Journal of Oral Implantology October 2012 - (Page 603)

CASE REPORT Clinical Application of Stereolithographic Surgical Guide With a Handpiece Guidance Apparatus: A Case Report Oguz Ozan, DDS, PhD* Emre Seker, DDS Sevcan Kurtulmus-Yilmaz, DDS Ahmet Ersan Ersoy, DDS, PhD The success of implant-supported restorations depends on the treatment planning and the transfer of planning through the surgical field. Recently, new computer-aided design and manufacturing (CAD/CAM) techniques, such as stereolithographic (SLA) rapid prototyping, have been developed to fabricate surgical guides to improve the precision of implant placement. The objective of the present case is to introduce a recently developed SLA surgical guide system into the rehabilitation of a 62-year-old male patient with mandibular edentulism. After obtaining a cone-beam computerized tomography (CBCT) scan of the mandible with a radiographic template, the images were transferred into a 3-dimensional (3D) image-based software for implant planning. The StentCad Beyond SLA surgical guide system, which is a combination of a currently used surgical template with pilot hollows and a surgical handpiece guidance apparatus, was designed to transfer a preoperatively defined implant position onto the surgical site without any drill-surgical guide contact. For the fabrication of this system, a surgical handpiece was scanned by a laser optical scanner and a mucosa-supported surgical guide was designed according to the patient’s 3D model, which was attained from the CBCT images. Four dental implants were inserted through the SLA surgical guide system by a torque-controlled surgical handpiece to the interforaminal region via a flapless surgical procedure. Implants were assessed 3 months after surgery, and an implant-retained mandibular overdenture was fabricated. The present case emphasizes that CAD/CAM SLA surgical guides, along with CBCT images and scanning data, may help clinicians plan and place dental implants. Key Words: SLA surgical guide, CT, dental implant, flapless surgery INTRODUCTION n recent years, dental implant rehabilitation has faced demands from the prosthetic and esthetic arenas calling for increasingly ideal outcomes, which require precise planning via advanced radiographic procedures and placement with surgical guides.1,2 Computerized tomography (CT) is a useful tool in the rehabilitation of complex cases when anatomic limitations, reduced bone dimensions, and compromised bone density are present.3 Thus, in the past decade it has become the gold standard for pre-implant assessment of the Department of Prosthodontics, Faculty of Dentistry, Near East University, Mersin 10, Turkey. * Corresponding author, e-mail: oguzozan@gmail.com DOI: 10.1563/AAID-JOI-D-11-00010 I jaws.4 With the use of a radiographic template during the CT scanning procedure, a restorative implant practitioner can also visualize the location of the planned implants from an esthetic and biomechanical standpoint.5 Various CT-based software programs and navigation systems have been developed to assist with surgery and presurgical planning.6,7 The software allows the practitioner to view a longitudinal and a concentric graph of bone density value around each planned implant8 and graphical 3-dimensional (3D) implant simulation.5 Computer-aided design and manufacturing (CAD/CAM) techniques make it possible to use data from CT not only for planning implant rehabilitation but also to fabricate surgical guides.9 The technique uses stereolithography (SLA), a laser-driven polymerization process that Journal of Oral Implantology 603

Table of Contents for the Digital Edition of Journal of Oral Implantology October 2012

Should the Implant Fit the Patient or Should the Patient Fit the Implant?
Histologic and Biomechanical Evaluation of Alumina-Blasted/Acid-Etched and Resorbable Blasting Media Surfaces
Impact of Dental and Zygomatic Implants on Stress Distribution in Maxillary Defects: A 3-Dimensional Finite Element Analysis Study
Precision of Implant Placement With Stereolithographic Templates: A Pilot In Vitro Study
An Evaluation of Biocompatibility of Indigenously Produced Pure Titanium: An Experimental Study in Rabbits
Relationship Between Smoking and Bleeding on Probing
Stress Analysis in Platform-Switching Implants: A 3-Dimensional Finite Element Study
Acrylic Resin Polymerization in Direct Contact to the Abutment and the Temperature at Bone-Implant Interface: A Pilot In Vitro Study
Clinical Application of Stereolithographic Surgical Guide With a Handpiece Guidance Apparatus: A Case Report
Fixed Rehabilitation of Severely Atrophic Jaws Using Immediately Loaded Basal Disk Implants After In Situ Bone Activation
A Functional Open-Tray Impression Technique for Implant-Retained Overdenture Prostheses
Use of Plasma Rich in Growth Factor for Schneiderian Membrane Management During Maxillary Sinus Augmentation Procedure
A Technique to Facilitate the Fabrication of Provisional Restorations for ITI Solid Abutments
Influence of Etiologic Factors in Peri-Implantitis: Literature Review and Case Report
Simplistic Partially Limiting Surgical Guide for Flapless Implant Placement: A Case Report
Types of Implant Surgical Guides in Dentistry: A Review
Rehabilitation of Atrophic Posterior Maxilla With Zygomatic Implants: Review

Journal of Oral Implantology October 2012