Evaluation of accuracy of insertion of dental implants and prosthetic treatment by computer-aided navigation in minipigs (original) (raw)
Related papers
Computer-aided navigation in dental implantology: 7 years of clinical experience
Journal of Oral and Maxillofacial Surgery, 2004
Purpose: This long-term study gives a review over 7 years of research, development, and routine clinical application of computer-aided navigation technology in dental implantology. Benefits and disadvantages of up-to-date technologies are discussed. Materials and Methods: In the course of the current advancement, various hardware and software configurations are used. In the initial phase, universally applicable navigation software is adapted for implantology. Since 2001, a special software module for dental implantology is available. Preoperative planning is performed on the basis of prosthetic aspects and requirements. In clinical routine use, patient and drill positions are intraoperatively registered by means of optoelectronic tracking systems; during preclinical tests, electromagnetic trackers are also used. Results: In 7 years (1995 to 2002), 55 patients with 327 dental implants were successfully positioned with computer-aided navigation technology. The mean number of implants per patient was 6 (minimum, 1; maximum, 11). No complications were observed; the preoperative planning could be exactly realized. The average expenditure of time for the preparation of a surgical intervention with navigation decreased from 2 to 3 days in the initial phase to one-half day in clinical routine use with software that is optimized for dental implantology. Conclusions: The use of computer-aided navigation technology can contribute to considerable quality improvement. Preoperative planning is exactly realized and intraoperative safety is increased, because damage to nerves or neighboring teeth can be avoided.
The Art of Using Computer-Assisted Navigation Systems in Guided Implant Surgery: A Review
2021
Background and Aim: Computer-aided design/computer-aided manufacturing (CAD/ CAM) has been widely used in implant dentistry. Recent computer-guided dynamic navigation systems promise an accurate approach to minimally invasive implant placement. Robot-assisted surgery has been used in dentistry since 2017. The present study aims to review the properties, clinical outcomes, advantages, and limitations of navigation, robotics, and CAD/CAM in implant placement surgery. Materials and Methods: An electronic search of the literature was conducted mainly through PubMed, ScienceDirect, Cochrane Library, and Google Scholar databases. Studies in the English language were considered for inclusion if they evaluated robotics, CAD/CAM, and navigation in implant placement. Finally, 21 articles were selected. Results: Guided implant surgery is assumed accurate, precise, and reliable; it also has a lower complication rate compared to freehanded implant surgery. Surgical guides could be indicated for patients with limited mouth opening, tight interdental spaces, a strong gag reflex, and distal implants. Several studies have reported that computerassisted surgery improves the accuracy of implant placement. Expensive equipment, high costs, and gaps between the guides and drill bite are the disadvantages of digital implant placement. Conclusion: Computer-aided implant navigation systems can improve implant placement outcomes. Digital procedures have shown accurate outcomes in implant surgery. Despite the advantages of guided surgery, deviation of implant position from the planned position still occurs. However, improvements in digital dentistry are slowly overcoming these challenges.
Accuracy of a Navigation System for Computer-Aided Oral Implantology
Lecture Notes in Computer Science, 2000
Placement of endosteal implants is a widespread therapy for re-establishing full functionality in edentulous patients. As a first application of VISIT, a modular software system for research into computeraided surgery developed at our hospital, we have implemented a navigation system for computer-aided implant dentistry (CAID). Besides improved accuracy, benefits of CAID include fast translation of preoperative imaging to the operating theatre and the possibility to insert the implants without having to prepare large mucosa flaps. In this cadaver study, we have measured the overall accuracy of VISIT for inserting four intraforaminal implants in the edentulous mandible. Five cadaver mandibles were embedded into plaster. After high-resolution CT scanning, the mandibles were registered, and the implant channels were drilled by the surgeon. Training implants were inserted into the implant channels, and the plaster was removed. Again, the mandibles underwent CT scanning, and the pre-and postoperative scans were registered relative to each other. A gross registration between pre-and postoperative scans was achieved using surface-or mutual information matching since in some cases the fiducial markers were lost. After transformation to a common coordinate system, the accuracy was assessed by measuring the distance of the implant's center to the cortex of the jawbone. Average accuracy of the navigation system was found to be 0.9 ± 0.7 mm, range {0.0. .. 3.5} mm. We conclude that these results show that CAID is an interesting novel application of computer-aided surgery superior to conventional methods in oral surgery.
Journal of Cranio-Maxillofacial Surgery, 1999
System, VPS) has been described in previous studies for different indications in oral and maxillofacial surgery. The aim of the system is the intraoperative transfer of preoperative planning on radiographs or CT scans on the patient, in real-time, and independent of the position of the patient's head. Until now an electromagnetic tracking system has been used for intra-operative position measurement. For placement of dental implants, the electromagnetic tracking system is not suitable since the motor of the implant drill leads to a considerable distortion of the magnetic field, thus direct visualization of drilling the implant socket was not possible. To overcome this problem, an optical tracking system which is not disturbed by conductive materials was integrated in the VPS system. The first patient operated on with this system had a posttraumatic loss of the upper incisors; three implants have been placed according to the prosthetic axis previously planned on radiographs and CT scans. The experience gained in this intervention led to the conclusion that computer-aided surgery provides a valuable tool in implant dentistry.
