Use Of Surgical Guides Research Articles

Comparative evaluation of low-cost 3D scanning devices for ear acquisition

Autologous ear reconstruction is a surgical procedure performed in the case of defects of the outer ear in which the malformed anatomy is reconstructed with autologous cartilage tissue and often involves the use of surgical guides modelled from a digital reconstruction of the ear anatomy. To obtain such three-dimensional anatomy, traditional imaging methods, which are expensive and invasive, can be replaced by professional 3D scanners or low-cost commercial devices. In this context, this paper focuses on the evaluation of two devices for the acquisition of the outer ear, the Intel® RealSense D405™ (stereo camera) and the TrueDepth camera of the iPhone® 13 (structured light camera), proposing a comparison based on four parameters: accuracy, precision, deviation range and point-to-point distance, in order to assess their usability in the medical field, and in particular in the context of autologous ear reconstruction. The results show that, despite significantly different handling of the raw data, the performance of the two devices is comparable: average accuracy is 0.76 mm for the D405 and 0.95 mm for the iPhone 13, average precision is 0.071 mm for the D405 and 0.065 mm for the iPhone 13, average range of deviation is 3.12 mm for the D405 and 3.64 mm for the iPhone 13.

Use of both the diode and Er: YAG lasers in esthetic crown lengthening with the aid of digitally guided dual technique: 3 years follow-up.

To explore the feasibility of the usage of digital guides in combination with low- and high-power lasers for the treatment of excessive gingival display, also known as "gummy smile". Excessive gingival display due to altered passive eruption can affect patient's perception of their own esthetics and consequently have an impact on self-confidence. Therefore, the management of this condition should offer a predictable and stable long-lasting solution. To attain these objectives, digital planning emerges as a tool in optimizing the outcomes of crown lengthening surgery for this condition by enhancing precision through the use of surgical guides. Additionally, the usage of high- and low-powered lasers can provide a safe approach because of their tissue selective removal properties. The technique described showed satisfactory clinical results in the short- and long-term follow-up, leading to an improvement in patients' self-esteem. This approach integrates digital and laser technologies to deliver a surgical treatment characterized by precision, efficiency, and safety. Digital dentistry has contributed to innovative dental procedures, as personalizing surgical guides for patients, assisting and guiding incisions of the gingival margins, as well as the extension of the osteotomy, during the procedures for increasing the clinical crown. Furthermore, smile esthetics are directly related to an individual's improved emotional and social quality of life.

Surgical approach techniques for extraction of impacted or retained mesiodens: Literature review

The mesiodens corresponds to a number anomaly of dental development, which is formed between the upper central incisors. It is diagnosed by radiographic examination and the precise therapeutic option is extraction. The aim of this study is to review the different surgical techniques used in the extraction of intraosseous mesiodens by means of a review of the literature. Methodology: The collection of information was carried out through the search and selection of articles related to surgical techniques for the extraction of intraosseous mesiodens in the electronic databases PubMed, Google Scholar and Journal of Dental Research. The selection criteria taken into account were: age not older than 5 years, key words, human studies, impacted or retained mesiodens. From a total of 113 articles, 17 were chosen that are in accordance with the criteria of this research. Results and Conclusions: The free hand surgical approach has good results, but the use of surgical guides improves patient satisfaction, reduces operative time and difficulty of surgery and facilitates more precise osteotomies and incisions, without unnecessary tissue damage resulting in a more satisfactory postoperative improvement.

Acceptability of fully guided virtual implant planning software among dental undergraduate students

