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Accuracy of surgical guides from 2 different desktop 3D printers for computed tomography-guided surgery
Malmö University, Faculty of Odontology (OD).ORCID iD: 0000-0001-6186-4804
Malmö University, Faculty of Odontology (OD).
2019 (English)In: The Journal of prosthetic dentistry (Print), ISSN 0022-3913, E-ISSN 1097-6841, Vol. 121, no 3, p. 498-503, article id S0022-3913(18)30677-2Article in journal (Refereed) Published
Abstract [en]

STATEMENT OF PROBLEM: Different factors influence the degree of deviation in dental implant position after computed tomography-guided surgery. The surgical guide-manufacturing process with desktop 3D printers is such a factor, but its accuracy has not been fully evaluated.

PURPOSE: The purpose of this in vitro study was to evaluate the deviation in final dental implant position after the use of surgical guides fabricated from 2 different desktop 3D printers using a digital workflow.

MATERIAL AND METHODS: Twenty 3D-printed resin models were prepared with missing maxillary premolar. After preoperative planning, 10 surgical guides were produced with a stereolithography printer and 10 with a digital light-processing (DLP) printer. A guided surgery was performed; 20 dental implants (3.8×12 mm) were installed, and a digital scan of the dental implants was made. Deviations between the planned and final position of the dental implants were evaluated for both the groups.

RESULTS: A statistically significant difference between stereolithography and DLP were found for deviation at entry point (P=.023) and the vertical implant position (P=.009). Overall lower deviations were found for the guides from the DLP printer, with the exception of deviation in horizontal implant position.

CONCLUSIONS: The tested desktop 3D printers were able to produce surgical guides with similar deviations with regard to the final dental implant position, but the DLP printer proved more accurate concerning deviations at entry point and vertical implant position.

Place, publisher, year, edition, pages
Elsevier, 2019. Vol. 121, no 3, p. 498-503, article id S0022-3913(18)30677-2
National Category
Dentistry
Identifiers
URN: urn:nbn:se:mau:diva-17194DOI: 10.1016/j.prosdent.2018.08.009ISI: 000460655400023PubMedID: 30442377Scopus ID: 2-s2.0-85056421631OAI: oai:DiVA.org:mau-17194DiVA, id: diva2:1429057
Available from: 2020-05-07 Created: 2020-05-07 Last updated: 2024-02-05Bibliographically approved
In thesis
1. On the Clinical Outcome of Different Single Implant Treatment Modalities
Open this publication in new window or tab >>On the Clinical Outcome of Different Single Implant Treatment Modalities
2020 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Today there are several treatment techniques available to replace a missing tooth. Since the beginning of the 1990s, it has become increasingly common to treat individual tooth loss with dental implants. Important patient factors are survival, success, functionality, aesthetics, oral health and quality of life.

The range of indications and possibilities for implant treatment has broadened compared to the originally proposed treatment indications. A variety of methods, components and materials are available today. Improvements of the implant surface have led to shorter healing periods, which has affected the overall treatment time. Methods for computer-assisted implant planning and surgical guides have been developed to improve treatment planning. Several techniques are involved in the manufacturing of implant-supported single crowns, from the traditional plaster models, wax, casting and porcelain veneering to 3D scanning, computer aided design and manufacturing. It is important that all these treatment modalities are evaluated in a systematic and scientific way to ensure that the treatment given is the best one possible according to the individual conditions that exist.

The general aim of this project was to evaluate the treatment outcome between different treatment modalities for single dental implants. Study I aims to retrospectively evaluate implant survival. Patient reported outcome measures, marginal bone loss (MBL), clinical and esthetic outcomes following conventional single implant treatment. The aim of study II, a prospective randomized clinical study, was to compare the overall treatment outcome following immediate loading (IL) and delayed loading (DL) of single implants. In study III the aim was to in a vitro setting evaluate the deviation in final dental implant position after the use of surgical guides fabricated from two different desktop 3D printers using a digital workflow. For study IV the aim was to, in a non-randomized study, compare clinical and aesthetic outcomes between immediately loaded single implants placed with and without a fully guided-surgery procedure (DIL). In study I a total of 85 implants were examined after a mean follow-up time of 7.51 years. The 5-year implant survival rate was98.4% (95% CI: 96.3% - 100%), with a crown survival rate of91.8% (95% CI: 86.3%-97.3%). Overall mean MBL was -0.13 mm. Final and initial total Pink esthetic score (PES) were 9.61 and 11.49 (P<.001) Mean White esthetic score (WES) was 6.48 at final follow-up. Visual analog scale (VAS) score for soft tissue and implant-supported crown aesthetics were 73.5 and 82.1 (maximum score 100). A oral health impact profile-14 (OHIP-14) 14 score of 16.11 was observed at the final follow-up. Study II and IV found implant survival rates of 100%, 96% and 90.5 % for IL, DL and DIL, respectively, after 1-year. No statistically significant differences were found for MBL, PES, WES and OHIP-14after 1-year. Statistically significant lower papilla index scores were found for the IL. Overall statistically significant improvement inPES, WES and OHIP-14 were found over time. In the DIL group a moderate correlation between aesthetics and deviation in fixture position was found. For Study III a statistically significant difference between stereolithography and direct light processing (DLP) was found fordeviation at entry point (P = .023) and the vertical implant position(P = .009). Overall lower deviations were found for the guides from the DLP printer, with the exception of deviation in horizontal implant position.The results from these studies suggest that good clinical results can be achieved with different treatment modalities for single implants. Positive advantages with immediate loading and guided surgery is primarily seen in the early faces of the treatment procedure only. Care needs to be exerted with technically complicated treatment procedures as the effect on implant survival should not be underestimated. Further studies have to be performed to evaluate guided surgery and immediate loading to identify possible factors effecting survival.

Place, publisher, year, edition, pages
Malmö: Malmö universitet, 2020. p. 122
Series
Doctoral Dissertation in Odontology
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-18188 (URN)10.24834/isbn.9789178770892 (DOI)978-91-7877-088-5 (ISBN)978-91-7877-089-2 (ISBN)
Public defence
2020-09-18, D131, Nordenskiöldsg. 10, Malmö, 09:15
Opponent
Available from: 2020-09-07 Created: 2020-09-07 Last updated: 2022-06-27Bibliographically approved

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Gjelvold, BjörnMahmood, Deyar Jallal HadiWennerberg, Ann

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