Clinical application of surgical fixation screws in implant prosthodontics--Part II: Indexing implant position

The accurate transfer of intraoral implant position to the definitive cast in situations of immediate implant loading in completely edentulous patients is an important step and may be difficult to achieve with common transfer and impression methods. Intraoral fixed points of reference accurately transferred to the definitive cast are necessary to provide precise and stable placement of radiographic and surgical templates during the presurgical diagnostic phase, during implant placement, and during fabrication of an immediate provisional restoration. This article describes a technique using surgical microfixation screws to provide fixed reference points and transfer the position of the conventional implants to the definitive cast.     

Bone reduction surgical guide for the Novum implant procedure: technical note

The Novum System offers a unique opportunity to create a definitive, immediately loaded fixed prosthesis on the edentulous mandible for patients who meet specific presurgical criteria. Since this system is based on precisely placed implants and prefabricated bar structures, the surgical techniques are critical in obtaining a satisfactory result. It is especially important that the bone reduction required to create space for the implants and bar assembly be in the proper plane and deep enough to leave room for eventually setting and processing teeth. The surgical guide described here can be an important adjunct during bone reduction to assure proper spatial positioning of the preformed titanium bars. Mounted casts of the correct or corrected maxillary dentition and mandibular arch are required at the appropriate vertical dimension of occlusion. The mandibular cast is reduced in prescribed dimensions to allow the subsequent creation of a processed resin surgical guide for use during the initial stages of surgery. This guide, when used for bone reduction during surgery, eliminates the arbitrary removal of osseous structure and helps assure the plane of implant placement is appropriate for each patient. When used routinely, a significant complication of the Novum procedure can be minimized or eliminated completely. Setting of teeth and processing are subsequently simplified, especially in the posterior dimensions, with this guide technique.     

Integrating the surgical and prosthodontic stages of implant therapy with a sterile implant position registration

A new implant position registration technique utilizing an autoclavable thermoplastic material is described. This technique, which has been in use since 1994, allows the clinician to fabricate a provisional restoration for insertion at stage II surgery to enhance the soft tissue contour and the aesthetics of the final restoration.     

种植牙手术的导向模板定向法临床研究

本文介绍了用于人工牙根种植手术的一种导向模板定向法。该导向模板由圆柱形金属定向杆、导向钛管、负压成型的塑料牙列套及自凝塑料增强基托组成。临床应用35例.效果满意。     

The use and fabrication of a self-retaining surgical guide for controlled implant placement: a technical note.

A technique for using a surgical guide construction with a self-retaining feature, which has proven to be a significant improvement for stage 1 surgical procedures, is described. This design is more convenient to use than previously described occlusal extension splints. It maintains the concepts for ideal fixture placement that have proven so valuable in creating both a functionally and esthetically uncompromised prosthesis supported by implants.     

The surgical template: a prescription for implant success.

The surgical template is utilized in the planning and execution of a successful implant rehabilitation. A method of template fabrication is presented which is useful for cases requiring precise root form fixture placement. Stents are fabricated using a duplicate denture or acrylic base and orthodontic wire, which is contoured to create the acceptable perimetric limits of fixture placement. This approach provides good visual access, operator flexibility, and template stability. The technique can be utilized for the edentulous and the partially edentulous arch.     

A surgical guide for implant placement.

Mounted diagnostic casts aid in determining whether sufficient space exists for a fixed cantilevered implant prosthesis. These casts are also used to construct a surgical guide. Such a technique is described.     

Assessing the accuracy of fabricated implant surgical guides by reconstructing the implant position based on cone beam computed tomography images: A dental technique

A protocol for qualitatively reviewing the accuracy of fabricated implant surgical guides is presented. Once these guides have been inserted and fixed intraorally, cone beam computed tomography (CBCT) scans are made. Implant positions can be recalculated by processing the series of sleeve images on the CBCT scans. This protocol offers an opportunity for double-checking the accuracy of a fabricated guide before surgery in certain circumstances.     

