Invention and Accuracy Assessment of Supplemental Surgical Devices for Converting Traditional PW Plus Drilled Set to Computer-guided Implant Surgery

Surgical drilled set that used in computer guided implant placement must be manufactured specifically which have high cost for manufacturing and importation. In addition, PW plus dental implant which produced by Thai company still is not supported by this technique. The aim of this research was to invent supplemental surgical devices that can be used to convert traditional PW plus surgical drilled set to computer guided surgery and to assess the accuracy of implant placement by using these devices in models. Methods of this study comprised of two steps. The first step was design and lathe the supplemental surgical devices composed of 5 elements including master key, pilot key, final key, expand key and implant driver key. The second step was to assess the accuracy of implant placement by these devices in 20 plastic models. Eight implants which had 3.3, 3.75, 4.2, and 5.0 mm in diameter and 12 mm in length were placed in each model. Presurgical and postsurgical CBCT images were superimposed to evaluate deviation between virtual and actual implant position by three parameters (3D linear deviation at coronal and apical part of implant and 3D angular deviation). The results showed that 3D linear deviations at coronal and apical part were 0.83 ± 0.30 and 1.13 ± 0.36 mm respectively, and angular deviation were 4.59° ± 0.49°. No statistical significance difference was found in different implant diameters (p<0.05). Considering the intrinsic error of these devices, the tolerance of metal contacting, allows for a maximum theoretical angulation error of 1.04°. The factor that affected the deviation at coronal part of implant placement by these devices was the distance between the sleeve and the entry pointed at the alveolar crest. While the length of the implant affected the deviation at apical part of implant.

1. Misch K, Wang H-L. Implant surgery complications: etiology and treatment. Implant Dent 2008; 17(2): 159-168.

2. Lazzara RJ. Effect of implant position on implant restoration design. J Esthet Restor Dent. 1993; 5(6): 265-269.

3. Sarment DP, Sukovic P, Clinthorne N. Accuracy of implant placement with a stereolithographic surgical guide. Int J Oral Maxillofac Implants 2003; 18(4): 571-577.

4. Al R, Mandelaris G, Tarieu P. Prosthetically directed implant placement using computer software to ensure precise placement and predictable prosthetic outcomes. Part 2: Rapid-prototype medical modeling and stereolithographic drilling guides requiring bone exposure. Int J Periodontics Restorative Dent 2006; 26: 347-353.

5. Rosenfeld AL, Mandelaris GA, Tardieu PB. Prosthetically directed implant placement using computer software to ensure precise placement and predictable prosthetic outcomes. Part 3: stereolithographic drilling guides that do not require bone exposure and the immediate delivery of teeth. Int J Periodontics Restorative Dent 2006; 26(5): 493-499.

6. Rosenfield A, Mandelaris G, Tardieu P. Prosthetically directed implant placement using computer software to ensure precise placement and predictable prosthetic outcomes. Part 1: diagnostics, imaging, and collaborative accountability. Int J Periodontics Restorative Dent 2006; 26(3): 215-221.

7. Orentlicher G, Horowitz A, Abboud M. Computer-guided implant surgery: indications and guidelines for use. Compend Contin Educ Dent 2012; 33(10): 720-732.

8. Scherer M, Kattadiyil M, Parciak E, Puri S. CAD/CAM guided surgery in implant dentistry. A review of software packages and step-by-step protocols for planning surgical guides. Alpha Omegan 2013; 107(1): 32-38.

9. Schneider D, Marquardt P, Zwahlen M, Jung RE. A systematic review on the accuracy and the clinical outcome of computer‐guided template‐based implant dentistry. Clin Oral Implants Res 2009; 20(s4): 73-86.

10. Valente F, Schiroli G, Sbrenna A. Accuracy of computer-aided oral implant surgery: a clinical and radiographic study. Int J Oral Maxillofac Implants 2009; 24(2): 234-242.

11. Block MS, Chandler C. Computed tomography–guided surgery: complications associated with scanning, processing, surgery, and prosthetics. J Oral Maxillofac Surg 2009; 67(11): 13-22.

12. Ozan O, Turkyilmaz I, Ersoy AE, McGlumphy EA, Rosenstiel SF. Clinical accuracy of 3 different types of computed tomography-derived stereolithographic surgical guides in implant placement. J Oral Maxillofac Surg 2009; 67(2): 394-401.

13. Van AN, Quirynen M. Tolerance within a surgical guide. Clin Oral Implants Res 2010; 21(4): 455-458.

14. Koop R, Vercruyssen M, Vermeulen K, Quirynen M. Tolerance within the sleeve inserts of different surgical guides for guided implant surgery. Clin Oral Implants Res 2013; 24(6): 630-634.

