METHOD OF SURGICAL GUIDE MANUFACTURING FOR DENTAL IMPLANTATION
Basis of dental implantation is insertion of an implant infrastructure in-to the alveolar bone and use of it for fixing of denture. It is difficult to over-estimate importance of an adequate implant location. In dental implantology the guided planning allows us to attain high precision of implant insertion, taking into account anatomic terms next to minimum invasion interference.
A surgical template is the individually made device for the correct keeping of drill during the operation of implantation and, as a rule, it is a plate, which is supported by teeth, gum of jaw or both with the shells located in it through which preparing of bone is conducted.
There are different methods of surgical guide making. Some of them require the exact account of anatomic features of area of implantation which can be realized by the use of information of computer tomography and CAD-CAM technologies (Nobel Guide: Nobel Biocare; SKYplanX: Bredent, SimPlant: Materialise Dental; Implant 3D: Med 3D та ін.), or by measuring of thickness of mucus membrane (mucosa mapping) taking into account information of panoramic skiagraphy.
We set a goal to develop the method of surgical guide taking into account information of computer tomography, but without the use of the special software and expansive equipment of the commercial systems of planning of dental implantation.
Materials and methods. Analyzing modern technologies of surgical guide making, which are based on CT data, we selected three basic methods which differ on principle of transference of computer planning information from a virtual environment to the real surgical template. We took as a basis method of transference of information of an implant position in anatomic structures is received after the virtual planning of implantation using scanpattern and model positioning device with the use of the specialized software. Thus a template is made on a stone model which is set in a positioning device (SkyplanX, Bredent (Germany) and Implant 3d, Med 3d (USA)). The original constructions of scanpattern and positioning device for this purpose were developed and build.
Computer tomography was conducted on a high-speed cone-beam tomography Pax–zenith 3d, VATECH, South Korea. For a vision and analyzing of CT-research the regular software Ez3d 2009, VATECH was used.
As a result the next stages of surgical guide manufacturing were developed:
- Making of scantemplet. This stage includes impression taking, diagnostic model casting, positioning of X- ray contrast markers and templet forming.
- Lead through of computed tomography with scan- pattern.
- Installation of guiding shells in-to the template. This stage includes the next steps: drawing of marking elements (determining of drilling location), determining and fixation of model ground position using of positioning device, determining of drilling angulation based on CT data measurements using of positioning device, drilling of model, preparing of template and fixation of guiding shells.
We have developed a method of surgical guide manufacturing, which has several advantages, including: the use of standard dental parallelometer and a relatively simple device for model positioning, which is installed in a standard coupling parallelometer. The method of transferring of CT scan data to the model using a original designed template does not require of specialized for planning of dental implantation. For our techniques you can use any software suitable for viewing and analyzing, and in special cases may make a guide without a computer using a standard CT scans printout.
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