Evaluation of the accuracy of two different surgical guides in dental implantology: stereolithography fabricated vs. positioning device fabricated surgical guides

Chang-Ryeol Kwon; Byung-Ho Choi; Seung-Mi Jeong; Sang-Dong Joo

doi:10.4047/jkap.2012.50.4.271

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Kwon, Choi, Jeong, and Joo: Evaluation of the accuracy of two different surgical guides in dental implantology: stereolithography fabricated vs. positioning device fabricated surgical guides

Original Article

The Journal of Korean Academy of Prosthodontics

The Journal of Korean Academy of Prosthodontics 2012; 50(4): 271-278.

Published online: 31 October 2012

DOI: https://doi.org/10.4047/jkap.2012.50.4.271

Evaluation of the accuracy of two different surgical guides in dental implantology: stereolithography fabricated vs. positioning device fabricated surgical guides

Chang-Ryeol Kwon, DDS¹, Byung-Ho Choi, DDS, PhD², Seung-Mi Jeong, DDS, PhD¹, Sang-Dong Joo, DDS, PhD³

¹Department of Prosthodontics, Wonju College of Medicine, Yonsei University, Wonju, South Korea.

²Department of Oral and Maxillofacial Surgery, Wonju College of Medicine, Yonsei University, Wonju, South Korea.

³Ye Dental Clinic, Daegu, South Korea.

Corresponding Author: Seung-Mi Jeong. Department of Prosthodontics, Yonsei University, Wonju College of Medicine, 162 Ilsan-dong, Wonju, South Korea. +82 33 741 1435: smj3@yonsei.ac.kr

Received 11 September 2012 Revised 8 October 2011 Accepted 12 October 2012

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

Recently implant surgical guides were used for accurate and atraumatic operation. In this study, the accuracy of two different types of surgical guides, positioning device fabricated and stereolithography fabricated surgical guides, were evaluated in four different types of tooth loss models.

Materials and methods

Surgical guides were fabricated with stereolithography and positioning device respectively. Implants were placed on 40 models using the two different types of surgical guides. The fitness of the surgical guides was evaluated by measuring the gap between the surgical guide and the model. The accuracy of surgical guide was evaluated on a pre- and post-surgical CT image fusion.

Results

The gap between the surgical guide and the model was 1.4 ± 0.3 mm and 0.4 ± 0.3 mm for the stereolithography and positioning device surgical guide, respectively. The stereolithography showed mesiodistal angular deviation of 3.9 ± 1.6°, buccolingual angular deviation of 2.7 ± 1.5° and vertical deviation of 1.9 ± 0.9 mm, whereas the positioning device showed mesiodistal angular deviation of 0.7 ± 0.3°, buccolingual angular deviation of 0.3 ± 0.2° and vertical deviation of 0.4 ± 0.2 mm. The differences were statistically significant between the two groups (P<.05).

Conclusion

The laboratory fabricated surgical guides using a positioning device allow implant placement more accurately than the stereolithography surgical guides in dental clinic.

Keywords: Surgical guide, Surgical stent, Anyguide, Computer-aided surgery, Flapless implant

Figures and Tables

Fig. 1

Models for study. A: Partial edentulous models, ⓐ: Single missing model, ⓑ: Kennedy Class-IV model, ⓒ: Kennedy Class-I model, ⓓ: Kennedy Class-III model. B: Gutta-percha markers.

Fig. 2

The radiographic guide and designing the surgical guide with stereolithography. A: Radiographic guide for stereolithography, B: Design the surgical guide with Osstem Quickguide®.

Fig. 3

Fabricating the surgical guide with stereolithography. A: Fabricating the surgical guide after fusing the two groups of CBCT DICOM files. B: Stereolithography fabricated surgical guide.

Fig. 4

The radiographic guide and designing the surgical guide with positioning device. A: Radiographic guide for positioning device, B: Design the surgical guide with Simplant®.

Fig. 5

Fabricating surgical guide with positioning device. A: Fabricating the surgical guide with positioning device, B: Laboratory fabricated surgical guide with positioning device.

Fig. 6

Flapless implant surgery with surgical guides. A: Flapless implant surgery with sereolithography fabricated surgical guide, B: Flapless implant surgery with laboratory fabricated surgical guide.

Fig. 7

Measuring the gap between the surgical guide and the model to evaluated the fitness.

Fig. 8

Evaluating the accuracy of surgical guides. A: Image fusioning of pre- and post- operational image, B: The accuracy of surgical guide was evaluated.

Fig. 9

The gap between the surgical guide and the model. A: Stereolithography, B: Laboratory fabricated.

Table 1

The fitness of the surgical guides to the models

Table 2

The accuracy of the surgical guides: angle and depth

Table 3

The accuracy of the surgical guides on each model: Mesiodistal angle (°)

Table 4

The accuracy of the surgical guides on each model: Buccolingual angle (°)

Table 5

The accuracy of the surgical guides on each model: Depth (mm)

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