Application of integrated digital maxillodental model in computer aided design and manufacturing of individualized miniscrew surgical guides

Abstract

Objective (1) To apply an integrated digital maxillodental model in computer aided design and manufacturing(CAD/CAM) of individualized miniscrew surgical guides (2) and to evaluate the accuracy of miniscrew placement by using the surgical guides. Methods Integrated the cone beam computerized tomography (CBCT)-based maxillodental model and laser-scanned dental model in 12 subjects. Virtual positions of miniscrews were determined based on the integrated digital maxillodental models. 3D virtual surgical guides were designed according to the virtual implantation plans and fabricated with stereolithographic appliance(SLA). Miniscrews were implanted in the patient's upper jaw area using surgical guides (experimental group, n=12) or periapical X-ray (control group, n=12). Deviation between actual and planned placements were measured as 3D angular deviations and distance (coronal and apical) deviations. The security and stability of miniscrews implantation was evaluated. Results In the surgical guides group, the angular deviation was a mean of 4.97±1.79°, and the distance deviations in the coronal and apical areas were mean of 0.98±0.30 mm and 1.03±0.22 mm .There was no root damage from miniscrew placement, and 10 of the miniscrews were placed in the middle of roots. While in control group, 4 of the miniscrews were placed in the middle of roots. Conclusions The surgical guide has high accuracy and will be especially useful for patients who require precise miniscrew placement. Key words: integrated digital maxillodental model; CBCT; CAD/CAM; individualized miniscrew surgical guides