Friday, April 28, 2017

3D printed dental implant surgical guides

What are the options and techniques for a 3D printed dental implant surgical guide?

What are the options for surgical guides if don’t print own?

$35 to scan satone model and print surgical guide. 3-5 day turn around

Dominion Milling Center will print a surgical guide for you for $35.  Need scan of teeth no model printing.

 

What are the 3D printing in office surgical guide options?
Never absolute precision in CBCT. Most systems have 20-30% barium sulphate acrylic scan prosthesis (not Nobel that uses gp). If partially edentulous may not need at all, use teeth as reference.

Types – with any of these types it helps to have holes in guide or drill holes self to ensure fully seating. Post 35

  1. Tooth born=most accurate
  2. Tissue born
  3. Bone born

Companies

  1. SimPlant – Facilitate (bone guide available)
  2. NobelGuide/NobelClinician
  3. 3D Diagnostix (bone guide available)
  4. Sicat – Sirona
  5. VIP3 – Biohorizons (no pilot)
  6. Blue Sky Plan (bone guide available)
  7. CoDiagnostix
  8. Cybermed – OnDemand (bone guide available)
  9. iGuide by iDent
  10. EasyGuide by Keystone dental (pilot only)
  11. gonyX by Straumann
  12. Guided Surgery Solutions
  13. Anatomage – InVivo5 (bone guide available)
  14. 360 Imaging
  15. Canada Bay
  16. Implant Concierge
  17. Jurim Dental Studio
  18. Nemotec
  19. nSequence Great bone guide system
  20. Ottawa Dental Lab
  21. Swiss Meda/SMOP
  22. GuideSMILE V2R Biomedical Great pin referenced provisional in use Tischler article in dentalcetoday

Indications

  1. 3 or more implants in a row
  2. Proximity to vital structures, adjacent teeth
  3. Questionable bone volume (significant soft or hard tissue defects)
  4. Implant position critical to restorative success
  5. Flapless plan
  6. Multiple unit or complete arch immediate restorations planned

94% patients have some form of nonodontogenic pathology!! List is here

Large volume CBCT has 2.7-25 times radiation pano, kind of useless since we use limited image.
CBCT is about 20% conventional CT in radiation
Thyroid collar can reduce exposure by 40%
CAS (carotid artery stenosis) found in pano is about 2-5%. Duplex ultrasound is gold standard to confirm

Place cotton roll under upper lip before CBCT to prevent shadowing.

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