Journal of the Korean Association of Oral and Maxillofacial Surgeons

The Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회)
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Implant surgery based on computer simulation surgical stent and the assessment with the image fusion technique

컴퓨터 시뮬레이션 기반의 외과용 스텐트를 이용한 임플란트 시술과 영상융합기술을 이용한 평가

  • Lee, Jee-Ho (Department of Oral and Maxillofacial Surgery, Seoul Asan Medical Center, College of Medicine, Ulsan University) ;
  • Kim, Soung-Min (Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University) ;
  • Paeng, Jun-Young (Department of Oral and Maxillofacial Surgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University) ;
  • Kim, Myung-Jin (Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University)
  • 이지호 (울산의과대학교 서울아산병원 구강악안면외과) ;
  • 김성민 (서울대학교 치의학대학원 구강악안면외과) ;
  • 팽준영 (성균관대학교 의과대학 삼성서울병원 구강악안면외과) ;
  • 김명진 (서울대학교 치의학대학원 구강악안면외과)
  • Received : 2010.05.24
  • Accepted : 2010.10.13
  • Published : 2010.10.29
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Abstract

Introduction: The planning of implant surgery is an important factor for the implant prosthesis. Stereolithographic (SLA) surgical stents based on a computer simulation are quite helpful for clinicians to perform the surgery as planned. Although many clinical and technical trials have been performed for computed tomography (CT)-guided implant stents to improve the surgical procedures and prosthetic treatment, there are still many problems to solve. We developed a system of a surgical guide based on 3 dimensional (3D) CT for implant therapy and achieved satisfactory results in the terms of planning and operation. Materials and Methods: Fifteen patients were selected and 30 implant fixtures were installed. The preoperative CT data for surgical planning were prepared after obtaining informed consent. Surgical planning was performed using the simulation program, Ondemend3D In2Guide. The stents were fabricated based on the simulation data containing information of the residual bone, the location of the nerve, and the expected design of the prostheses. After surgery with these customized stents, the accuracy and reproducibility of implant surgery were evaluated based on the computer simulation. The data of postoperative CT were used to confirm this system using the image fusion technique and compare the implant fixtures between the planned and implanted. Results: The mean error was 1.18 (${\pm}0.73$) mm at the occlusal center, 1.23 (${\pm}0.67$) mm at the apical center, and the axis error between the two fixtures was $3.25^{\circ}C$ (${\pm}3.00$). These stents showed superior accuracy in maxilla cases. The lateral side error at the apical center was significantly different from the error at the occlusal center but there were no significant differences between the premolars, 1st molars and 2nd molars. Conclusion: SLA surgical stents based on a computer simulation have the satisfactory accuracy and are expected to be useful for accurate planning and surgery if some errors can be improved.

Keywords

References

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