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Accuracy of a cone beam computed tomography–guided surgical stent for orthodontic mini-implant placement
Authors:Jae-Jung Yu  Gyu-Tae Kim  Yong-Suk Choi  Eui-Hwan Hwang  Janghyun Paek  Seong-Hun Kim  John C. Huang
Abstract:Objective:To validate the accuracy of a cone-beam computed tomography (CBCT)–guided surgical stent for orthodontic mini-implant (OMI) placement by quantitatively evaluating the difference between CBCT-prescribed and actual position of mini-implants in preoperative and postoperative CBCT images.Materials and Methods:A surgical stent was fabricated using Teflon-Perfluoroalkoxy, which has appropriate biological x-ray attenuation properties. Polyvinylsiloxane impression material was used to secure the custom-made surgical stent onto swine mandibles. CBCT scanning was done with the stent in place to virtually plan mini-implants using a three-dimensional (3D) software program. An appropriate insertion point was determined using 3D reconstruction data, and the vertical and horizontal angulations were determined using four prescribed angles. A custom-designed surveyor was used to drill a guide hole within the surgical stent as prescribed on the CBCT images for insertion of 32 OMIs. The mandibles with a surgical stent in place were rescanned with CBCT to measure the deviations between the virtual planning data and surgical results.Results:The difference between the prescribed and actual vertical angle was 1.01 ± 7.25, and the horizontal difference was 1.16 ± 6.08. The correlation coefficient confirms that there was no intrarater variability in either the horizontal (R  =  .97) or vertical (R  =  .74) vectors.Conclusions:The surgical stent in this study guides mini-implants to the prescribed position as planned in CBCT. Since the statistical difference was not significant, the surgical stent can be considered to be an accurate guide tool for mini-implant placement in clinical use.
Keywords:Mini-implant   Root proximity   Surgical stent   CBCT
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