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The digitisation for the immediate dental implantation of incisors with immediate individual prosthetic restoration

Dobrzański L. B., Achtelik-Franczak A., Dobrzańska J., Dobrzański L. A.

Journal of Achievements in Materials and Manufacturing Engineering

2019

Vol. 97, nr 2

57--68

Purpose: The purpose of this study is to present the author's method of planning the procedure of immediate implant-prosthetic restoration in place of a tooth qualified for removal by performing a surgical template and implant-prosthetic restoration based on data obtained in the CBCT test and intraoral scanning 3D model. Design/methodology/approach: The method of planning the implant surgery through the design and manufacture of surgical templates and implant prostheses performed before the start of medical procedures was described on the basis of actual clinical data from patients with anterior segment teeth qualified for extraction for reasons of complications after endodontic treatment. The placement of the implant was planned using virtual reality, where the bone model and the virtual soft tissue model were combined, which made it possible to perform a surgical template and prosthetic implant restoration. For the manufacturing, 3D printing as stereolithography SLA and selective laser sintering SLS for the surgical template manufacturing and CNC milling in the case of the prosthetic implant were used for restoration. Findings: The method allows planning the implant position based on two connected bone and soft tissue models and allows to design and manufacture a surgical guide. In this way, it becomes possible to place implants in the patient's bone during surgery procedure in the planned position and to install the prosthetic implant restoration in the form of an individual abutment and a PMMA crown during the same procedure in the surgical part. Practical implications: Thanks to the method of computer-aided design/manufacturing CAD/CAM production of surgical templates and prosthetic restoration based only on digital models and the planned position of the implant, it is possible to carry out the procedure of immediate tooth extraction and replacement with permanent prosthetic restoration. The whole process is based on the CBCT test performed at the beginning. The presented method allows shortening the procedure time by four times and the rehabilitation time by 3-6 months when performing the procedure in a minimally invasive manner. Originality/value: This article presents the original design and production method of surgical guides. It allows for precise planning of the implant position and transfer of this data to the patient's mouth during the procedure, enabling permanent prosthetic restoration before starting medical procedures.

Computer-aided design and manufacturing of dental surgical guides based on cone beam computed tomography

Malara P., Dobrzański L. B.

Archives of Materials Science and Engineering

2015

Vol. 76, nr 2

140--149

Purpose: The aim of the paper is to present the own method of design and manufacturing of surgical guides on the basis of cone beam computed tomography (CBCT) scans and three-dimensional models of teeth and soft tissue obtained from impressions or intraoral optical scans, which are possible to use during surgical implant placement. Design/methodology/approach: The method of designing and manufacturing of surgical guides was developed on the basis of real clinical data coming from patients with severe bone deficit qualified for implantological treatment. The model of bone and virtual model of soft tissues were combined together. The project of the prosthetic restoration imposed on the virtual model of the bone was used to plan the position of the implants. The final surgical guide was manufactured with the use of a CNC milling machine. Findings: The method enables planning of the implant position based on two combined models of the bone and soft tissues and allows to design and manufacture a surgical guide. Thus, it becomes possible to place the implants in the bone of the patient during a surgical procedure in a preplanned position. Practical implications: Thanks to the method of designing and manufacturing of surgical guides a range of clinical tasks in preparation of the guides is restricted to registration of the intraoral situation, taking of CBCT scans of the bone and determination of the type of the prosthetic restoration. Properly made surgical guides allow to shorten the time of the surgical procedure and carry it out in a minimally invasive manner. Originality/value: This paper presents an original method of designing and manufacturing of surgical guides. This allows for precise planning of the position and the number of implants and the transfer of these data into the mouth of a patient during the surgery without the use of commercially available closed software.