Digital implantology-a review of virtual planning software for guided implant surgery. Part II: Prosthetic set-up and virtual implant planning.

BACKGROUND: Patient- and technology-related parameters influence the successful implementation of virtual implant planning and guided implant surgery. Besides data processing and computer aided design of drill guides as described in Part I, the possibilities and limitations for prosthetic set-up and virtual implant planning are essential (Part II). METHODS: The following software systems were examined using two different clinical situations for implant therapy: coDiagnostiX™, DentalWings, Canada (CDX); Simplant Pro™, Dentsply, Sweden (SIM); Smop™, Swissmeda, Switzerland (SMP); NobelClinician™, Nobel Biocare, Switzerland (NC); Implant Studio, 3Shape, Denmark (IST). Assessment criteria geared towards interfaces and integrated tools for prosthetic set-up and virtual implant planning. RESULTS: A software interface for an individual virtual prosthetic set-up was provided by two systems (CDX, IST), whereas the set-up of standardized teeth was provided by four systems (CDX, SIM, SMP, IST). Alternatively, a conventional set-up could be scanned and imported. One system could solely work with the digitization of a conventional set-up for virtual implant planning (NC). Stock abutments could be displayed for implant planning, but none of the tested software systems provided tools for the design of an individual abutment. All systems displayed three-dimensional reconstructions or two-dimensional cross-sections with varying orientation for virtual implant placement. The inferior alveolar nerve could be marked to respect a minimum distance between the nerve and the planned implant. Three implant planning systems provided a library to display more than 50 implant systems (CDX, SIM, IST), one system provided 33 implant systems (SMP) and one implant system provided 4 implant systems (NC). CONCLUSION: Depending on the used software system, there are limited options for a virtual set-up, virtual articulators and the display of a virtual prosthetic set-up. The implant systems used by the clinician is important for the decision which software system to choose, as there is a discrepancy between available implant systems and the number of supported systems in each software.

A review of virtual planning software for guided implant surgery - data import and visualization, drill guide design and manufacturing.

BACKGROUND: Virtual implant planning systems integrate (cone beam-) computed tomography data to assess bone quantity and virtual models for the design of the implant-retained prosthesis and drill guides. Five commercially available systems for virtual implant planning were examined regarding the modalities of integration of radiographic data, virtual dental models and the design of drill guides for guided implant surgery. The purpose of this review was to describe the limitations of these available systems regarding the import of imaging data and the design and fabrication of a drill guide. METHODS: The following software systems were examined regarding the import of imaging data and the export of the virtual implant planning for the design and fabrication of a drill guide with the help of two clinical situations requiring dental implant therapy: coDiagnostiX™, DentalWings, Canada (CDX); Simplant Pro™, Dentsply, Sweden (SIM); Smop™, Swissmeda, Switzerland (SMP); NobelClinician™, Nobel Biocare, Switzerland (NC); Implant Studio, 3Shape, Denmark (IST). Assessment criteria included data formats and management as well as the workflow for the design and production of drill guides. RESULTS: All systems have a DICOM-interface ("Digital Imaging and Communication in Medicine") for the import of radiographic data. Imaging artefacts could be reduced but not eliminated by manual data processing. The import of virtual dental models in a universal format (STL: Standard Tesselation Language) was possible with three systems; one system could only be used with a proprietary data format. All systems display three-dimensional surface models or two-dimensional cross-sections with varying orientation for virtual implant planning. Computer aided design and manufacturing (CAD/CAM) of drill guides may be performed by the user with the help of default parameters or solely by the provider of the software and thus without the influence of the clinician. CONCLUSION: Data bases of commonly used implant systems are available in all tested software, however not all systems allow to plan and execute fully guided implant placement. An individual design and in-house manufacturing of the drill guide is only available in some software systems. However, at the time of publication most recent software versions showed flexibility in individual design and in-house manufacturing of drill guides.