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Published in: Current Oral Health Reports 4/2019

01-12-2019 | Denture | Modern Production Laboratory Advances in Dental Technology (M Bergler and E Steger, Section Editors)

Current Workflows for Computer-Aided Implant Surgery: a Review Article

Authors: Mariam Margvelashvili-Malament, Andre’ Barbisan De-Souza, Wael Att

Published in: Current Oral Health Reports | Issue 4/2019

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Abstract

Purpose of Review

Implant dentistry is a fast-evolving field and the computer-aided implant placement is becoming an inseparable part of it. There is a vast variety of techniques, workflows, and software making it hard for the dental practitioner to know which technique to apply to which clinical scenario. Therefore, the purpose of this review is to classify and describe current techniques and compare advantages and disadvantages of different methods. Workflows for various clinical scenarios are also presented to guide a clinician in decision-making.

Recent Findings

Static computer-aided implant surgery offers safe and prosthetically driven implant placement and gives the possibility for flapless surgery to reduce postoperative healing time and the number of appointments. However, appropriate training is mandatory even if fully computer-aided implant placement is being done.

Summary

Based on current trends, it is obvious that further digitization and automatization are inevitable for the academic and the private dental environments. However, one should realize that major safety screenings are yet to be conducted for newly introduced methods.
Literature
1.
go back to reference Verstreken K, Van Cleynenbreugel J, Marchal G, Naert I, Suetens P, van Steenberghe D. Computer-assisted planning of oral implant surgery: a three-dimensional approach. Int J Oral Maxillofac Implants. 1996;11(6):806–10.PubMed Verstreken K, Van Cleynenbreugel J, Marchal G, Naert I, Suetens P, van Steenberghe D. Computer-assisted planning of oral implant surgery: a three-dimensional approach. Int J Oral Maxillofac Implants. 1996;11(6):806–10.PubMed
2.
go back to reference Guerrero ME, Jacobs R, Loubele M, Schutyser F, Suetens P, van Steenberghe D. State-of-the-art on cone beam CT imaging for preoperative planning of implant placement. Clin Oral Investig. 2006;10(1):1–7.CrossRef Guerrero ME, Jacobs R, Loubele M, Schutyser F, Suetens P, van Steenberghe D. State-of-the-art on cone beam CT imaging for preoperative planning of implant placement. Clin Oral Investig. 2006;10(1):1–7.CrossRef
3.
go back to reference Vercruyssen M, Laleman I, Jacobs R, Quirynen M. Computer-supported implant planning and guided surgery: a narrative review. Clin Oral Implants Res. 2015;26(Suppl 11):69–76.CrossRef Vercruyssen M, Laleman I, Jacobs R, Quirynen M. Computer-supported implant planning and guided surgery: a narrative review. Clin Oral Implants Res. 2015;26(Suppl 11):69–76.CrossRef
4.
go back to reference Jung RE, Schneider D, Ganeles J, Wismeijer D, Zwahlen M, Hammerle CH, et al. Computer technology applications in surgical implant dentistry: a systematic review. Int J Oral Maxillofac Implants. 2009;24(Suppl):92–109.PubMed Jung RE, Schneider D, Ganeles J, Wismeijer D, Zwahlen M, Hammerle CH, et al. Computer technology applications in surgical implant dentistry: a systematic review. Int J Oral Maxillofac Implants. 2009;24(Suppl):92–109.PubMed
5.
go back to reference Block MS, Emery RW. Static or dynamic navigation for implant placement-choosing the method of guidance. J Oral Maxillofac Surg. 2016;74(2):269–77.CrossRef Block MS, Emery RW. Static or dynamic navigation for implant placement-choosing the method of guidance. J Oral Maxillofac Surg. 2016;74(2):269–77.CrossRef