BackgroundFully guided implant surgery as a technique is gaining popularity. It has been observed that use of surgical guides improves precision and predictability for dental implant placement. However, like any other newer technology, the acceptance of fully guided dental implant technology among users is based upon its perceived usability. This study aimed at evaluating the perception about using Virtual Implant Planning Software (VIPS) among undergraduate dental students at the university of Sharjah.MethodsNinety-Six dental surgery students from the University of Sharjah were included in the study. One week after the Virtual Implant Planning Software (Planmeca Romexis version 6.2 procedure, students were asked to complete a Combined technology acceptance model and the theory of planned behaviour (C-TAM TPB) questionnaire. Sixty-six students responded to the questionnaire.ResultsCronbach’s alpha surpassed 0.7 for perceived usefulness, perceived ease of use, perceived behavioral control, and subjective norm. Attitude and behavioural intention reported Cronbach’s alpha values less than 0.7. Spearman’s correlation coefficient was significant for all the constructs. Perceived ease of use explained 49%, 33%, and 42% of the variance of perceived usefulness (R2 = 0.49), attitude (R2 = 0.33), and perceived behavioral control (R2 = 0.42) respectively. Perceived usefulness explained 25%, 18%, and 23% of the variance of attitude (R2 = 0.25), behavioral intention (R2 = 0.18), and perceived behavioral control (R2 = 0.23) respectively. Attitude accounted for 25%, 33%, and 29% of the variance of behavioral intention (R2 = 0.25), perceived behavioral control (R = 0.33), and subjective norm (R = 0.29) respectively.ConclusionThe fully guided VIPS was acceptable by dental students specifically because of its usability. This makes VIPS a very effective tool for teaching implantology for dental students. VIPS also allows students to perform multiple repetitions of the implant planning procedure which enhances understanding and content retention.

Multi goal, guided approach as a minimally invasive treatment: a case report

The use of surgical guides provides accuracy, predictability and shortens clinical time. Templates are widely used in implant dentistry. Studies present also the application of guides for targeted endodontic microsurgery. Nevertheless, most studies focus on one application of guided surgery. This case report presents single guided surgery for implants placement, sinus floor elevation and endodontic microsurgery. The 3-in-1 surgery was planned as an alternative to a staged approach. A 57-year-old female required endodontic microsurgery of tooth 24 and implants in sites 25 and 26 where sinus lift procedure was needed. One complex surgery was performed using the flapless approach for implant placement. OneCAS kit was used for guided, hydrostatic sinus floor elevation and OneGuide kit for implant placement and targeted micro endodontic apicoectomy through the VISTA approach. Retro preparation and retro fill were done. Implants and healing abutments were placed according to the virtual plan. Tapered implants 4.0 × 10 and 4.5 × 8.5 were placed with ISQ 78 and 76, respectively, for 25 and 26 sites. Healing was uneventful and sutures were removed after 7 days. After 4 months, impressions were taken for crowns on teeth 24 and 27 and implants 25 and 26. After one year from initial surgery no complications happened, clinical and radiological examinations reveal proper healing of all treated sites. Multi goal approach and combining a few surgeries in one, supported by proper planning and guided execution may be an option for low invasive and efficient treatment.

Precise modification of surgical and positioning guides for temporomandibular joint prostheses

Alloplastic temporomandibular joint (TMJ) replacement combined with orthognathic surgery has become an increasingly frequent procedure for the maxillofacial surgeon.1–3 The use of surgical guides, which mark the osteotomies and also serve as repositioning guides for the prostheses, has become absolutely indispensable in these surgeries.4

Novel alternative use of surgical guides in full-mouth implant rehabilitation cases: A case series

Novel alternative use of surgical guides in full-mouth implant rehabilitation cases: A case series

Guided Insertion of Temporary Anchorage Device in Form of Orthodontic Titanium Miniscrews with Customized 3D Templates—A Systematic Review with Meta-Analysis of Clinical Studies

(1) Background: Miniscrew insertion, using a surgical guide, aims to avoid possible adverse effects or complications. With the higher availability of both 3D imaging and printing, 3D surgical guides have been used more frequently in orthodontics. The aim of the present systematic review was to find scientific clinical evidence concerning the precision of the 3D guided insertion of miniscrews for temporary orthodontic anchorage. (2) Methods: Literature searches were performed in the following five search engines: Pubmed (Medline), Pubmed Central, Scopus, Web of Science and Embase on 10 September 2021 (articles from 1950 to 10 September 2021). A meta-analysis was performed using the random-effect model, with Standardized Mean Differences (SMD) and 95% confidence intervals (95% CI) calculated as effect estimates. The heterogeneity was assessed quantitatively. (3) Results: The search strategy identified 671 potential articles. After the removal of duplicates, 530 articles were analyzed. Subsequently, 487 papers were excluded, because they were not associated with the subject of the study. Of the remaining 43 papers, 34 were excluded because they did not meet the methodological criteria. Finally, only nine papers were subjected to a qualitative analysis. (4) Conclusions: The current literature concerning guided miniscrew insertion reveals, for the most part, a low methodological level. High-quality clinical trials are in the minority. The use of surgical guides increases insertion accuracy, stability and reduces the failure rate of orthodontic miniscrews. Tooth-borne insertion guides supported on the edges of the teeth ensure a higher insertion precision compared to mucosa-borne ones. The study protocol was registered in PROSPERO under the number CRD42021267248.

