J Adv Prosthodont.  2018 Aug;10(4):279-285. 10.4047/jap.2018.10.4.279.

The accuracy of a 3D printing surgical guide determined by CBCT and model analysis

Affiliations
  • 1Department of Prosthodontics, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea. ykd@jnu.ac.kr
  • 2DMAX Co. Ltd., Gwangju, Republic of Korea.

Abstract

PURPOSE
The aim of this clinical study was to assess the accuracy of the implants placed using a universal digital surgical guide.
MATERIALS AND METHODS
Among 17 patients, 28 posterior implants were included in this study. The digital image of the soft tissue acquired from cast scan and hard tissue from CBCT have been superimposed and planned the location, length, diameter of the implant fixture. Then digital surgical guides were created using 3D printer. Each of angle deviations, coronal, apical, depth deviations of planned and actually placed implants were calculated using CBCT scans and casts. To compare implant positioning errors by CBCT scans and plaster casts, data were analyzed with independent samples t-test.
RESULTS
The results of the implant positioning errors calculated by CBCT and casts were as follows. The means for CBCT analyses were: angle deviation: 4.74 ± 2.06°, coronal deviation: 1.37 ± 0.80 mm, and apical deviation: 1.77 ± 0.86 mm. The means for cast analyses were: angle deviation: 2.43 ± 1.13°, coronal deviation: 0.82 ± 0.44 mm, apical deviation: 1.19 ± 0.46 mm, and depth deviation: 0.03 ± 0.65 mm. There were statistically significant differences between the deviations of CBCT scans and cast.
CONCLUSION
The model analysis showed lower deviation value comparing the CBCT analysis. The angle and length deviation value of the universal digital guide stent were accepted clinically.

Keyword

Stents; Computer-Assisted Surgery; Computer-Assisted Radiotherapy Planning

MeSH Terms

Casts, Surgical
Clinical Study
Humans
Printing, Three-Dimensional*
Radiotherapy Planning, Computer-Assisted
Stents
Surgery, Computer-Assisted

Figure

  • Fig. 1 Pre-surgical procedure. (A) Diagnostic cast, (B) STL data scanned by 3D model scanner, (C) Pre-surgical CBCT image, (D) Planning on position and angulation of the implant, (E) Surgical guide fabricated by stereolithography.

  • Fig. 2 Surgical procedures of flapless implant fixture installation by using surgical guide. (A) Surgical template applied over the edentulous area and adjacent teeth, (B) Removal of soft tissue with punch, (C) Drilling through the implant template with a drill, (D) Postoperative view of installed implant.

  • Fig. 3 Overlapping observation between planned and inserted implants for measurement of deviations. (A) Cross-sectional view of the overlapping, (B) Panoramic view of the overlapping.

  • Fig. 4 Inserted model. (A) The cast of inserted model, (B) STL data of inserted model scanned by 3D model scanner, (C) Component used for fabrication of planned model, (D) The cast of planned model, (E) STL data of planned model scanned by 3D model scanner.

  • Fig. 5 (A) Illustrations of the deviations between planned and inserted implant on the method with cast, (B) The accuracy analysis between planned and inserted implant by 3D analysis program.

  • Fig. 6 The angle and length deviation between CBCT and cast. Results show mean ± SD angle deviation. * indicates statistical differences (P < .05).

  • Fig. 7 Scatter plot for the Pearson correlation between CBCT analysis and cast analysis. (A) The angle deviation (P = .001, R = 0.635), (B) The coronal deviation (P = .054, R = 0.368), (C) The apical deviation (P = .024, R = 0.426).


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