6.
go back to reference Edwards PJ, King AP, Hawkes DJ, Fleig O, Maurer CR Jr, Hill DL, et al. Stereo augmented reality in the surgical microscope. Stud Health Technol Inform. 1999;62:102–8.PubMed Edwards PJ, King AP, Hawkes DJ, Fleig O, Maurer CR Jr, Hill DL, et al. Stereo augmented reality in the surgical microscope. Stud Health Technol Inform. 1999;62:102–8.PubMed
7.
go back to reference • Gargallo-Albiol J, Barootchi S, Salomo-Coll O, Wang HL. Advantages and disadvantages of implant navigation surgery. A systematic review. Ann Anat. 2019;225:1–10. This is a recent systematic review focused on the classification of implant navigation methods. Although the article does not provide the description of the workflows, advantages and disadvantages of different methods are very clearly summarized. CrossRef • Gargallo-Albiol J, Barootchi S, Salomo-Coll O, Wang HL. Advantages and disadvantages of implant navigation surgery. A systematic review. Ann Anat. 2019;225:1–10. This is a recent systematic review focused on the classification of implant navigation methods. Although the article does not provide the description of the workflows, advantages and disadvantages of different methods are very clearly summarized. CrossRef
8.
go back to reference Hammerle CH, Stone P, Jung RE, Kapos T, Brodala N. Consensus statements and recommended clinical procedures regarding computer-assisted implant dentistry. Int J Oral Maxillofac Implants. 2009;24(Suppl):126–31.PubMed Hammerle CH, Stone P, Jung RE, Kapos T, Brodala N. Consensus statements and recommended clinical procedures regarding computer-assisted implant dentistry. Int J Oral Maxillofac Implants. 2009;24(Suppl):126–31.PubMed
9.
go back to reference D’Haese J, Ackhurst J, Wismeijer D, De Bruyn H, Tahmaseb A. Current state of the art of computer-guided implant surgery. Periodontol 2000. 2017;73(1):121–33.CrossRef D’Haese J, Ackhurst J, Wismeijer D, De Bruyn H, Tahmaseb A. Current state of the art of computer-guided implant surgery. Periodontol 2000. 2017;73(1):121–33.CrossRef
10.
go back to reference Gintaute AAW. Digital workflow in implant dentistry. Implantologie. 2017;25(1):7–20. Gintaute AAW. Digital workflow in implant dentistry. Implantologie. 2017;25(1):7–20.
11.
go back to reference Schnutenhaus S, Edelmann C, Rudolph H, Dreyhaupt J, Luthardt RG. 3D accuracy of implant positions in template-guided implant placement as a function of the remaining teeth and the surgical procedure: a retrospective study. Clin Oral Investig. 2018;22(6):2363–72.CrossRef Schnutenhaus S, Edelmann C, Rudolph H, Dreyhaupt J, Luthardt RG. 3D accuracy of implant positions in template-guided implant placement as a function of the remaining teeth and the surgical procedure: a retrospective study. Clin Oral Investig. 2018;22(6):2363–72.CrossRef
12.
go back to reference Grant B-TN. Implant surgery with robotic guidance - digital workflows for patient care. Oral Health. 2019. Grant B-TN. Implant surgery with robotic guidance - digital workflows for patient care. Oral Health. 2019.
13.
go back to reference • Marei HF, Abdel-Hady A, Al-Khalifa K, Al-Mahalawy H. Influence of surgeon experience on the accuracy of implant placement via a partially computer-guided surgical protocol. Int J Oral Maxillofac Implants. 2019. The article measures the influence of the surgeon experience on the accuracy of implant placement using a teeth-supported surgical guide. They conclude that the level of the surgeon experience influences the accuracy outcomes. Therefore, one should keep in mind that the use of computer-assisted implant placement does not necessarily compensate for the lack of the experience. The learning curve and skills are mandatory even when computer-aided implant placement is being done. • Marei HF, Abdel-Hady A, Al-Khalifa K, Al-Mahalawy H. Influence of surgeon experience on the accuracy of implant placement via a partially computer-guided surgical protocol. Int J Oral Maxillofac Implants. 