How Accurate Is Oral Implant Installation Using Surgical Guides Printed from a Degradable and Steam-Sterilized Biopolymer?
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Department of Prosthetic Dentistry, Center for Dental Medicine, Medical Center—University of Freiburg, Faculty of Medicine—University of Freiburg, 79106 Freiburg, Germany
2
Department of Prosthodontics, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Geriatric Dentistry and Craniomandibular Disorders, 14197 Berlin, Germany
3
Department of Orthodontics, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Dentofacial Orthopedics and Pedodontics, Aßmannshauser Str. 4-6, 14197 Berlin, Germany
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(8), 2322; https://doi.org/10.3390/jcm9082322
Received: 23 June 2020
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Revised: 17 July 2020
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Accepted: 17 July 2020
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Published: 22 July 2020
(This article belongs to the Special Issue Digital Dentistry: Advances and Challenges)
3D printed surgical guides are used for prosthetically-driven oral implant placement. When manufacturing these guides, information regarding suitable printing techniques and materials as well as the necessity for additional, non-printed stock parts such as metal sleeves is scarce. The aim of the investigation was to determine the accuracy of a surgical workflow for oral implant placement using guides manufactured by means of fused deposition modeling (FDM) from a biodegradable and sterilizable biopolymer filament. Furthermore, the potential benefit of metal sleeve inserts should be assessed. A surgical guide was designed for the installation of two implants in the region of the second premolar (SP) and second molar (SM) in a mandibular typodont model. For two additive manufacturing techniques (stereolithography [SLA]: reference group, FDM: observational group) n = 10 surgical guides, with (S) and without (NS) metal sleeves, were used. This resulted in 4 groups of 10 samples each (SLA-S/NS, FDM-S/NS). Target and real implant positions were superimposed and compared using a dedicated software. Sagittal, transversal, and vertical discrepancies at the level of the implant shoulder, apex and regarding the main axis were determined. MANOVA with posthoc Tukey tests were performed for statistical analyses. Placed implants showed sagittal and transversal discrepancies of <1 mm, vertical discrepancies of <0.6 mm, and axial deviations of ≤3°. In the vertical dimension, no differences between the four groups were measured (p ≤ 0.054). In the sagittal dimension, SLA groups showed decreased deviations in the implant shoulder region compared to FDM (p ≤ 0.033), whereas no differences in the transversal dimension between the groups were measured (p ≤ 0.054). The use of metal sleeves did not affect axial, vertical, and sagittal accuracy, but resulted in increased transversal deviations (p = 0.001). Regarding accuracy, biopolymer-based surgical guides manufactured by means of FDM present similar accuracy than SLA. Cytotoxicity tests are necessary to confirm their biocompatibility in the oral environment.
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Keywords:
accuracy; additive manufacturing; biodegradability; computer-aided design; dental implants; fused deposition modelling; medical device; lignin; surgical guides
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MDPI and ACS Style
Pieralli, S.; Spies, B.C.; Hromadnik, V.; Nicic, R.; Beuer, F.; Wesemann, C. How Accurate Is Oral Implant Installation Using Surgical Guides Printed from a Degradable and Steam-Sterilized Biopolymer? J. Clin. Med. 2020, 9, 2322. https://doi.org/10.3390/jcm9082322
AMA Style
Pieralli S, Spies BC, Hromadnik V, Nicic R, Beuer F, Wesemann C. How Accurate Is Oral Implant Installation Using Surgical Guides Printed from a Degradable and Steam-Sterilized Biopolymer? Journal of Clinical Medicine. 2020; 9(8):2322. https://doi.org/10.3390/jcm9082322
Chicago/Turabian StylePieralli, Stefano, Benedikt C. Spies, Valentin Hromadnik, Robert Nicic, Florian Beuer, and Christian Wesemann. 2020. "How Accurate Is Oral Implant Installation Using Surgical Guides Printed from a Degradable and Steam-Sterilized Biopolymer?" Journal of Clinical Medicine 9, no. 8: 2322. https://doi.org/10.3390/jcm9082322
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