A 2-trajectories surgical guide for infrazygomatic mini-implants insertion

Abstract

• An adjustable surgical guide can be designed and printed for infrazygomatic mini-implants insertion. • The guide template with an adjustable guide trajectory was fabricated based on CBCT images and digital intraoral scanning images. • Transformation of the insertion angle can be realized during the infrazygomatic mini-screws placement procedures. • The entire guide template is fabricated from 3D printers by acrylic, low-cost and conducive to popularization in clinics. Objective: To develop an adjustable surgical guide template for the placement of infrazygomatic mini-implant using the three-dimensional (3D) cone-beam computed tomography (CBCT) images and digital intraoral scanning images. Methods: Superimpose the digital intraoral scanning images on the CBCT images to acquire the fine 3D dentition model. The surgical guide template was then fabricated with a 3D printing printer with two different trajectories angles. Try to place the guide template intraorally onto the teeth and ensure its fitness and retention, then perform a post-operative CBCT after the mini-implant was inserted. Results: An adjustable surgical guide was fabricated successfully. A mean deviation of 1.2 mm and 1.3 mm at the mini-implant apex and crown was indicated, and the mean angular deviation was 5.4°. Conclusion: The infrazygomatic mini-implant insertion guide fabricated based on the 3D integrated dentition model can realize the transformation of guide trajectory, and it is helpful to place a mini-implant. But the accuracy and long-term stability should be evaluated further.