The success rate of mini-screws for incisors intrusion and patient age, gender, and insertion angle in the maxilla using CBCT and implant-guided surgery. A split-mouth, randomized control trail.

BACKGROUND AND OBJECTIVES: The intrusion of anterior teeth is a routine procedure in orthodontics, which has been performed efficiently with the help of mini-screws in the anterior region, especially the upper maxilla. This study aimed to investigate the effect of insertion angle and sociodemographic features on the success rate of mini-screws at the anterior maxillary region. MATERIALS AND METHODS: Twenty-nine patients (18 Females and 11 Males) aged 18-40 years old were involved in the current study. A split-mouth design was carried out in which recruited patients needed bilateral anterior screws at the labial bone in the region of the incisor for the intrusion of upper anterior incisor teeth as part of their orthodontic treatment with a fixed appliance (upper right side received 90-degree insertion angle mini-screw and 45° for left side) using a surgical guide fabricated from patients CBCT and intraoral scans. The mini-screws were inserted at the attached gingiva bilaterally to achieve intrusion of upper anterior teeth with a power chain ligated from the main archwire to the anterior min-implants. The patient was recalled monthly for orthodontic appliance activation and screw assessment for 6 months. The intrusion force was 15 g on each side. RESULTS: The results of the study showed that screw stability was higher in the male group than the female group at the 6th monthly follow-up visit with a statistically significant difference between both genders (P = .044). Concerning insertion angle, results showed a statistically significant difference between 45° and 90° as an insertion angle with a P-value <.01 in most of the follow-up months. CONCLUSION: This study found that male patients with mini-screws inserted at 90° showed greater screw stability over time.

Accuracy of dental implant placement with computer-guided surgery: a retrospective cohort study.

BACKGROUND: The aim of this study was to assess the accuracy of virtual planning of computer-guided surgery based on the actual outcomes of clinical dental implant placement. METHODS: This retrospective study enrolled patients among whom implant treatment was planned using computer-guided surgery with cone beam computed tomography (CBCT). The patients who received implant according to the guide with the flapless and flapped approach were classified as group 1 and 2, respectively, and the others who could not be placed according to the guide were allocated to the drop-out group. The accuracy of implant placement was evaluated with the superimposition of CBCT. RESULTS: We analyzed differences in the deviated distance of the entrance point and deviated angulation of the insertion of implant fixtures. With regard to the surgical approach, group 2 exhibited greater accuracy compared to group 1 in deviation distance (2.22 ± 0.88 and 3.18 ± 0.89 mm, respectively, P < 0.001) and angulation (4.27 ± 2.30 and 6.82 ± 2.71°, respectively, P = 0.001). The limitations of guided surgery were discussed while considering the findings from the drop-out group. CONCLUSIONS: Computer-guided surgery demonstrates greater accuracy in implant placement with the flapless approach. Further research should be conducted to enhance the availability of guides for cases with unfavorable residual bone conditions.

Full-digital workflow to rehabilitate a high value aesthetic zone. A case report.

Replacing missing teeth in the aesthetic area is a clinical challenge which must be solved by a multidisciplinary approach in order to obtain an esthetic and functional implant-prosthetic rehabilitation. First therapeutic choice should be the less invasive option, in accordance with patients' expectations. The present clinical case presents the rehabilitation of the upper incisor group using a full-digital workflow to reduce operative time, costs and patient discomfort. The use of computer-guided-surgery and 3D technologies, as intraoral scanners or cone-beam-computed-tomography, allows the clinician to visualize all patient's information when planning the rehabilitation in order to obtain a more predictable and a less invasive surgery.

Is Digital Guided Implant Surgery Accurate and Reliable?

The digital workflow for computer-aided implant surgery includes a range of steps leading to generation of a prosthetically driven, 3-dimensional virtual plan, which is transitioned into the patient's mouth by the surgical guide and protocol. Guided implant surgery is believed to be accurate and reliable compared with free-handed implant surgery. However, deviation between implant virtual plan and implant real position may occur as a result of accumulated errors throughout the digital workflow. This article reviews the digital workflow of static computer-aided implant surgery. Factors that may affect the accuracy and clinical outcome of the guided surgery are also reviewed.

Computer-assisted surgery and intraoral welding technique for immediate implant-supported rehabilitation of the edentulous maxilla: case report and technical description.

BACKGROUND: Complications are frequently reported when combining computer assisted flapless surgery with an immediate loaded prefabricated prosthesis. The authors have combined computer-assisted surgery with the intraoral welding technique to obtain a precise passive fit of the immediate loading prosthesis. METHODS: An edentulous maxilla was rehabilitated with four computer assisted implants welded together intraorally and immediately loaded with a provisional restoration. RESULTS: A perfect passive fit of the metal framework was obtained that enabled proper osseointegration of implants. Computer assisted preoperative planning has been shown to be effective in reducing the intraoperative time of the intraoral welding technique. No complications were observed at 1 year follow-up. CONCLUSIONS: This guided-welded approach is useful to achieve a passive fit of the provisional prosthesis on the inserted implants the same day as the surgery, reducing intraoperative time with respect to the traditional intraoral welding technique. Copyright © 2015 John Wiley & Sons, Ltd.

Software tools and surgical guides in dental-implant-guided surgery.

Cone beam computed tomography has become an essential tool in the diagnosis and planning for implant dentistry. New hardware and software developments have emerged to help implant surgeons to successfully adopt and use different systems in patients requiring prosthetically driven implant dentistry. However, there is the need to develop an adequate planning protocol that includes appropriate acquisition/data manipulation, appropriate use of software tools for interpretation, and appropriate application of such systems during implant surgery. This article examines essential characteristics of the entire implant-guided surgery planning process and points out potential sources of error that could affect clinical accuracy outcomes.