Advantages and limitations of implant surgery with CAD/CAM surgical guides: A literature review.

I Turkyilmaz,G Unsal,S Lakhia

doi:10.4317/jced.55871

Abstract

BackgroundThe purpose of this study is to review the available literature associated with implant surgery using computer-aided design/computer-aided manufacturing (CAD/CAM) surgical guides and discuss the advantages and disadvantages of this advanced technique. Material and MethodsAn electronic literature search was conducted in the PubMed database for the relevant information on implant placement with CAD/CAM surgical guides. This review was constructed following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Articles were limited to those published within the past 10 years and in the English language. Only clinical studies were included. Inclusion criteria were: studies including 10 implants or more and studies presenting angular deviations in degrees and linear deviations in millimeter. Observational studies, reviews, animal studies, in vitro studies, case reports, simulation studies were excluded. Nine articles were included for qualitative synthesis. ResultsThe initial search detected 61 articles, and after screening abstracts, a total of 15 articles were selected for full-text review. After the full-text analysis of the 15 articles, six articles were excluded as they did not meet inclusion criteria for study design, study population, and implant placement with data presentation for angular and linear deviations. Ultimately, nine articles providing angular and linear deviations between planned and actual placed implants were used in this review. Common problems that may be encountered by clinicians were listed, and recommendations were made on how to avoid those problems. ConclusionsIt has been suggested that although unrealistic expectations are often associated with implant placement with CAD/CAM surgical guides, there is no impeccable accuracy in the clinic. This review demonstrated that the practitioners should be aware of the angular and linear deviations up to 5 ° and 2.3 mm. Therefore, inexperienced dentists should obtain adequate training and be familiar with the basic steps with CAD/CAM surgical guides to avoid complications. Key words:CAD/CAM, CBCT, implant, stereolithography, surgical guide.

Highlights

The loss of just one tooth will eventually have a global impact on the entire stomatognathic system
Utilizing a CBCT scan, a CAD/CAM surgical guide may be fabricated based on the precise location of a planned implant [11]
Three different surgical guide designs depending on their supporting surfaces have been described [16]; a) tooth-supported surgical guide is placed on the remaining natural teeth; b) mucosa-supported surgical guide is directly placed on the mucosa, allowing flapless implant placement; c) bone-supported surgical guide is placed on the bone following a full-thickness mucoperiostal flap elevation

Summary

Introduction

The loss of just one tooth will eventually have a global impact on the entire stomatognathic system. When restoring with dental implants, the implants can be placed in an ideal, predictable, and planned location by using recently introduced technology such as cone-beam computed-tomography (CBCT), 3-dimensional (3-D) implant planning software, and surgical guide utilizing computer-aided design and computer-aided manufacturing (CAD/CAM) [7,8,9]. Utilizing a CBCT scan, a CAD/CAM surgical guide may be fabricated based on the precise location of a planned implant [11]. The purpose of this study is to review the dental literature regarding implant placement with CAD/CAM surgical guides, and emphasize advantages and limitations of this recently popular method. The purpose of this study is to review the available literature associated with implant surgery using computer-aided design/computer-aided manufacturing (CAD/CAM) surgical guides and discuss the advantages and disadvantages of this advanced technique. Inexperienced dentists should obtain adequate training and be familiar with the basic steps with CAD/CAM surgical guides to avoid complications

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