The Impact of Surgical Guide Fixation and Implant Location on Accuracy of Static Computer-Assisted Implant Surgery.

To evaluate the accuracy of static computer-assisted implant surgery (sCAIS) for tooth-supported free-end dental implantation with the aid/and without the aid of fixation pins to secure the surgical template through comparison between planned, 3D printed guide position and placement implant position. Thirty-two duplicated maxillary resin models were used in the present in vitro study. Digital planning was performed and fabrication of a surgical template that allowed implant placement on the distal extension edentulous site of the model (maxillary left side). A first optical scan was performed after fitting the surgical template on the model to assess the deviation at the surgical guide level. After placing implants in the model using the surgical guide, scan bodies were attached to the implants, and a second scan was performed to record the position of placed implants. The digital representations were later superimposed to the pre-operative scan and measurements of implant deviations were performed. Global (coronal and apical), horizontal (coronal and apical), depth and angular deviations were recorded between planned implant position, guide position, and placement implant position. Three-way ANOVA was used to compare implant location (#13, 14, and 15), fixation pin (with or without pin), and guide comparison (planned, guided, and placement). Final implant placement based on the digital plan and based on the 3D printed guide were very similar except for depth deviation. Use of fixation pin had a statistically significant effect on the depth and angular deviation. Overall, without fixation pins and based on guide versus placement, mean global coronal (0.88 ± 0.36 mm), horizontal coronal (0.55 ± 0.32 mm), and apical (1.44 ± 0.75 mm), and angular deviations (4.28 ± 2.01°) were similar to deviations with fixation pins: mean global coronal (0.88 ± 0.36 mm); horizontal coronal (0.67 ± 0.22 mm) and apical (1.60 ± 0.69 mm); and angular deviations (4.53 ± 2.04°). Horizontal apical without pins (1.63 ± 0.69 mm) and with fixation pins (1.72 ± 0.70 mm) was statistically significant (p = 0.044). Depth deviation without pins (-0.5 ± 0.5 mm) and with fixation pins (-0.16 ± 0.62 mm) was also statistically significant (p = 0.005). Further analysis demonstrated that the final sleeve position on the 3D printed guide was on average 0.5 mm more coronal than the digital plan. The use of surgical guides with or without fixation pins can provide clinically acceptable outcomes in terms of accuracy in implant position. There was a statistically significant difference in the accuracy of implant position when utilizing fixation pins only for horizontal apical and depth deviation. Additionally, a statistically significant difference between the planned and the 3D printed surgical guide when considering the sleeve position was detected.

Use of Surgical Guides for the Immediate Placement of Post-Extraction Implants

Depending on the time that has elapsed since extraction, the placement of one or more implants in the maxilla or mandible will be determined directly by the clinical and radiographic characteristics of the implant bed. In the case of multirooted teeth, placing an implant immediately after extraction is more complex due to the anatomical sites involved.

Accuracy of orthodontic mini-implants placed at the anterior palate by tooth-borne or gingiva-borne guide support: a cadaveric study.

