An assessment of template-guided implant surgery in terms of accuracy and related factors
Identifieur interne : 002E93 ( Pmc/Curation ); précédent : 002E92; suivant : 002E94An assessment of template-guided implant surgery in terms of accuracy and related factors
Auteurs : Jee-Ho Lee [Corée du Sud] ; Ji-Man Park [Corée du Sud] ; Soung-Min Kim [Corée du Sud] ; Myung-Joo Kim [Corée du Sud] ; Jong-Ho Lee [Corée du Sud] ; Myung-Jin Kim [Corée du Sud]Source :
- The Journal of Advanced Prosthodontics [ 2005-7806 ] ; 2013.
Abstract
Template-guided implant therapy has developed hand-in-hand with computed tomography (CT) to improve the accuracy of implant surgery and future prosthodontic treatment. In our present study, the accuracy and causative factors for computer-assisted implant surgery were assessed to further validate the stable clinical application of this technique.
A total of 102 implants in 48 patients were included in this study. Implant surgery was performed with a stereolithographic template. Pre- and post-operative CTs were used to compare the planned and placed implants. Accuracy and related factors were statistically analyzed with the Spearman correlation method and the linear mixed model. Differences were considered to be statistically significant at
The mean errors of computer-assisted implant surgery were 1.09 mm at the coronal center, 1.56 mm at the apical center, and the axis deviation was 3.80°. The coronal and apical errors of the implants were found to be strongly correlated. The errors developed at the coronal center were magnified at the apical center by the fixture length. The case of anterior edentulous area and longer fixtures affected the accuracy of the implant template.
The control of errors at the coronal center and stabilization of the anterior part of the template are needed for safe implant surgery and future prosthodontic treatment.
Url:
DOI: 10.4047/jap.2013.5.4.440
PubMed: 24353883
PubMed Central: 3865200
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<author><name sortKey="Lee, Jee Ho" sort="Lee, Jee Ho" uniqKey="Lee J" first="Jee-Ho" last="Lee">Jee-Ho Lee</name>
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<wicri:regionArea>Department of Oral and Maxillofacial Surgery, Seoul Asan Medical Center, Seoul</wicri:regionArea>
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<author><name sortKey="Park, Ji Man" sort="Park, Ji Man" uniqKey="Park J" first="Ji-Man" last="Park">Ji-Man Park</name>
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<country xml:lang="fr" wicri:curation="lc">Corée du Sud</country>
<wicri:regionArea>Department of Prosthodontics, Ewha Womans University, School of Medicine, Seoul</wicri:regionArea>
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<author><name sortKey="Kim, Soung Min" sort="Kim, Soung Min" uniqKey="Kim S" first="Soung-Min" last="Kim">Soung-Min Kim</name>
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<author><name sortKey="Kim, Myung Joo" sort="Kim, Myung Joo" uniqKey="Kim M" first="Myung-Joo" last="Kim">Myung-Joo Kim</name>
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<author><name sortKey="Kim, Myung Jin" sort="Kim, Myung Jin" uniqKey="Kim M" first="Myung-Jin" last="Kim">Myung-Jin Kim</name>
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<series><title level="j">The Journal of Advanced Prosthodontics</title>
<idno type="ISSN">2005-7806</idno>
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<front><div type="abstract" xml:lang="en"><sec><title>PURPOSE</title>
<p>Template-guided implant therapy has developed hand-in-hand with computed tomography (CT) to improve the accuracy of implant surgery and future prosthodontic treatment. In our present study, the accuracy and causative factors for computer-assisted implant surgery were assessed to further validate the stable clinical application of this technique.</p>
</sec>
<sec><title>MATERIALS AND METHODS</title>
<p>A total of 102 implants in 48 patients were included in this study. Implant surgery was performed with a stereolithographic template. Pre- and post-operative CTs were used to compare the planned and placed implants. Accuracy and related factors were statistically analyzed with the Spearman correlation method and the linear mixed model. Differences were considered to be statistically significant at <italic>P</italic>
≤.05.</p>
</sec>
<sec><title>RESULTS</title>
<p>The mean errors of computer-assisted implant surgery were 1.09 mm at the coronal center, 1.56 mm at the apical center, and the axis deviation was 3.80°. The coronal and apical errors of the implants were found to be strongly correlated. The errors developed at the coronal center were magnified at the apical center by the fixture length. The case of anterior edentulous area and longer fixtures affected the accuracy of the implant template.</p>
