Search

Objectives: The objective of this study is (1) to compare the accuracy of an open‐sleeved static computer‐assisted implant system (sCAIS) with a closed‐sleeve sCAIS and free‐hand approach in immediate implant placement (IIP) of maxillary molar sites and (2) to investigate the influence of socket morphology on these approaches. Materials and Methods: Ninety partially edentulous duplicated maxillary models simulating three different molar sockets (type A, B, and C based on Smith and Tarnow's classification) were investigated. Three modalities, including sCAIS with open‐sleeves, sCAIS with closed‐sleeves, and free‐hand approach, were applied separately to 30 models with 120 sockets. A customized Python script automatically measured the deviations between the virtual and actual implant positions for all 360 implants. Results: The 3D deviations of sCAIS were significantly influenced by the socket and sleeve types. Both guided groups exhibited significantly less deviation than the free‐hand approach. Type A and C sockets resulted in better implant positions than type B socket sites. In type B sockets, the open‐sleeve group achieved significantly less deviation compared to the closed‐sleeve group, with respect to apical global (1.34 ± 0.53 vs. 1.84 ± 0.59 mm), coronal horizontal (0.68 ± 0.36 vs. 0.93 ± 0.34 mm), apical horizontal (1.21 ± 0.59 vs. 1.74 ± 0.63 mm), and angular (3.30 ± 1.41 vs. 4.41 ± 1.96°) deviations. Conclusions: Guided implant surgery significantly reduces deviations during molar IIP compared to free‐hand procedures. Furthermore, the use of open‐sleeve sCAIS appears to be more effective in minimizing deviations in type B sockets when compared with the closed‐sleeve guided system. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this in vitro study was to compare the trueness and precision of complete arch implant impressions using conventional impression, intraoral scanning with and without splinting, and stereophotogrammetry. Materials and Methods: An edentulous model with six implants was used in this study. Four implant impression techniques were compared: the conventional impression (CI), intraoral scanning (IOS) without splinting, intraoral scanning with splinting (MIOS), and stereophotogrammetry (SPG). An industrial blue light scanner was used to generate the baseline scan from the model. The CI was captured with a laboratory scanner. The reference best‐fit method was then applied in the computer‐aided design (CAD) software to compute the three‐dimensional, angular, and linear discrepancies among the four impression techniques. The root mean square (RMS) 3D discrepancies in trueness and precision between the four impression groups were analyzed with a Kruskal–Wallis test. Trueness and precision between single analogs were assessed using generalized estimating equations. Results: Significant differences in the overall trueness (p =.017) and precision (p <.001) were observed across four impression groups. The SPG group exhibited significantly smaller RMS 3D deviations than the CI, IOS, and MIOS groups (p <.05), with no significant difference detected among the latter three groups (p >.05). Conclusions: Stereophotogrammetry showed superior trueness and precision, meeting misfit thresholds for implant‐supported complete arch prostheses. Intraoral scanning, while accurate like conventional impressions, exhibited cross‐arch angular and linear deviations. Adding a splint to the scan body did not improve intraoral scanning accuracy. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the efficacy of various interdental cleaning aids for artificial biofilm removal on different implant‐supported crown designs. Methods: Mandibular models with missing first molar were fabricated and installed with single implant analogs and loaded with crowns of different designs (concave, straight, and convex). Artificial biofilm was made with occlusion spray. Thirty volunteers (periodontists, dental hygienists, and laypersons) were asked to clean the interproximal areas. The crowns were unscrewed and photographed in a standardized setting. The outcome was measured by the cleaning ratio which represents the cleaned surfaces in relation to the area of the tested surface. Results: A significant difference in favor of concave crown (p <.001) on the basal surface was cleaned by all tools, except the water flosser. There was evidence of an overall effect of "cleaning tool," "surface," and "crown design" (p <.0001) except for the "participant" factor. The mean cleaning ratio for each cleaning tool and overall combined surfaces were (in%): dental floss: 43.02 ± 23.93, superfloss: 42.51 ± 25.92, electric interspace brush: 36.21 ± 18.78, interdental brush: 29.10 ± 15.95, and electric water flosser: 9.72 ± 8.14. Dental floss and superfloss were significantly better (p <.05) than other tools in removing plaque. Conclusions: Concave crown contour had the greatest artificial biofilm removal, followed by straight and convex crowns at the basal surface. Dental floss and superfloss were the most effective interdental cleaning devices for artificial biofilm removal. None of the tested cleaning devices were able to completely remove the artificial biofilm from the interproximal/basal surfaces. [ABSTRACT FROM AUTHOR]