The aim of this cadaveric study was to measure the transfer accuracy of orthodontic mini-implant placement at the anterior palate depending on tooth-borne or gingiva-borne guide support. Forty orthodontic mini-implants were placed paramedian in the anterior palate of 20 cadaver heads using tooth-borne (TBG) or gingiva-borne guides (GBG). Placement was planned after superimposition of lateral cephalograms and corresponding plaster models. After mini-implant placement, digital impressions were taken with scanbodies. For the measurement of both linear and angle deviations, virtual planning models and postoperative oral scans were compared using automatic surface registration based on an iterative closest point algorithm. Statistical differences between TBG and GBG were detected for lateral deviations 0.88mm (SD 0.46) versus 1.65mm (SD 1.03) (p = .004) and sagittal angular deviations 3.67° (SD 2.25) versus 6.46° (SD 5.5) (p = .043). No differences were found for vertical deviations 2.34mm (SD 0.74) versus 2.14mm (SD 0.73) (p = .40) and transverse angular deviations 3.60° (SD 2.89) versus 4.06° (SD 3.04) (p = .62). The use of surgical guides based on silicone provides sufficient control of orthodontic mini-implant placement and is comparable to CAD/CAM templates. However, when compared with guided dental implantology, the planned mini-implant position is more inaccurate. However, accuracy can be significantly increased by guide extension involving the teeth. Clinical investigations have to prove if the accuracy is sufficient for receiving an orthodontic appliance. The use of lateral cephalograms and plaster models for silicone guide construction leads to lower radiation exposure and provides sufficient accuracy for palatal orthodontic mini-implant placement.

A retrospective study of the accuracy of template-guided versus freehand implant placement: A nonradiologic method

The aim of this retrospective case study was to evaluate implant placement accuracy in inexperienced clinicians with use of a surgical guide template vs the freehand method for preoperatively planned implant position. Oral implant therapy was performed by inexperienced dental practitioners (<20 implants placed) on eligible patients after cone beam computer tomography (CBCT)-based software planning. Two patients' groups were formed according to the surgical technique: guided and freehand implant placement. The casts used for the fabrication of reconstructions were scanned by using a 3-dimensional (3D) laser scanner, the implant positions were superimposed with preoperative planning data, and the 3D deviations were calculated. Twenty adult patients were included in this retrospective study (20 guided and 21 freehand implant placements). Mean calculated deviations with use of a surgical guide template were significantly lower compared with those of the freehand method with regard to angulation (P = .002), apical position (P = .002), and basal position (P = .012). No significant differences in implant placement accuracy were detected between the groups according to the implant position (premolars/molars; upper jaw/lower jaw) (P > .05). Computer-aided planning and the use of surgical guides in accordance with CBCT images may help inexperienced clinicians to place implants with high accuracy.

Accuracy of surgical guides from 2 different desktop 3D printers for computed tomography-guided surgery

Statement of problemDifferent factors influence the degree of deviation in dental implant position after computed tomography–guided surgery. The surgical guide–manufacturing process with desktop 3D printers is such a factor, but its accuracy has not been fully evaluated. PurposeThe purpose of this in vitro study was to evaluate the deviation in final dental implant position after the use of surgical guides fabricated from 2 different desktop 3D printers using a digital workflow. Material and methodsTwenty 3D-printed resin models were prepared with missing maxillary premolar. After preoperative planning, 10 surgical guides were produced with a stereolithography printer and 10 with a digital light-processing (DLP) printer. A guided surgery was performed; 20 dental implants (3.8×12 mm) were installed, and a digital scan of the dental implants was made. Deviations between the planned and final position of the dental implants were evaluated for both the groups. ResultsA statistically significant difference between stereolithography and DLP were found for deviation at entry point (P=.023) and the vertical implant position (P=.009). Overall lower deviations were found for the guides from the DLP printer, with the exception of deviation in horizontal implant position. ConclusionsThe tested desktop 3D printers were able to produce surgical guides with similar deviations with regard to the final dental implant position, but the DLP printer proved more accurate concerning deviations at entry point and vertical implant position.

СОВРЕМЕННЫЕ ЗНАНИЯ И КЛИНИЧЕСКИЕ ПЕРСПЕКТИВЫ ИСПОЛЬЗОВАНИЯ ДЛЯ ПОЗИЦИОНИРОВАНИЯ ДЕНТАЛЬНЫХ ИМПЛАНТАТОВ ХИРУРГИЧЕСКИХ ШАБЛОНОВ. ОБЗОР ЛИТЕРАТУРЫ

