J Korean Acad Prosthodont.  2012 Oct;50(4):271-278. 10.4047/jkap.2012.50.4.271.

Evaluation of the accuracy of two different surgical guides in dental implantology: stereolithography fabricated vs. positioning device fabricated surgical guides

• Kwon CR
• Choi BH
• Jeong SM
• Joo SD

• KMID: 2195468
• DOI: http://doi.org/10.4047/jkap.2012.50.4.271

Abstract

PURPOSE
Recently implant surgical guides were used for accurate and atraumatic operation. In this study, the accuracy of two different types of surgical guides, positioning device fabricated and stereolithography fabricated surgical guides, were evaluated in four different types of tooth loss models.
MATERIALS AND METHODS
Surgical guides were fabricated with stereolithography and positioning device respectively. Implants were placed on 40 models using the two different types of surgical guides. The fitness of the surgical guides was evaluated by measuring the gap between the surgical guide and the model. The accuracy of surgical guide was evaluated on a pre- and post-surgical CT image fusion.
RESULTS
The gap between the surgical guide and the model was 1.4 +/- 0.3 mm and 0.4 +/- 0.3 mm for the stereolithography and positioning device surgical guide, respectively. The stereolithography showed mesiodistal angular deviation of 3.9 +/- 1.6degrees, buccolingual angular deviation of 2.7 +/- 1.5degrees and vertical deviation of 1.9 +/- 0.9 mm, whereas the positioning device showed mesiodistal angular deviation of 0.7 +/- 0.3degrees, buccolingual angular deviation of 0.3 +/- 0.2degrees and vertical deviation of 0.4 +/- 0.2 mm. The differences were statistically significant between the two groups (P<.05).
CONCLUSION
The laboratory fabricated surgical guides using a positioning device allow implant placement more accurately than the stereolithography surgical guides in dental clinic.

Keyword

Surgical guide; Surgical stent; Anyguide; Computer-aided surgery; Flapless implant

MeSH Terms

Dental Clinics
Surgery, Computer-Assisted
Tooth Loss

Figure

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  Fig. 1 Models for study. A: Partial edentulous models, ⓐ: Single missing model, ⓑ: Kennedy Class-IV model, ⓒ: Kennedy Class-I model, ⓓ: Kennedy Class-III model. B: Gutta-percha markers.

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  Fig. 2 The radiographic guide and designing the surgical guide with stereolithography. A: Radiographic guide for stereolithography, B: Design the surgical guide with Osstem Quickguide®.

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  Fig. 3 Fabricating the surgical guide with stereolithography. A: Fabricating the surgical guide after fusing the two groups of CBCT DICOM files. B: Stereolithography fabricated surgical guide.

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  Fig. 4 The radiographic guide and designing the surgical guide with positioning device. A: Radiographic guide for positioning device, B: Design the surgical guide with Simplant®.

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  Fig. 5 Fabricating surgical guide with positioning device. A: Fabricating the surgical guide with positioning device, B: Laboratory fabricated surgical guide with positioning device.

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  Fig. 6 Flapless implant surgery with surgical guides. A: Flapless implant surgery with sereolithography fabricated surgical guide, B: Flapless implant surgery with laboratory fabricated surgical guide.

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  Fig. 7 Measuring the gap between the surgical guide and the model to evaluated the fitness.

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  Fig. 8 Evaluating the accuracy of surgical guides. A: Image fusioning of pre- and post- operational image, B: The accuracy of surgical guide was evaluated.

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  Fig. 9 The gap between the surgical guide and the model. A: Stereolithography, B: Laboratory fabricated.

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