15. Cassetta M, Di Mambro A, Di Giorgio G, Stefanelli LV, Barbato E. The influence of the tolerance between mechanical components on the accuracy of implants inserted with a stereolithographic surgical guide: a retrospective clinical study. Clin Implant Dent Relat Res 2015; 17(3): 580-588.

16. de Almeida EO, Pellizzer EP, Goiatto MC, et al. Computer-guided surgery in implantology: review of basic concepts. J Craniofac Surg 2010; 21(6): 1917-1921.

17. www.pwplus.co.th [URL of homepage on the Internet]. Thailand: PW Plus Co.,Ltd. Available from: HYPERLINK “http://www.pwplus.co.th/menu"http://www.pwplus.co.th/menu.

18. Lee DH, An SY, Hong MH, Jeon KB, Lee KB. Accuracy of a direct drill-guiding system with minimal tolerance of surgical instruments used for implant surgery: a prospective clinical study. J Adv Prosthodont 2016; 8(3): 207-213.

19. Jung RE, Schneider D, Ganeles J, et al. Computer technology applications in surgical implant dentistry: a systematic review. Int J Oral Maxillofac Implants 2009; 24(7): 92-109.

20. Block MS, Emery RW. Static or dynamic navigation for implant placement—choosing the method of guidance. J Oral Maxillofac Surg 2016; 74(2): 269-277.

21. D'souza KM, Aras MA. Types of implant surgical guides in dentistry: a review. J Oral Implantol 2012; 38(5): 643-652.

22. Cassetta M, Di Mambro A, Giansanti M, Stefanelli L, Cavallini C. The intrinsic error of a stereolithographic surgical template in implant guided surgery. Int J Oral Maxillofac Surg 2013; 42(2): 264-275.

23. Tehemar SH. Factors affecting heat generation during implant site preparation: a review of biologic observations and future considerations. Int J Oral Maxillofac Implants 1999; 14(1): 127-136.

Kittisupakorn S, Jaisawang A, Chaoklaiwong B, Pisitanusorn A. Invention and Accuracy Assessment of Supplemental Surgical Devices for Converting Traditional PW Plus Drilled Set to Computer-guided Implant Surgery: Original articles. CM Dent J [Internet]. 2019 Mar 20 [cited 2024 May 10];40(1):31-45. Available from: https://www.dent.cmu.ac.th/cmdj/frontend/web/?r=site/viewarticle&id=76

Kittisupakorn, S., Jaisawang, A., Chaoklaiwong, B. & Pisitanusorn, A. (2019). Invention and Accuracy Assessment of Supplemental Surgical Devices for Converting Traditional PW Plus Drilled Set to Computer-guided Implant Surgery. CM Dent J, 40(1), 31-45. Retrieved from: https://www.dent.cmu.ac.th/cmdj/frontend/web/?r=site/viewarticle&id=76

Kittisupakorn, S., Jaisawang Ataya,Chaoklaiwong Boonchai and Pisitanusorn Attavit. 2019. "Invention and Accuracy Assessment of Supplemental Surgical Devices for Converting Traditional PW Plus Drilled Set to Computer-guided Implant Surgery." CM Dent J, 40(1), 31-45. https://www.dent.cmu.ac.th/cmdj/frontend/web/?r=site/viewarticle&id=76

Kittisupakorn, S. et al. 2019. 'Invention and Accuracy Assessment of Supplemental Surgical Devices for Converting Traditional PW Plus Drilled Set to Computer-guided Implant Surgery', CM Dent J, 40(1), 31-45. Retrieved from https://www.dent.cmu.ac.th/cmdj/frontend/web/?r=site/viewarticle&id=76

Kittisupakorn, S., Jaisawang, A., Chaoklaiwong, B. and Pisitanusorn, A. "Invention and Accuracy Assessment of Supplemental Surgical Devices for Converting Traditional PW Plus Drilled Set to Computer-guided Implant Surgery", CM Dent J, vol.40, no. 1, pp. 31-45, Mar. 2019.

Kittisupakorn, S., Jaisawang, A., Chaoklaiwong, B., et al. "Invention and Accuracy Assessment of Supplemental Surgical Devices for Converting Traditional PW Plus Drilled Set to Computer-guided Implant Surgery." CM Dent J, vol.40, no. 1, Mar. 2019, pp. 31-45, https://www.dent.cmu.ac.th/cmdj/frontend/web/?r=site/viewarticle&id=76