><p>Study workflow.</p></caption><graphic xlink:href="IJD2017-4292081.006"></graphic></fig><fig id="fig7" orientation="portrait" position="float"><label>Figure 7</label><caption><p>Measurement of 3D accuracy of the planned (reference) and effective implant insertion (test), <italic>∗</italic> represents degree symbol (°) as it measures an angle.</p></caption><graphic xlink:href="IJD2017-4292081.007"></graphic></fig><fig id="fig8" orientation="portrait" position="float"><label>Figure 8</label><caption><p>Qualitative color-codded graphical analysis of implants planned (reference) and placed (test) in Geomagic Qualify® software.</p></caption><graphic xlink:href="IJD2017-4292081.008"></graphic></fig><fig id="fig9" orientation="portrait" position="float"><label>Figure 9</label><caption><p>Mean 3D error at entry point, measured at the center of the implant in mandible and maxilla.</p></caption><graphic xlink:href="IJD2017-4292081.009"></graphic></fig><fig id="fig10" orientation="portrait" position="float"><label>Figure 10</label><caption><p>Mean 3D error at the apex measured at the center of the implant in mandible and maxilla.</p></caption><graphic xlink:href="IJD2017-4292081.010"></graphic></fig><fig id="fig11" orientation="portrait" position="float"><label>Figure 11</label><caption><p>Mean angular deviation for implants inserted in mandible and maxilla.</p></caption><graphic xlink:href="IJD2017-4292081.011"></graphic></fig><table-wrap id="tab1" orientation="portrait" position="float"><label>Table 1</label><caption><p>Discrepancy values at entry point, apex, angular deviation, and vertical deviation.</p></caption><table frame="hsides" rules="groups"><thead><tr><th rowspan="2" align="left" colspan="1"> </th><th rowspan="2" align="center" colspan="1">Overall (<italic>n</italic> = 65) implants <break></break>Mean (SD)</th><th colspan="3" align="center" rowspan="1"> Mandible (<italic>n</italic> = 33 implants)</th><th colspan="3" align="center" rowspan="1"> Maxilla (<italic>n</italic> = 32 implants)</th></tr><tr><th align="center" rowspan="1" colspan="1">Mean (SD)</th><th align="center" rowspan="1" colspan="1">Max.</th><th align="center" rowspan="1" colspan="1">Min.</th><th align="center" rowspan="1" colspan="1">Mean (SD)</th><th align="center" rowspan="1" colspan="1">Max.</th><th align="center" rowspan="1" colspan="1">Min.</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">3D error entry point (mm)</td><td align="center" rowspan="1" colspan="1">0.79 (±0.52)</td><td align="center" rowspan="1" colspan="1">0.65 (±0.43)</td><td align="center" rowspan="1" colspan="1">1.59</td><td align="center" rowspan="1" colspan="1">0.11</td><td align="center" rowspan="1" colspan="1">0.94 (±0.56)</td><td align="center" rowspan="1" colspan="1">2.30</td><td align="center" rowspan="1" colspan="1">0.04</td></tr><tr><td align="left" rowspan="1" colspan="1">3D error apex (mm)</td><td align="center" rowspan="1" colspan="1">1.17 (±0.63)</td><td align="center" rowspan="1" colspan="1">0.96 (±0.49)</td><td align="center" rowspan="1" colspan="1">2.00</td><td align="center" rowspan="1" colspan="1">0.32</td><td align="center" rowspan="1" colspan="1">1.38 (±0.69)</td><td align="center" rowspan="1" colspan="1">3.22</td><td align="center" rowspan="1" colspan="1">0.18</td></tr><tr><td align="left" rowspan="1" colspan="1">Angular deviation (degree)</td><td align="center" rowspan="1" colspan="1">2.34 (±0.85)</td><td align="center" rowspan="1" colspan="1">2.11 (±0.88)</td><td align="center" rowspan="1" colspan="1">3.90</td><td align="center" rowspan="1" colspan="1">0.50</td><td align="center" rowspan="1" colspan="1">2.58 (±0.75)</td><td align="center" rowspan="1" colspan="1">4.22</td><td align="center" rowspan="1" colspan="1">1.08</td></tr><tr><td align="left" rowspan="1" colspan="1">Vertical deviation at entry point (<italic>z</italic>-axis, mm)</td><td align="center" rowspan="1" colspan="1">0.50 (±0.38)</td><td align="center" rowspan="1" colspan="1">0.46 (±0.34)</td><td align="center" rowspan="1" colspan="1">1.54</td><td align="center" rowspan="1" colspan="1">0.00</td><td align="center" rowspan="1" colspan="1">0.55 (±0.42)</td><td align="center" rowspan="1" colspan="1">1.96</td><td align="center" rowspan="1" colspan="1">0.02</td></tr></tbody></table></table-wrap></floats-group></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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