CONTROL ID: 2603648
CONTACT: neil meredith
CURRENT CATEGORY: Clinical
PRESENTATION TYPE: Poster
A Novel Surgical Navigation Technique For The Surgical Alignment Of Dental Implants
AUTHORS: meredith, neil
Alignment and parallelism of multiple dental implants is critical to enable successful prosthetic reconstruction. Implant abutment connection geometries vary between different systems enabling a degree of divergence between adjacent implants. Typically this can be no greater than 20 degrees. A new technique has been developed using a processor controlled sensor system attached directly to a dental handpiece. This investigation examines the accuracy of such a system, comparing it with freehand placement and the use of CAD generated stents.
A series of 3D printed model mandibles were printed in PLA creating a repeatable geometry. Alignment points were created on the crest of the alveolar ridge representing reproducible sites for implant placement. Three methods were utilized to determine implant angulation and orientation during preparation; freehand, CAD stent and surgical navigation.
The surgical navigation system comprised three parts; the sensor on the handpiece, returning euler coordinate data to a processor that in turn provided motor control feedback for the handpiece. Dental implants were then placed in the mandibles with the objective of being truly parallel. The parallelism of the implants was then measured separately by attaching marker pins to the implants, scanning the models and calculating parallelism with image analysis software.
Freehand measurements of parallelism range between 3 and 5 degrees bearing in mind that this was with a highly experienced operator under optimal conditions. Parallelism with CAD generated stents varied between 2 and 4 degrees. The surgical navigation achieved parallelism of better than 1 degree between implants.
The parallelism achieved freehand can be considered to be the best possible under ideal conditions. A considerably higher variation can be expected under real world conditions. Although CAD generated stents are perceived as being of high accuracy some variability can be observed attributable to the tolerances between the drills and stent components. The surgical navigation system proved the most accurate technique with a reported accuracy of better than 0.1 degree. The added convenience of haptic feedback and motor control preventing operation of the drill unless orientation is ideal is attractive.
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