Effect of Anchor-Guiding Sleeve Length on the Accuracy of Computer-Guided Flapless Implant Surgery.

The objective of this study was to evaluate the effect of anchor-guiding sleeve length on the accuracy of computer-guided flapless implant surgery in edentulous cases. Twelve identical polyurethane edentulous mandibular models were equally divided into short and long anchor-guiding sleeve groups based on the type of anchor-guiding sleeve. After implant placement and scan body connections, digital impressions were taken using the intraoral scanner. Using the software's measurement function, the deviation parameters between the planned and actual position of the placed implants were calculated and compared using the Mann-Whitney U test. In the short anchor-guiding sleeve group, the median angular deviation was 4.05° (range, 2.87°-7.55°). The median linear deviation was 1.17 mm (range, 0.24-2.17 mm) for the implant apex and 0.82 mm (range, 0.43-1.67 mm) for the implant shoulder. The median deviation of the depth was 0.31 mm (range, 0.20-0.79 mm). In the long anchor-guiding sleeve group, the median angular deviation was 2.70° (range, 1.77°-4.08°). The median linear deviation was 0.88 mm (range, 0.21-1.77 mm) for the implant apex and 0.63 mm (range, 0.11-1.97 mm) for the implant shoulder. The median deviation of the depth was 0.24 mm (range, 0.09-0.53 mm). There were significant differences between the 2 groups in the angular and linear deviations at the implant apex and the shoulder and depth deviation. The accuracy of the muco-supported surgical guide was improved using the long anchor-guiding sleeve, thus providing more accurate flapless implant placement in edentulous models. However, model experiments do not always produce predictable and possible uncontrolled cause-and-effect outcomes under natural clinical conditions. Therefore, further in vivo investigations are required to determine whether the results of this study are consistent with clinical findings.

Reliability of a Trapezium Miniplate with Endoscope-Assisted Internal Fixation in Mandibular Subcondylar Fractures: A Three-Dimensional Analysis.

This study aimed to evaluate the reliability of a trapezium plate for open reduction and internal fixation (ORIF) of mandibular subcondylar fractures with the simultaneous use of an endoscope. We selected and retrospectively studied 18 patients (12 males and 6 females) with unilateral mandibular subcondylar fractures who visited the Wonju Severance Christian Hospital. The mean age of the patients was 43.43 ± 15.76 years. Patients underwent ORIF with trapezium miniplate application through an intraoral incision under general anesthesia. The clinical and radiographic findings of the fractured side were compared with those of the non-operated side at 6 months follow-up. All occlusions became stable, and transient functional disturbances disappeared within 6 months of periodic follow-up. Functional mandibular movement recovered within the normal range, with an average mouth opening of 41.5 mm, protrusion of 7.5 mm, and lateral excursion of 7 mm at 6 months. Radiographic controls and statistical analysis confirmed a decent anatomical reduction in all 18 cases. In conclusion, the use of a trapezium miniplate with endoscope-assisted ORIF in mandibular subcondylar fractures can be useful for fixation and functional recovery.