Surgical Planning and Prosthesis Construction Using Computed Tomography, CAD/CAM Technology, and the Internet for Immediate Loading of Dental Implants
Tóm tắt
This report describes a protocol that uses computer technology and medical imaging to virtually place anterior and posterior dental implants and to construct a precise surgical template and prosthesis, which is connected at the time of implant placement. This procedure drastically reduces patient office time, surgical treatment time, and the degree of post‐treatment recovery. Patients with an edentulous arch or a partially edentulous area had a denture with radiopaque markers constructed for computed tomography (CT) scans of the appropriate jaw. The CT images, having acquisition slices of 0.4 mm, are transposed in a three‐dimensional image‐based program for planning and strategic placement of dental implants. After virtual implant placement on the computer, the surgical treatment plan is sent to a manufacturing facility for construction of the surgical template. The manufactured surgical components and surgical template arrive on the clinical site. From the surgical template, the dental laboratory retro‐engineers the master cast, articulates it with the opposing dentition based on a duplicate of the scanning denture, and creates the prosthesis. Using the surgical template, minimally invasive surgery is performed without a flap, and the prosthesis is delivered, achieving immediate functional loading to the implants. Minor occlusal adjustments are made. The total surgical treatment time required is typically between 30 and 60 minutes. Postoperative symptoms such as pain, swelling, and inflammation are dramatically reduced.
Identification of the bone in relationship to the tooth position via three‐dimensional CT prior to surgery allows the clinician to precisely place implants. Computer‐aided design/computer‐assisted manufacture technology using the three‐dimensional images allows for fabrication of the surgical template. This is a significant advancement in implant dentistry and promotes interdisciplinary approaches to patient treatment. The implant surgeon and restorative dentist can agree upon implant locations and screw access locations prior to the surgical episode.
Từ khóa
Tài liệu tham khảo
Brånemark P‐I, 1985, Osseointegration in clinical dentistry
Schnitman P, 1990, Immediate fixed prostheses supported by two‐stage threaded implants: methodology and results, J Oral Implantol, 16, 96
Schnitman P, 1997, Ten‐year results for Brånemark implants loaded with fixed prostheses at implant placement, Int J Oral Maxillofac Implants, 12, 495
Tarnow D, 1997, Immediate loading of threaded implants at stage I surgery in edentulous arches: ten consecutive case reports with 1‐ to 5‐year data, Int J Oral Maxillofac Implants, 12, 319
Ericsson I, 2000, Early functional loading of Brånemark dental implants: 5‐year clinical follow‐up study, Clin Oral Implants Res, 2, 70
Gatti C, 2000, Implant‐retained mandibular overdentures with immediate loading: a prospective study of ITI implants, Int J Oral Maxillofac Implants, 15, 383
Wolfinger GJ, 2003, Immediate functional loading of Brånemark system implants in edentulous mandibles: clinical report of the results of developmental and simplified protocols, Int J Oral Maxillofac Implants, 18, 250
Petropoulos VC, 2004, Treatment of a patient with cleidocranial dysplasia using osseointegrated implants: a patient report, Int J Oral Maxillofac Implants, 19, 282
Balshi TJ, 2001, A new protocol for immediate functional loading of dental implants, Dent Today, 20, 60
Vidjak F, 2003, Immediate‐loading dental endosteal implants and the elderly patient, J Calif Dent Assoc, 31, 917, 10.1080/19424396.2003.12224275
Balshi TJ, 2002, Immediate placement and implant loading for expedited patient care: a patient report, Int J Oral Maxillofac Implants, 17, 587
Rocci A, 2001, Immediate function of single and partial reconstructions in the maxilla using Mk IV fixtures, Appl Osseointegration Res, 2, 22
Balshi TJ, 2003, Immediate loading of dental implants in the edentulous maxilla: case study of a unique protocol, Int J Periodont Rest Dent, 23, 37
Horiuchi K, 2000, Immediate loading of Brånemark system implants following placement in edentulous patients: a clinical report, Int J Oral Maxillofac Implants, 15, 824
Kinsel RP, 2000, Development of gingival esthetics in the edentulous patient with immediate loaded, single‐stage, implant‐supported fixed prostheses: a clinical report, Int J Oral Maxillofac Implants, 15, 711
Salama H, 1995, Immediate loading of bilaterally splinted titanium root‐form implants in fixed prosthodontics—a technique reexamined: two case reports, Int J Periodont Restor Dent, 15, 345
Nikellis I, 2004, Immediate loading of 190 endosseous dental implants: a prospective observational study of 40 patient treatments with up to 2‐year data, Int J Oral Maxillofac Implants, 19, 116
Jaffin RA, 2004, Immediate loading of dental implants in the completely edentulous maxilla: a clinical report, Int J Oral Maxillofac Implants, 19, 721
Balshi SF, 2005, A resonance frequency analysis assessment of maxillary and mandibular immediately loaded implants, J Oral Maxillofac Implants, 20, 584
Benson BW., 2001, Presurgical radiographic planning for dental implants, Oral Maxillofac Surg Clin North Am, 13, 751, 10.1016/S1042-3699(20)30119-9
Balshi SF, 2006, Surgical planning and prosthesis construction using computer technology and medical imaging for immediate loading of implants in the pterygomaxillary region, Int J Periodont Rest Dent, 26, 239