Accuracy of implant position when placed using static computer-assisted implant surgical guides manufactured with two different optical scanning techniques: a randomized clinical trial

Data from cone beam computed tomography (CBCT) and optical scans (intraoral or model scanner) are required for computer-assisted implant surgery (CAIS). This study compared the accuracy of implant position when placed with CAIS guides produced by intraoral and extraoral (model) scanning. Forty-seven patients received 60 single implants by means of CAIS. Each implant was randomly assigned to either the intraoral group (n = 30) (Trios Scanner, 3Shape) or extraoral group (n = 30), in which stereolithographic surgical guides were manufactured after conventional impression and extraoral scanning of the stone model (D900L Lab Scanner, 3Shape). CBCT and surface scan data were imported into coDiagnostiX software for virtual implant position planning and surgical guide design. Postoperative CBCT scans were obtained. Software was used to compare the deviation between the planned and final positions. Average deviation for the intraoral vs. model scan groups was 2.42° ± 1.47° vs. 3.23° ± 2.09° for implant angle, 0.87 ± 0.49 mm vs. 1.01 ± 0.56 mm for implant platform, and 1.10 ± 0.53 mm vs. 1.38 ± 0.68 mm for implant apex; there was no statistically significant difference between the groups (P > 0.05). CAIS conducted with stereolithographic guides manufactured by means of intraoral or extraoral scans appears to result in equal accuracy of implant positioning.     

Atraumatic surgical technique and implant bed preparation.

The issues of bone necrosis and implant bed congruency are both central to the success or failure of endosseous dental implants to achieve osseointegration. Use of internally irrigated drilling instruments has been postulated to minimize bone necrosis. The ability of the cutting instruments to produce a smooth, congruent implant bed and retain fine bone structures is also critical to achieving primary integration. In the experiment conducted, the use of internally cooled instruments reduced the likelihood of thermal bone damage, particularly when trephine mills were used. Trephine mills were able to retain the fine bone structures of the walls of the implant bed site. No visible degradation occurred from multiple uses of the instruments.     

Trajectory surgical guide stent for implant placement.

This article describes a new implant placement surgical guide that gives both implant location and trajectory to the surgeon. Radiopaque markers are placed on diagnostic dentures and a lateral cephalometric radiograph is made that shows the osseous anatomy at the symphysis and the anterior tooth location. The ideal implant location and trajectory data are transferred to a surgical stent that programs the angle and location of the fixtures at time of surgery. The stent has the additional benefit of acting as an occlusion rim, a mouth prop, and tongue retractor. Use of this stent has resulted in consistently programming the placement of implant fixtures that are prosthodontically ideal.     

The Graz implant supported pendulum, a technical note.

A new, immediately loadable palatal implant with rotational stability and an implant-supported pendulum for patients with dental class II dysgnathia and dental crowding is presented. In seven cases, the treatment goal of distalization of all upper molars without extraction of a single tooth was achieved within 8 months.     

New implant surgical guide

This article describes the process of making and using a surgical guide stent. It is intended to enable the surgeon to maintain the same horizontal and vertical axes of cylindrical endosseous implants during the surgical phase of implant placement as those determined at the treatment planning stage. Furthermore, the stent can be used with the entire series of surgical drills, thereby minimizing the chance of inadvertently enlarging the implant site as a result of freehand use of the handpiece.     

Positioning implants for overdentures: a prototype implant-paralleling device. Technical note

As implant-assisted dentistry continues to grow, increasing emphasis is being placed on the surgical positioning of implants so that they can be optimally restored. While this is essential for esthetics with fixed implant restorations, it is equally important with implant overdentures, where the type of retentive mechanism artificial tooth position, and denture flange contour may be affected by implant position Unfortunately, surgical guides or templates may be used less often with overdenture cases because of the associated time, costs, and difficulty in positioning during surgery, leading to compromised implant location or orientation. This paper describes a prototype paralleling device that can aid in the surgical positioning of implants for overdentures.     

A surgical guide for insertion of implant fixtures.

Successful prosthodontic rehabilitation of edentulous ridges with implants is dependent upon the alignment of multiple fixtures. A simple technique for fabricating a surgical guide is presented in this article.     

Template fabrication for a midpalatal orthodontic implant: technical note

An implant has been developed as an adjunct to conventional orthodontic anchorage. Planning is advisable to determine the available bone and soft tissue thickness and the optimum position for orthodontic utilization. A simple method is described for fabrication of a radiographic and surgical template to aid in optimal placement of the implant.