Abstract
This in vitro study investigated the accuracy and wear conditions of three drill sleeve distances (0.01, 0.02, and 0.03 mm) for 3D-guided stents in simulated clinical dental implant surgery. Fifteen sets of upper and lower partially edentulous epoxy tooling board models with four edentulous first molar sites were prepared in a Nissin Simple Manikin II and set on a dental chair. Sixty computer-aided design and computer-aided manufacturing (CAD/CAM) designed and guided stents with three drill sleeve distances were prepared in this study. The maximum height (Sz) of the wear roughness of drills, maximum deviation, and drilling time were observed. The highest maximum horizontal deviations were observed at the upper first molar (0.48 ± 0.12 mm, p < 0.001). The highest maximum vertical and angular deviations were observed at the lower left first molar (1.08 ± 0.35 mm and 5.61° ± 1.21°, respectively, p < 0.001). Only angular deviation significantly differed among the three drill sleeve distances (p = 0.046); the 0.03 mm distance exhibited the maximum angular deviation (3.92° ± 1.87°). The bigger drill sleeve distance (0.03 mm) was associated with more wear roughness (8.70 ± 2.29 µm) of the drills. Guided stents with varying drill-sleeve distances (0.01, 0.02, and 0.03 mm) exhibited no significant difference in preparation drilling time and abrasive wear. In practice, the optimal drill sleeve distance for single-type CAD/CAM-guided stents of dental implantation was 0.01 mm.
Highlights
Modern advancements in implant dentistry have revolutionized computer-assisted digital workflows [1]
Cone-beam computed tomography (CBCT) produces 3-dimensional (3D) images that can be stored as digital imaging and communications in medicine (DICOM) files, and intraoral scan and conventional models can generate images as stereolithography (STL) files
In their systematic review, Tahmaseb et al [8] reported that the mean errors of implant placement were approximately 1.2 and 1.4 mm at the coronal and apical points, respectively, with a deviation of 3.5◦
Summary
Modern advancements in implant dentistry have revolutionized computer-assisted digital workflows [1]. Computer-guided implant surgery has been demonstrated to be more precise and accurate than conventional surgical guides or free-hand implant placement [2,3,4,5,6,7,8]. Software can merge DICOM and STL files, virtual planning software can be used to determine the ideal implant position for the surgical guided stent. Tang et al [7] demonstrated that an implant deviation of 1.22 ± 0.63 mm at the entrance point and 1.91 ± 1.17 mm at the apical point and an angulation of 7.93◦ ± 5.56◦ were achieved through free-hand placement. The reported accuracy of CAI varied among multiple studies [13]
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