</sec>
<sec><title>CONCLUSION</title>
<p>The control of errors at the coronal center and stabilization of the anterior part of the template are needed for safe implant surgery and future prosthodontic treatment.</p>
</sec>
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<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Adv Prosthodont</journal-id>
<journal-id journal-id-type="iso-abbrev">J Adv Prosthodont</journal-id>
<journal-id journal-id-type="publisher-id">JAP</journal-id>
<journal-title-group><journal-title>The Journal of Advanced Prosthodontics</journal-title>
</journal-title-group>
<issn pub-type="ppub">2005-7806</issn>
<issn pub-type="epub">2005-7814</issn>
<publisher><publisher-name>The Korean Academy of Prosthodontics</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">24353883</article-id>
<article-id pub-id-type="pmc">3865200</article-id>
<article-id pub-id-type="doi">10.4047/jap.2013.5.4.440</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Original Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>An assessment of template-guided implant surgery in terms of accuracy and related factors</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Lee</surname>
<given-names>Jee-Ho</given-names>
</name>
<degrees>BS</degrees>
<degrees>DDS</degrees>
<degrees>MSD</degrees>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Park</surname>
<given-names>Ji-Man</given-names>
</name>
<degrees>DDS</degrees>
<degrees>MSD</degrees>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kim</surname>
<given-names>Soung-Min</given-names>
</name>
<degrees>DDS</degrees>
<degrees>MSD</degrees>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kim</surname>
<given-names>Myung-Joo</given-names>
</name>
<degrees>DDS</degrees>
<degrees>MSD</degrees>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Lee</surname>
<given-names>Jong-Ho</given-names>
</name>
<degrees>DDS</degrees>
<degrees>MSD</degrees>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author" corresp="yes"><name><surname>Kim</surname>
<given-names>Myung-Jin</given-names>
</name>
<degrees>DDS</degrees>
<degrees>MSD</degrees>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
</contrib-group>
<aff id="A1"><label>1</label>
Department of Oral and Maxillofacial Surgery, Seoul Asan Medical Center, Seoul, Republic of Korea.</aff>
<aff id="A2"><label>2</label>
Department of Prosthodontics, Ewha Womans University, School of Medicine, Seoul, Republic of Korea.</aff>
<aff id="A3"><label>3</label>
Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, Seoul, Republic of Korea.</aff>
<aff id="A4"><label>4</label>
Department of Prosthodontics, Seoul National University Dental Hospital, Seoul, Republic of Korea.</aff>
<author-notes><corresp>Corresponding author: Myung-Jin Kim. Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, 275-1, Yeongeon-dong, Jongno-gu, Seoul, 110-768 Republic of Korea. Tel. 82220722631: <email>omsljh@gmail.com</email>
</corresp>
</author-notes>
<pub-date pub-type="ppub"><month>11</month>
<year>2013</year>
</pub-date>
<pub-date pub-type="epub"><day>28</day>
<month>11</month>
<year>2013</year>
</pub-date>
<volume>5</volume>
<issue>4</issue>
<fpage>440</fpage>
<lpage>447</lpage>
<history><date date-type="received"><day>07</day>
<month>5</month>
<year>2013</year>
</date>
<date date-type="rev-recd"><day>18</day>
<month>10</month>
<year>2013</year>
</date>
<date date-type="accepted"><day>21</day>
<month>10</month>
<year>2013</year>
</date>
</history>
<permissions><copyright-statement>© 2013 The Korean Academy of Prosthodontics</copyright-statement>
<copyright-year>2013</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>Template-guided implant therapy has developed hand-in-hand with computed tomography (CT) to improve the accuracy of implant surgery and future prosthodontic treatment. In our present study, the accuracy and causative factors for computer-assisted implant surgery were assessed to further validate the stable clinical application of this technique.</p>
</sec>
<sec><title>MATERIALS AND METHODS</title>
<p>A total of 102 implants in 48 patients were included in this study. Implant surgery was performed with a stereolithographic template. Pre- and post-operative CTs were used to compare the planned and placed implants. Accuracy and related factors were statistically analyzed with the Spearman correlation method and the linear mixed model. Differences were considered to be statistically significant at <italic>P</italic>
≤.05.</p>
</sec>
<sec><title>RESULTS</title>