Subject. Since the mid-20th century, there has been an increase of interest in implantation for the treatment of partial and complete loss of teeth. P. I. Branemark was one of the first pioneers who developed an implant that forms osseointegration. Anatomical restrictions and restorative requirements prompt the implantologist to achieve the accuracy of planning and surgical positioning of dental implants. The ideal placement of the implant facilitates the creation of favorable forces on implants and prosthetic structures, and also provides an aesthetic result. Therefore, it is advisable to establish a logical continuity between the planned restoration and the surgical stages, it is important to use the transmitting device, which undoubtedly increases the effectiveness of the implantation. In 1987, M. J. Edge et al. recommended the use of surgical guides before the implantation operation. Currently, surgical templates have become increasingly used. The article presents data on the features of planning of implant placement and the technology of applying a surgical template for positioning the dental implant unit. Goal. To show the value of using surgical templates for the rational installation of dental implants and preventing possible errors and complications. Methodology. A search for literature using search engines such as Google, Yahoo and scientific bibliographic databases such as PubMed, Medline and textbooks was conducted until September 2017 using medical thematic headings like «Dental Implants», «Surgical Templates». More than 300 sources of literature were identified, after studying which they reduced to 28 sources of articles and literary reviews. Conclusions. The study of available to us literature, revealed the advantages and disadvantages of using surgical templates. The main advantages: precise placement of implants, preservation of anatomical structures; three-dimensional technology allows to accurately estimate anatomical points, such as the size of the maxillary sinus in the upper jaw and the location of the alveolar nerve in the lower jaw, high observable accuracy of 0.1 mm, reduction of the time of surgical intervention. Disadvantages: lack of visibility and tactile control during the surgical procedure, insufficient opening of the mouth jeopardizes the result of complex treatment, there is a risk of damage to vital anatomical structures.

Modified Le Fort III Osteotomy: Different Applications.

Based on the new concepts of the modified Le Fort III osteotomy (MLFIIIO), Three variations of this technique are implemented: (A) the modified osteotomy Le Fort III Champy (1980) technique to be described with the use of surgical guides, and subciliary approach or an transconjunctival approach. Excellent technique for horizontal advancement no further to 6mm, without requiring any type of graft.. (B) The modified Le Fort III osteotomy in "Z": to solve horizontal (posterior anterior) problems of more than 6mm without bone grafting. It is itself a modification of the technique described by Champy. (C) The modified Le Fort III osteotomy ascending: modified the original technique described by Bell and Epker with interpositional grafts, was modified by the called ascendant, making it higher in cases where the patient has an acceptable nasal bridge, but exorbitism the lateral wall of the orbit. Le Fort III osteotomy combined with a Le Fort I osteotomy and a front implant. As pointed out in Part I for the modified oblique Le Fort III osteotomy, methods for the design of the osteotomy Le Fort III property will depend on the requirements of individual patients, and this has led us to design specific techniques for the deformity. Patients have a right projection of the middle third, and protection of the eyeball. The techniques presented for the advancement of the middle third have excellent results with the ability to be tailored to each patient deformity.

Использование 3D планирования и хирургического шаблона для профилактики неправильной установки цилиндрических имплантатов в костной ткани челюстей

&lt;p class="p1"&gt;&lt;span class="s1"&gt;&lt;strong&gt;Actuality: &lt;/strong&gt;&lt;/span&gt;&lt;span class="s2"&gt;In the treatment of patients with partial or complete loss of teeth, implants are being more widely used in prosthetics. When placement of cylindrical implants (CI), a serious complication is their wrong placement in the jaw bone tissue. &lt;/span&gt;&lt;span class="s1"&gt;&lt;strong&gt;The aim of the study &lt;/strong&gt;&lt;/span&gt;&lt;span class="s2"&gt;was rationale of the use of surgical templates as a method of prevention of improper placement of cylindrical implants. Objectives: 1. The study of the used methods of planning and placement of cylindrical implants in clinics of Yekaterinburg. 2. Analysis of errors and complications on the example of clinical cases when planning the installation of CI was done using x-ray methods when the absence of surgical templates. 3. Rationale for the use of 3D planning for implant placement and the use of surgical templates on the example of clinical cases. The results of this research was the study of the clinical use of surgical guides and software system IMPLANT-ASSISTANT® for the prevention of complications of improper installation of CI. &lt;/span&gt;&lt;/p&gt;

Design Active Intelligent Multi Degrees of Freedom Joint Controller for Dental Automation

