Computer-assisted Design + Self-designed Surgical Guide Used In Implantology: A Clinic Study

Background In recently years , computer navigation has been used in medical area especially in implantology. Implants were placed in the jaw bone precisely to achieve the best position from the prosthesis , meanwhile , minimally invasion should be considered in the procedure. However, the position of the implants has decisive effect on the final results in terms of mastication, phonation, and esthetics. In order to achieve a predicable treatment outcome, a comprehensive diagnostic work - up of the planed implant positions and then precisely transferring to the implant surgery is a paramount before surgery. Image guided navigation surgery or stereographic surgical guide by technique are developed for this purpose. There are many software and hardware designed by different companies available in the market nowadays such as Nobel guide and Materealize guide. But this technique has been restricted rapidly to develop by expensive price and long time to made in the laboratory . Purpose In this study, we used a simulated dental cast model to test the precision between the planned pre—operative implant position and the actual placed implant position using metal tube guided surgical templates. The radiographic examination and analysis of the implant position were performed with CT and Simplant software respectively. Methods Thirteen patients ranging from 20 to 73 years were recruited from Inner Mongolia Hospital, thirty—four implants were placed. The 2. 2 diameter pilot guide drill was used to create a precise, minimally invasion initial penetration through the mucosa and into bone . The parameters evaluated were depth from mucosal margin to bone crest . implant position including depth and angulation in the bone. From the preoperation and postoperation CT image, for 34 implants placed in 13 patients , the data was statisticed by SPSS 16. 0 software. Results 1. Data obtained from this study shows that the depth and angulation in panoramic is perfect : the depth deflexion mean is 0.62mm, P<0.05; the angulation in cross sectional deflexion mean is 9.44 degree to the designation of pre - operation , P< 0.05, angulation abutment can adjust the dental prosthetic restoration to a correct occlusion relationship. 2. This article presents a technique for dental implants in a flapless approach that utilizes the tracking technology of a computerized navigation system. Conclusion 1. The preoperative planning of implant position could be predictably transferred to the operative field using metal tube guided surgical template. Using the techniques described in our study, the implant could be placed as accurately as other commercialized products like Simplant Surgical Guide 2. The results of this study demonstrate that following diagnostic treatment planning criteria, flapless surgery using a minimally invasive technique is a predictable procedure. The benefits of this procedure are lessened surgical time; minimal changes in crestal bone levels, probing depth, and inflammation; perceived minimized bleeding; and lessened postoperative discomfort.