RESUMO
The aim of this study was to measure the angular and linear deviations between planned and placed dental implant positions at different depths in an in vitro model. Ten dental manikins of a maxilla without the central and lateral incisors were used. The implants were placed in the tooth positions using a prototype guide based on computed tomographic scans of dental casts. The groups consisted of implants placed at varying depths according to tooth position: 1 mm deep for the right lateral incisor, 2 mm deep for the right central incisor, 3 mm deep for the left central incisor, and 4 mm deep for the left lateral incisor (n = 10 per group). After implant placement, the manikin was scanned again to compare the positioning of the implants to the planned positions. Statistical analysis evaluated the linear deviations between planned and placed implant positions at 3 points (coronal, central, and apical) as well as the angular discrepancies. The analysis showed that the depth of the implant placement proportionally affected the linear deviation of the actual position from the planned position; thus, the deeper implants showed significantly greater linear deviations (P < 0.05; 1-way analysis of variance and Tukey test). There were no statistically significant differences in the mean angular deviations of the groups. Thus, the results suggest that implants placed at greater depths present greater linear deviations than implants placed at shallower depths, but the angular deviation is not affected by implant depth.
Assuntos
Implantes Dentários , Cirurgia Assistida por Computador , Tomografia Computadorizada de Feixe Cônico , Implantação Dentária Endóssea/métodos , Humanos , Imageamento Tridimensional , Incisivo , Cirurgia Assistida por Computador/métodosRESUMO
A tomografia computadorizada (TC) em Implantodontia permite planejar virtualmente a posição ideal do implante dentário considerando as características anatômicas e restauradoras. Através desse planejamento, o guia cirúrgico prototipado pode ser confeccionado possibilitando a integração dos determinantes protéticos no posicionamento dos implantes. Nesse contexto, a "técnica da tomografia do molde" para obtenção do guia prototipado consiste na realização da TC do molde do paciente que será vazado virtualmente para a obtenção de um modelo 3D, capaz de reproduzir tecidos moles e elementos dentais. Posteriormente, essa imagem é virtualmente sobreposta à tomografia da boca do paciente, permitindo uma avaliação óssea conjunta com o tecido mole e elementos dentais ausentes. O relato de caso descreve a reabilitação oral com implantes osseointegráveis utilizando um guia prototipado confeccionado através da "técnica da tomografia do molde". Paciente apresentava ausência dos dentes 17, 16, 14, 12, 11, 21, 22 e 26. Devido à presença de qualidade e quantidade óssea adequadas, foi planejada a reabilitação das áreas edêntulas com implantes dentários posicionados utilizando guia prototipado confeccionado pela "técnica da tomografia do molde". Após a obtenção do guia, os implantes dentários foram posicionados. Com a instalação dos provisórios, após 4 meses de osseointegração, constatou-se que a realização da cirurgia guiada com a utilização do guia prototipado obtido através da "técnica da tomografia do molde" garantiu previsibilidade no posicionamento dos implantes dentários trazendo facilidade na execução das próteses, além de sucesso estético/funcional no tratamento restaurador e maior comodidade ao paciente do início ao final do tratamento (AU).
The computed tomography (CT) in implant Dentistry allows virtually plan of the dental implant ideal position considering restorative and anatomical characteristics. Through this planning, a surgical guide can be prototyped for integrate prosthetic aspects in the positioning of the implants. In this context, the "mold tomography technique" for obtaining prototyped guide consists in use the CT of the patient mold to be poured virtually for obtaining a 3D model capable of reproducing soft tissues and dental elements. Then, this image is superimposed on the virtual scan of the patient's mouth, allowing a complete evaluation of bone and soft tissues. This case report describes the oral rehabilitation with dental implants using a prototyped guide made by "mold tomography technique." Patient had no 17, 16, 14, 12, 11, 21, 22, and 26 teeth. Due to the presence of quality and adequate bone quantity, it was planned rehabilitation of edentulous areas with dental implants positioned using prototyped guide made by "mold tomography technique." After obtaining the guide, dental implants were positioned. After 4 months of osseointegration, the final restaurations have been installed. With the installation of the provisory, after 4 months of osseointegration, it has noted that the realization of guided surgery using the guide prototyped obtained by "mold tomography technique" guaranteed predictability in the placement of dental implants bringing ease of application of the prosthesis beyond aesthetic / functional success in restorative treatment and convenience to the patient from beginning to end of treatment (AU).