Following the developments in industrial robot technology, robotics has found its way into the medical field and is used in a range of surgical disciplines. The main purpose of the use of robots is to increase the precision, quality and safety of surgical procedures. Robotics is not yet used in dentistry even though all the necessary technologies have already been developed and could easily be adapted. Some of the technologies are already used in dentistry, such as image-based simulation of implant surgery followed by the use of surgical guides, and creating digital impressions of pre parathions using an intra-oral scanner, after which a milling device produces the restoration, but we have not yet seen any robot able to prepare teeth for crowns, inlays or bridges. Such a robot would fundamentally be a dental drilling device coupled with a navigation device to determine the correct position of the device in relation to the patient. However this technique is very essential to have the minimal pain and reduce bleeding but control of these robots/joints are very complicated. This paper proposes new fuzzy type sliding mode controller for multi-DOF joints to control of motor vibration. The fuzzy (PD+I) 2 single-input single-output (SISO) fuzzy system is used to control of chattering in sliding mode controller. In most research al researchers wants to eliminate the chattering but, this research focuses on chattering control. Various operation situations such as the set point control and the trajectory control are simulated. The simulation results demonstrate that the chattering and the steady state errors, which usually occur in the classical sliding mode control, are limitation control and satisfactory trajectory tracking is achieved.

Mandibular reconstructions using computer-aided design/computer-aided manufacturing: A systematic review of a defect-based reconstructive algorithm.

Modern planning techniques, including computer-aided design/computer-aided manufacturing (CAD-CAM) can be used to plan reconstructive surgery, optimising aesthetic outcomes and functional rehabilitation. However, although many such applications are available, no systematic protocol yet describes the entire reconstructive procedure, which must include virtual planning, custom manufacture, and a reconstructive algorithm. We reviewed current practices in this novel field, analysed case series described in the literature, and developed a new, defect-based reconstructive algorithm. We also evaluated methods of mandibular reconstruction featuring virtual planning, the use of surgical guides, and laser printing of custom titanium bony plates to support composite free flaps, and evaluated their utility.

Overview of surgical guides for implant therapy

Prosthetically driven implant prosthesis assures good aesthetics, function and more importantly hygiene maintenance enabling long time success. Accuracy in treatment planning and implementation of planned treatment is vital for this success. Following advancements that have occurred in treatment planning (virtual software) for implant prosthesis; an equal rise is to be expected in transferring the planned therapy to surgical fruition. In this regard, surgical templates have enabled clinician to deliver predictable surgical & prosthetic rehabilitation. Surgical guides have not only decreased the chances of iatrogenic damage of critical anatomic structures; they also increase the esthetic and functional advantages of prosthodontic-driven implant. Within the constraints of this article, the authors describes an over view of use of surgical guides in clinical situation. If clinician is considered a pilot, then surgical guide is his navigator.

Accuracy of miniscrew surgical guides assessed from cone-beam computed tomography and digital models

Several methods are available to enhance the precision of miniscrew placement. The use of surgical guides based on cone-beam computed tomography is indicated especially in patients with risky or difficult anatomic situations. The purpose of this study was to evaluate the accuracy of miniscrew placement by using surgical guides developed with computer-aided design and manufacturing techniques. Miniscrews were placed in cadaver maxillae using stereolithographic computer-aided design and manufacturing techniques with assistance from surgical guides (surgical guide group, n = 25) or periapical x-rays (control group, n = 20). Insertion sites were selected using a 3-dimensional surgical planning program by fusing maxillary digital model images and cone-beam computed tomography images. Deviations between actual and planned placements were measured as 3-dimensional angular deviations and distance (coronal and apical) deviations. In the surgical guide group, the angular deviation was a median of 3.14° (range, 1.02°-10.9°), and the mesiodistal deviations in the coronal and apical areas were medians of 0.29 mm (range, 0.03-0.73 mm) and 0.21 mm (range, 0.03-0.97 mm), respectively. The deviations differed significantly between operators in the control group, but not in the surgical guide group. In the surgical guide group, there was no root damage from miniscrew placement, and 84% of the miniscrews were placed without contacting adjacent anatomic structures. In the control group, 50% of the miniscrews were placed between the roots (P <0.05). Surgical guide accuracy was improved when digital model imaging was used. Miniscrews were placed more accurately when using surgical guides than when using a direct method.