<p>The mean errors of computer-assisted implant surgery were 1.09 mm at the coronal center, 1.56 mm at the apical center, and the axis deviation was 3.80°. The coronal and apical errors of the implants were found to be strongly correlated. The errors developed at the coronal center were magnified at the apical center by the fixture length. The case of anterior edentulous area and longer fixtures affected the accuracy of the implant template.</p>
</sec>
<sec><title>CONCLUSION</title>
<p>The control of errors at the coronal center and stabilization of the anterior part of the template are needed for safe implant surgery and future prosthodontic treatment.</p>
</sec>
</abstract>
<kwd-group><kwd>Computer-assisted surgery</kwd>
<kwd>Dental implant</kwd>
<kwd>Accuracy</kwd>
</kwd-group>
<funding-group><award-group><funding-source country="KR">National Research Foundation</funding-source>
<award-id>NRF-2012R1A1A2008544</award-id>
</award-group>
</funding-group>
</article-meta>
</front>
<floats-group><fig id="F1" orientation="portrait" position="float"><label>Fig. 1</label>
<caption><p>The location and angulation of the implant were determined through the use of planning software and virtual surgery by considering the critical anatomical structures and the future dental prostheses.</p>
</caption>
<graphic xlink:href="jap-5-440-g001"></graphic>
</fig>
<fig id="F2" orientation="portrait" position="float"><label>Fig. 2</label>
<caption><p>The information from the planned fixture was used to create the stereolithographic implant template. (A) Completion of planning of implant surgery on 3D software, (B) Stereolithographic template for computer-assisted implant surgery.</p>
</caption>
<graphic xlink:href="jap-5-440-g002"></graphic>
</fig>
<fig id="F3" orientation="portrait" position="float"><label>Fig. 3</label>
<caption><p>Surgical procedure for template-guided implant surgery. (A) Preparation of operation field, (B) Setting of surgical template in the oral cavity, (C) Flap elevation for sequential drilling, (D) Implantation of fixture guided by the template.</p>
</caption>
<graphic xlink:href="jap-5-440-g003"></graphic>
</fig>
<fig id="F4" orientation="portrait" position="float"><label>Fig. 4</label>
<caption><p>(A) Comparison of the planned and placed implants by superimposition of the pre- and postoperative images, (B) Disassembly of the total errors into horizontal and vertical directions at the coronal center, (C) Disassembly of the total errors into horizontal and vertical directions at the apical center.</p>
<p>a: coronal distance, b: apical distance, c: axis deviation, <italic>h</italic>
: horizontal deviation, <italic>v</italic>
: vertical deviation.</p>
</caption>
<graphic xlink:href="jap-5-440-g004"></graphic>
</fig>
<table-wrap id="T1" orientation="portrait" position="float"><label>Table 1</label>
<caption><p>Patients and causative factors</p>
</caption>
<graphic xlink:href="jap-5-440-i001"></graphic>
<table-wrap-foot><fn><p>AP location: anterior-posterior location of implants (anterior, premolar, molar).</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="T2" orientation="portrait" position="float"><label>Table 2</label>
<caption><p>Mean errors between the planned and placed implants (Mean ± SD)</p>
</caption>
<graphic xlink:href="jap-5-440-i002"></graphic>
<table-wrap-foot><fn><p>SD means standard deviation.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="T3" orientation="portrait" position="float"><label>Table 3</label>
<caption><p>Correlations between errors</p>
</caption>
<graphic xlink:href="jap-5-440-i003"></graphic>
<table-wrap-foot><fn><p><sup>*</sup>
When the correlation coefficient (<italic>r</italic>
) was between 0.7 and 1.0, the items were considered to be strongly correlated.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="T4" orientation="portrait" position="float"><label>Table 4</label>
<caption><p>Significance (<italic>P</italic>
value) of each error that correlated with causative factors for implant fixtures</p>
</caption>
<graphic xlink:href="jap-5-440-i004"></graphic>
<table-wrap-foot><fn><p><sup>*</sup>
Considered significant at <italic>P</italic>
<.05. β means increasing amount of error according to one millimeter increase of length of fixture.</p>
<p>When <italic>P</italic>
value was less than .05, mean errors in each causative factor were presented as mean (mm) ± C.I (95% confidence interval).</p>
<p>Support: the type of template supporting (tooth-supported and mucosa-supported), Arch: the arch on which implant template was positioned (maxilla and mandibular arch), AP location: anterior-posterior location of implants (anterior, premolar, molar), Length: the length of implant fixture, Institute: the institute where template-guided implant surgery was performed (different environment and surgeons).</p>
</fn>
</table-wrap-foot>
</table-wrap>
</floats-group>
</pmc>
</record>
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