2019. The article measures the influence of the surgeon experience on the accuracy of implant placement using a teeth-supported surgical guide. They conclude that the level of the surgeon experience influences the accuracy outcomes. Therefore, one should keep in mind that the use of computer-assisted implant placement does not necessarily compensate for the lack of the experience. The learning curve and skills are mandatory even when computer-aided implant placement is being done.
14.
go back to reference Pettersson A, Komiyama A, Hultin M, Nasstrom K, Klinge B. Accuracy of virtually planned and template guided implant surgery on edentate patients. Clin Implant Dent Relat Res. 2012;14(4):527–37.CrossRef Pettersson A, Komiyama A, Hultin M, Nasstrom K, Klinge B. Accuracy of virtually planned and template guided implant surgery on edentate patients. Clin Implant Dent Relat Res. 2012;14(4):527–37.CrossRef
15.
go back to reference Van de Wiele G, Teughels W, Vercruyssen M, Coucke W, Temmerman A, Quirynen M. The accuracy of guided surgery via mucosa-supported stereolithographic surgical templates in the hands of surgeons with little experience. Clin Oral Implants Res. 2015;26(12):1489–94.CrossRef Van de Wiele G, Teughels W, Vercruyssen M, Coucke W, Temmerman A, Quirynen M. The accuracy of guided surgery via mucosa-supported stereolithographic surgical templates in the hands of surgeons with little experience. Clin Oral Implants Res. 2015;26(12):1489–94.CrossRef
16.
go back to reference Cassetta M, Bellardini M. How much does experience in guided implant surgery play a role in accuracy? A randomized controlled pilot study. Int J Oral Maxillofac Surg. 2017;46(7):922–30.CrossRef Cassetta M, Bellardini M. How much does experience in guided implant surgery play a role in accuracy? A randomized controlled pilot study. Int J Oral Maxillofac Surg. 2017;46(7):922–30.CrossRef
17.
go back to reference Sicilia A, Botticelli D, Working G. Computer-guided implant therapy and soft- and hard-tissue aspects. The Third EAO Consensus Conference 2012. Clin Oral Implants Res. 2012;23 Suppl 6:157–61.CrossRef Sicilia A, Botticelli D, Working G. Computer-guided implant therapy and soft- and hard-tissue aspects. The Third EAO Consensus Conference 2012. Clin Oral Implants Res. 2012;23 Suppl 6:157–61.CrossRef
18.
go back to reference Wismeijer D, Joda T, Flugge T, Fokas G, Tahmaseb A, Bechelli D, et al. Group 5 ITI consensus report: digital technologies. Clin Oral Implants Res. 2018;29(Suppl 16):436–42.CrossRef Wismeijer D, Joda T, Flugge T, Fokas G, Tahmaseb A, Bechelli D, et al. Group 5 ITI consensus report: digital technologies. Clin Oral Implants Res. 2018;29(Suppl 16):436–42.CrossRef
19.
go back to reference Smitkarn P, Subbalekha K, Mattheos N, Pimkhaokham A. The accuracy of single-tooth implants placed using fully digital-guided surgery and freehand implant surgery. J Clin Periodontol. 2019. Smitkarn P, Subbalekha K, Mattheos N, Pimkhaokham A. The accuracy of single-tooth implants placed using fully digital-guided surgery and freehand implant surgery. J Clin Periodontol. 2019.
20.