Objective: A buccal opening guide provides better view and better irrigation. The aim of this study was to investigate the accuracy of this open‐sleeve system. Material and Methods: Thirty duplicated maxillary models, each with six extraction sockets and four healed sites, were used. Based on the same digital plan, three modalities, sCAIS with open‐sleeves, closed‐sleeves, and free‐hand approach, were used to place implants. The global, horizontal, depth, and angular deviations between the virtual and actual implant positions were measured. Results: Both sCAIS groups exhibited better accuracy than the free‐hand group in two clinical scenarios. At healed sites, the closed‐sleeve group showed a significantly fewer error than the open‐sleeve group in global apical (0.68 ± 0.33 vs. 0.96 ± 0.49 mm), horizontal coronal (0.28 ± 0.15 vs. 0.44 ± 0.25 mm), horizontal apical (0.64 ± 0.32 vs. 0.94 ± 0.48 mm), and angular deviations (1.83 ± 0.95 vs. 2.86 ± 1.46°). For extraction sockets, the open‐sleeve group exhibited fewer deviations than the closed‐sleeve group in terms of global (coronal: 0.77 ± 0.29 vs. 0.91 ± 0.22 mm; apical: 1.08 ± 0.49 vs. 1.37 ± 0.52 mm) and horizontal (coronal: 0.60 ± 0.24 vs. 0.86 ± 0.20 mm; apical: 0.95 ± 0.50 vs. 1.32 ± 0.51 mm) deviations. However, the closed‐sleeve group was more accurate in the depth control (0.26 ± 0.20 vs. 0.40 ± 0.31 mm). Conclusion: In this in vitro investigation, open‐sleeve sCAIS proved better accuracy than free‐hand surgery for both delayed and immediate implant placement. Compared with a closed‐sleeve sCAIS system, open sleeve have the potential of providing better outcomes in extraction sockets but not in healed sites. [ABSTRACT FROM AUTHOR]

Objective: To compare the accuracy of computer‐guided surgery and freehand surgery on flapless immediate implant placement (IIP) in the anterior maxilla. Material and Methods: In this split‐mouth design, 24 maxillary incisors in eight human cadaver heads were randomly divided into two groups: computer‐guided surgery (n = 12) and freehand surgery (n = 12). Preoperatively, cone‐beam computed tomography (CBCT) scans were acquired, and all implants were planned with a software (Blue Sky Plan3). Then, two types of surgeries were performed. To assess any differences in position, the postoperative CBCT was subsequently matched with the preoperative planning. For all the implants, the angular, global, depth, bucco‐lingual, and mesio‐distal deviations between the virtual and actual implant positions were measured. Results: A significant lower mean angular deviation (3.11 ± 1.55°, range: 0.66–4.95, p = 0.002) and the global deviation at both coronal (0.85 ± 0.38 mm, range: 0.42–1.51, p = 0.004) and apical levels (0.93 ± 0.34 mm, range: 0.64–1.72, p < 0.001) were observed in the guided group when compared to the freehand group (6.78 ± 3.31°, range: 3.08–14.98; 1.43 ± 0.49 mm, range: 0.65–2.31, and 2.2 ± 0.79 mm, range: 1.01–4.02). However, the accuracy of these two approaches was similar for the depth (p = 0.366). In the buccal direction, the mean deviations of both groups showed a general tendency of implants to be positioned facially, occurring more in implants of the freehand group. Conclusion: In flapless IIP, computer‐guided surgery showed superior accuracy than freehand surgery in transferring the implant position from the planning. However, even with the help of a guide, the final fixture position tends to shift toward a facial direction. [ABSTRACT FROM AUTHOR]