2021
The use of virtual reality simulation (VRS) developed a new era in dentistry, where a pre-operative virtual planning in conjunction with a surgical guide could help the surgeon with a prosthetically-driven correct implant placement, especially in difficult clinical cases. Materials & methods: regarding this study, 14 patients were recruited with bounded partially edentulous spans in the maxilla. The patients were randomly assorted into 2 groups. The first group (control) is the static guide group (SG), while the second group (test group) is the dynamic navigation group (DN). After implant installation, a postoperative CBCT was obtained & the obtained image was superimposed over the original implant plan to determine the linear and angular deviation between the proposed plan and actual implant position. Results: Regarding the linear deviation between the planned and actual positions in both groups was measured at both the coronal apical areas. The independent sample t test showed a s...
Computer-Aided Implant Dentistry
Computer-aided implant dentistry (CAID), the direct translation of preoperative prosthetic planning to the operating theater by means of image guidance technologies, is a novel application of computer aided surgery (CAS). This work deals with the application of a modular software system for computer-aided interventions to CAID. The system is based on AVW-2.5, a software library dedicated to biomedical image processing, and a custom interface for communication with an optical tracker. A specific CAID toolset was also manufactured. We assessed the performance of two different point-based registration algorithms for this specific application of computer-aided preprosthetic surgery on several jaw models. The fiducial localization error (FLE) achievable with our system was found to be 0.7 mm, the fiducial registration error (FRE) accounted for 0.7 mm, and the target registration error TRE (the overall navigation accuracy) was found to be 1.3 mm. Since these results compare well to the resolution of the high-resolution computed tomography scan used we consider the precision of our system to be sufficient. Future enhancements of our system include the implementation of a medical augmented reality display system and the customization of the software package for exploration of other clinical applications of CAS.
International Journal of Surgery & Surgical Procedures
Objective: to evaluate in vitro and in vivo the accuracy and the precision of guided implant surgery, associated with three mini-implants placement used as precision pins. Materials and Methods: For in vitro evaluation, two acrylic resin model with artificial gum were prepared to represent edentulous mandibles. For the next in vivo evaluation two patients were treated using the same method. Three mini-implants used as reference points were placed before diagnostic and therapeutic procedure. Pre-and post-implantation CBCT images were superimposed using digital processing image software to evaluate the linear and angular deviations between the virtual planning data and the surgical results.
Accuracy of a laboratory-based computer implant guiding system
Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 2010
Objective. Computer-guided implant placement is a growing treatment modality in partially and totally edentulous patients, though data about the accuracy of some systems for computer-guided surgery is limited. The purpose of this study was to evaluate the accuracy of a laboratory computer-guided system. Study design. A laboratory-based computer guiding system (M Guide; MIS technologies, Shlomi, Israel) was used to place implants in a fresh sheep mandible. A second computerized tomography (CT) scan was taken after placing the implants. The drill plan figures of the planned implants were positioned using assigned software (Med3D, Heidelberg, Germany) on the second CT scan to compare the implant position with the initial planning. Values representing the implant locations of the original drill plan were compared with that of the placed implants using SPSS software. Results. Six measurements (3 vertical, 3 horizontal) were made on each implant to assess the deviation from the initial implant planning. A repeated-measurement analysis of variance was performed comparing the location of measurement (center, abutment, apex) and type of deviation (vertical vs. horizontal). The vertical deviation (mean Ϫ0.168) was significantly smaller than the horizontal deviation (mean 1.148). Conclusion. The laboratory computer-based guiding system may be a viable treatment concept for placing implants.
International Journal of Environmental Research and Public Health
Aim: the aim of this in vitro study was to test whether the implant placement accuracy and the operating time can be influenced by the operator’s experience. Materials and methods: sixteen models underwent a (Cone Beam Computer Tomography) CBCT and implant positioning was digitally planned on this. The models were randomly assigned to four operators with different levels of surgical experience. One hundred and twelve implant sites were drilled using a dynamic navigation system and operating times were measured. Based on postoperative CBCTs, dental implants were virtually inserted and superimposed over the planned ones. Two-dimensional and 3D deviations between planned and virtually inserted implants were measured at the entry point and at the apical point. Angular and vertical errors were also calculated. Results: considering coronal and apical 3D deviations, no statistically significant differences were found between the four operators (p = 0.27; p = 0.06). Some vectorial component...
Accuracy of Implant Placement with a Navigation System, a Laboratory Guide, and Freehand Drilling
2018
Purpose: Computer-aided surgery under navigation system guidance is widely applied in dental implant procedures. However, the accuracy of drilling with such navigation systems has not been comparatively evaluated alongside those of laboratory guide-based and freehand drilling. Therefore, this study aimed to compare the accuracies of these three drilling systems. Materials and Methods: A navigation system, a laboratory guide, and freehand drilling were used to drill 150 holes on 30 cast models. Two master models-one each for the maxilla and mandible-were prepared with the idea of placing five implants per cast. After drilling five holes on each cast, postoperative cone beam computed tomography images were acquired to measure the magnitude of errors. Results: The navigation system and laboratory guide were more accurate than freehand placement with respect to total errors at the entry and apex, lateral error at the apex, and angular error. The navigation system was more accurate than the laboratory guide with respect to angular error. Laboratory guide-based drilling was more accurate than freehand drilling in terms of lateral error at entry. Conclusion: In comparison with the laboratory guide and freehand placement, the navigation system exhibited lower angular and axial errors. Despite its higher accuracy, the navigation system requires the operator to pay greater attention.