Rapid prototyping in head and neck surgery planning

Abstract

Presurgical planning is essential to achieve esthetic and functional implants. The goal of this clinical study was to determine the angular and linear deviations at the implant neck and apex between planned and placed implants using stereolithographic (SLA) surgical guides.A total of 110 implants were placed using SLA surgical guides generated from computed tomography (CT). All patients used the radiographic templates during CT scanning. After obtaining 3-dimensional CT scans, each implant insertion was simulated on the CT images. SLA surgical guides using a rapid prototyping method including a laser beam were used during implant insertion. A new CT scan was made for each patient after implant insertion. Special software was used to match images of the planned and placed implants, and their positions and axes were compared.The mean angular deviation of all placed implants was 4.1° ± 2.3°, whereas mean linear deviation was 1.11 ± 0.7 mm at the implant neck and 1.41 ± 0.9 mm at the implant apex compared with the planned implants. The angular deviations of the placed implants compared with the planned implants were 2.91° ± 1.3°, 4.63° ± 2.6°, and 4.51° ± 2.1° for the tooth-supported, bone-supported, and mucosa-supported SLA surgical guides, respectively.The results of this study suggested that stereolithographic surgical guides using CT data may be reliable in implant placement, and tooth-supported SLA surgical guides were more accurate than bone- or mucosa-supported SLA surgical guides.