Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski, Gospodin Iliev
ISSN: 1312 773X (Online)
Issue: 2016, vol. 22, issue 3
Subject Area: Dental Medicine
Pages: 1279-1284
DOI: 10.5272/jimab.2016223.1279
Published online: 10 September 2016

J of IMAB 2016 Jul-Sep;22(3):1279-1284
Rosen Borisov Corresponding Autor,
Department of Oral and diagnostic imaging, Faculty of Dental medicine, Medical University - Sofia, Bulgaria.

The use of surgical guides in implant treatment increases the accuracy of the dental implant positioning compared with manual methods. Regardless of how they are made, deviations of implants from their intended position are established in all kinds of surgical guides. This article considers the use of plastic material and new scanning technique for the production of CAD/CAM surgical guides that aim to overcome the deficiencies of the currently applied technologies in the production of surgical guides.
Materials and methods: The study shows the techniques used to overcome degraded by metal artifacts CBCT images in implant treatment of patients with partial edentulism, and located medially to the defect metal-ceramic crowns. When planning implant treatment, a triple scan method has been implied. At the beginning, CBCT scan of the patient with a silicone impression material is made in the zone of interest. Secondly, CBCT scan only of the silicon impression is made, and thirdly - intraoral scanning of the patient with an intraoral scanner. Virtual analogues have been created of images from the three scans and have been repositioned one over another; as thereby an intraoral image have been accurately positioned over the CBCT image of the patient. Virtual planning of the implant positioning has been performed, and a model of surgical guide has been made for their placement. The guide has been printed with an SLA 3D printer technology of photopolymer with dualistic characteristics-rigid in the working part and plastic in the fixing part. Through it, implants have been placed to the treatment planning. Postoperative CBCT has been done on the patient to measure the implant deviation to their position in the treatment planning.
Results: Axes angular deviation of the planned and placed implants has not been established. Average linear displacement of 240 μ (+/- 40 μ) has been found.
Conclusions: Using the triple scan method is possible to overcome the poor image quality of the metal (metal-ceramic) structures artifacts in CBTC scan of patients for implant treatment. Using semi-plastic material for printing of the surgical guide allows its good fixation intraoperative and the accurate guidance of the implant drill that provides the implant placement with clinically negligible deviation from their intended position.

Key words: CAD/CAM surgical guides, CBCT, dental implant, intraoral scanner,

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Please cite this article in PubMed Style or AMA (American Medical Association) Style:
Borisov R. Use of plastic material and triple scan in the preparation of surgical guides for the dental implant treatment - case report. J of IMAB. 2016 Jul-Sep;22(3):1279-1284.

Correspondence to: Dr Rosen Borisov, Department of Oral and diagnostic imaging, Faculty of Dental medicine, Medical University, Sofia; 1, St. Georgi Sofiiski str., 1431 Sofia, Bulgaria; E-mail:

1. Misch CE. Contemporary Implant Dentistry. 3rd ed. St. Louis: Mosby. 2007.
2. Scherer U, Stoetzer M, Ruecker M, Gellrich NC, von See C. Template-guided vs. non-guided drilling in site preparation of dental implants. Clin Oral Investig. 2015 Jul;19(6):1339-46. [PubMed] [CrossRef]
3. Noharet R, Pettersson A, Bourgeois D Accuracy of implant placement in the posterior maxilla as related to 2 types of surgical guides: a pilot study in the human cadaver. J Prosthet Dent. 2014 Sep;112(3):526-32. [PubMed] [CrossRef]
4. Arisan V, Karabuda CZ, Mumcu E, Özdemir T. Implant positioning errors in freehand and computer-aided placement methods: a single-blind clinical comparative study. Int J Oral Maxillofac Implants. 2013 Jan-Feb;28(1):190-204. [PubMed] [CrossRef]
5. Vercruyssen M, Jacobs R, Van Assche N, van Steenberghe D. The use of CT scan based planning for oral rehabilitation by Means of implants and its transfer to the surgicalfield: acritical review on accuracy. J Oral Rehabil. 2008 Jun;35(6):454-74. [PubMed] [CrossRef]
6. Lanis A, Alvarez Del Canto O. The combination of digital surface scanners and cone beam computed tomography technology for guided implant surgery using 3Shape implant studio software: a case history report. Int J Prosthodont. 2015 Mar-Apr;28(2):169-78. [PubMed] [CrossRef]
7. Flügge TV, Nelson K, Schmelzeisen R, Metzger MC. Three-dimensional plotting and printing of an implant drilling guide: simplifying guided implant surgery. J Oral Maxillofac Surg. 2013 Aug;71(8):1340-6. [PubMed] [CrossRef]
8. Lee CY, Ganz SD, Wong N, Suzuki JB. Use of cone beam computed tomography and a laser intraoral scanner in virtual dental implant surgery: part 1. Implant Dent. 2012 Aug;21(4):265-71. [PubMed] [CrossRef]
9. Yatzkair G, Cheng A, Brodie S, Raviv E, Boyan BD, Schwartz Z . Accuracy of computer-guided implantation in a human cadaver model. Clin Oral Implants Res. 2015 Oct;26(10):1143-9. [PubMed] [CrossRef]
10. Cassetta M, Giansanti M, Di Mambro A, Stefanelli LV.Accuracy of positioning of implants inserted using a mucosa-supported stereolithographic surgical guide in the edentulous maxilla and mandible. Int J Oral Maxillofac Implants. 2014 Sep-Oct;29(5):1071-8. [PubMed] [CrossRef]
11. Vieira DM, Sotto-Maior BS, Barros CA, Reis ES, Francischone CE.Clinical accuracy of flapless computer-guided surgery for implant placement in edentulous arches. Int J Oral Maxillofac Implants. 2013 Sep-Oct;28(5):1347-51. [PubMed] [CrossRef]
12. Turbush SK, Turkyilmaz I. Accuracy of three different types of stereolithographic surgical guide in implant placement: an in vitro study. J Prosthet Dent. 2012 Sep;108(3):181-8. [PubMed]
13. Soares MM, Harari ND, Cardoso ES, Manso MC, Conz MB, Vidigal GM Jr.An in vitro model to evaluate the accuracy of guided surgery systems. Int J Oral Maxillofac Implants. 2012 Jul-Aug;27(4):824-31.  [PubMed]
14. Giordano M, Ausiello P, Martorelli M.Accuracy evaluation of surgical guides in implant dentistry by non-contact reverse engineering techniques. Dent Mater. 2012 Sep;28(9):e178-85. [PubMed]
15. Van Assche N, Vercruyssen M, Coucke W, Teughels W, Jacobs R, Quirynen M. Accuracy of computer-aided implant placement. Clin Oral Implants Res. 2012 Oct;23 Suppl 6:112-23. [PubMed] [CrossRef].

Received: 12 April 2016
Published online: 10 September 2016

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