go back to reference •• Tahmaseb A, Wu V, Wismeijer D, Coucke W, Evans C. The accuracy of static computer-aided implant surgery: A systematic review and meta-analysis. Clin Oral Implants Res. 2018;29 Suppl 16:416–35. The article is a recent systematic review that evaluates the literature on the accuracy of static computer-assisted implant surgery. It states that although the accuracy of static computer-assisted implant placement is within the clinically acceptable range, the safety zone of 2 mm should be taken in consideration. CrossRef •• Tahmaseb A, Wu V, Wismeijer D, Coucke W, Evans C. The accuracy of static computer-aided implant surgery: A systematic review and meta-analysis. Clin Oral Implants Res. 2018;29 Suppl 16:416–35. The article is a recent systematic review that evaluates the literature on the accuracy of static computer-assisted implant surgery. It states that although the accuracy of static computer-assisted implant placement is within the clinically acceptable range, the safety zone of 2 mm should be taken in consideration. CrossRef
21.
go back to reference Mercado F, Mukaddam K, Filippi A, Bieri OP, Lambrecht TJ, Kuhl S. Fully digitally guided implant surgery based on magnetic resonance imaging. Int J Oral Maxillofac Implants. 2019;34(2):529–34.CrossRef Mercado F, Mukaddam K, Filippi A, Bieri OP, Lambrecht TJ, Kuhl S. Fully digitally guided implant surgery based on magnetic resonance imaging. Int J Oral Maxillofac Implants. 2019;34(2):529–34.CrossRef
22.
go back to reference Joda T, Derksen W, Wittneben JG, Kuehl S. Static computer-aided implant surgery (s-CAIS) analysing patient-reported outcome measures (PROMs), economics and surgical complications: a systematic review. Clin Oral Implants Res. 2018;29(Suppl 16):359–73.CrossRef Joda T, Derksen W, Wittneben JG, Kuehl S. Static computer-aided implant surgery (s-CAIS) analysing patient-reported outcome measures (PROMs), economics and surgical complications: a systematic review. Clin Oral Implants Res. 2018;29(Suppl 16):359–73.CrossRef
23.
go back to reference Pozzi A, Polizzi G, Moy PK. Guided surgery with tooth-supported templates for single missing teeth: a critical review. Eur J Oral Implantol. 2016;9(Suppl 1):S135–53.PubMed Pozzi A, Polizzi G, Moy PK. Guided surgery with tooth-supported templates for single missing teeth: a critical review. Eur J Oral Implantol. 2016;9(Suppl 1):S135–53.PubMed
24.
go back to reference Cosyn J, Thoma DS, Hammerle CH, De Bruyn H. Esthetic assessments in implant dentistry: objective and subjective criteria for clinicians and patients. Periodontol 2000. 2017;73(1):193–202.CrossRef Cosyn J, Thoma DS, Hammerle CH, De Bruyn H. Esthetic assessments in implant dentistry: objective and subjective criteria for clinicians and patients. Periodontol 2000. 2017;73(1):193–202.CrossRef
25.
go back to reference Furhauser R, Mailath-Pokorny G, Haas R, Busenlechner D, Watzek G, Pommer B. Esthetics of flapless single-tooth implants in the anterior maxilla using guided surgery: association of three-dimensional accuracy and pink esthetic score. Clin Implant Dent Relat Res. 2015;17(Suppl 2):e427–33.CrossRef Furhauser R, Mailath-Pokorny G, Haas R, Busenlechner D, Watzek G, Pommer B. Esthetics of flapless single-tooth implants in the anterior maxilla using guided surgery: association of three-dimensional accuracy and pink esthetic score. Clin Implant Dent Relat Res. 2015;17(Suppl 2):e427–33.CrossRef
26.
go back to reference Belser UC, Grutter L, Vailati F, Bornstein MM, Weber HP, Buser D. Outcome evaluation of early placed maxillary anterior single-tooth implants using objective esthetic criteria: a cross-sectional, retrospective study in 45 patients with a 2- to 4-year follow-up using pink and white esthetic scores. J Periodontol. 2009;80(1):140–51.CrossRef Belser UC, Grutter L, Vailati F, Bornstein MM, Weber HP, Buser D. Outcome evaluation of early placed maxillary anterior single-tooth implants using objective esthetic criteria: a cross-sectional, retrospective study in 45 patients with a 2- to 4-year follow-up using pink and white esthetic scores. J Periodontol. 2009;80(1):140–51.CrossRef
27.
go back to reference Furhauser R, Florescu D, Benesch T, Haas R, Mailath G, Watzek G. Evaluation of soft tissue around single-tooth implant crowns: the pink esthetic score. Clin Oral Implants Res. 2005;16(6):639–44.CrossRef Furhauser R, Florescu D, Benesch T, Haas R, Mailath G, Watzek G. Evaluation of soft tissue around single-tooth implant crowns: the pink esthetic score. Clin Oral Implants Res. 2005;16(6):639–44.CrossRef
28.
go back to reference Berglundh T, Lindhe J, Ericsson I, Marinello CP, Liljenberg B, Thomsen P. The soft tissue barrier at implants and teeth. Clin Oral Implants Res. 1991;2(2):81–90.CrossRef Berglundh T, Lindhe J, Ericsson I, Marinello CP, Liljenberg B, Thomsen P. The soft tissue barrier at implants and teeth. Clin Oral Implants Res. 1991;2(2):81–90.CrossRef
29.
go back to reference Kan JY, Rungcharassaeng K, Umezu K, Kois JC. Dimensions of peri-implant mucosa: an evaluation of maxillary anterior single implants in humans. J Periodontol. 2003;74(4):557–62.CrossRef Kan JY, Rungcharassaeng K, Umezu K, Kois JC. Dimensions of peri-implant mucosa: an evaluation of maxillary anterior single implants in humans. J Periodontol. 2003;74(4):557–62.CrossRef
30.
go back to reference Kleinheinz J, Buchter A, Fillies T, Joos U. Vascular basis of mucosal color. Head Face Med. 2005;1:4.CrossRef Kleinheinz J, Buchter A, Fillies T, Joos U. Vascular basis of mucosal color. Head Face Med. 2005;1:4.CrossRef
31.
go back to reference Kaewsiri D, Panmekiate S, Subbalekha K, Mattheos N, Pimkhaokham A. The accuracy of static vs. dynamic computer-assisted implant surgery in single tooth space: a randomized controlled trial. Clin Oral Implants Res. 2019;30(6):505–14.PubMed Kaewsiri D, Panmekiate S, Subbalekha K, Mattheos N, Pimkhaokham A. The accuracy of static vs. dynamic computer-assisted implant surgery in single tooth space: a randomized controlled trial. Clin Oral Implants Res. 2019;30(6):505–14.PubMed
32.
go back to reference Stefanelli LV, DeGroot BS, Lipton DI, Mandelaris GA. Accuracy of a dynamic dental implant navigation system in a private practice. Int J Oral Maxillofac Implants. 2019;34(1):205–13.CrossRef Stefanelli LV, DeGroot BS, Lipton DI, Mandelaris GA. Accuracy of a dynamic dental implant navigation system in a private practice. Int J Oral Maxillofac Implants. 2019;34(1):205–13.CrossRef
33.
go back to reference Lin YK, Yau HT, Wang IC, Zheng C, Chung KH. A novel dental implant guided surgery based on integration of surgical template and augmented reality. Clin Implant Dent Relat Res. 2015;17(3):543–53.CrossRef Lin YK, Yau HT, Wang IC, Zheng C, Chung KH. A novel dental implant guided surgery based on integration of surgical template and augmented reality. Clin Implant Dent Relat Res. 2015;17(3):543–53.CrossRef
34.
go back to reference Pellegrino G, Mangano C, Mangano R, Ferri A, Taraschi V, Marchetti C. Augmented reality for dental implantology: a pilot clinical report of two cases. BMC Oral Health. 2019;19(1):158.CrossRef Pellegrino G, Mangano C, Mangano R, Ferri A, Taraschi V, Marchetti C. Augmented reality for dental implantology: a pilot clinical report of two cases. BMC Oral Health. 2019;19(1):158.CrossRef
35.
go back to reference Haidar Z. Autonomous robotics: a fresh era of implant dentistry...is a reality! J Oral Res 2017;6(9):230–231.CrossRef Haidar Z. Autonomous robotics: a fresh era of implant dentistry...is a reality! J Oral Res 2017;6(9):230–231.CrossRef
Metadata
Title
Current Workflows for Computer-Aided Implant Surgery: a Review Article
Authors
Mariam Margvelashvili-Malament
Andre’ Barbisan De-Souza
Wael Att
Publication date
01-12-2019
Publisher
Springer International Publishing
Published in
Current Oral Health Reports / Issue 4/2019
Electronic ISSN: 2196-3002
DOI
https://doi.org/10.1007/s40496-019-00234-5

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