The Research And Application Of Computer-aided Design Technology In Implant Therapy For Edentulous Patients

Objective1. Combined with the technologies, such as CAD/CAM, reverse engineering,rapid prototyping, the study has researched the fabrication of mucosal supportedsurgical template in edentulous patients. These surgical guides are used by the doctorto place the planned implants in the patient’s mouth in the same positions as in thevirtual treatment plan, allowing more accurate and predictable implant placement andreduced patient morbidity.2. Design and fabricate a new implant surgical template with handpieceguidance apparatus to improve the precision of implant placement. Then we evaluatedthe accuracy of implant placement with the new implant surgical template.Methods1. The application of mucosal supported surgical guides in edentulous patients:7edentulous patients presented to the Affiliated Stomatological Hospital, FujianMedical University from May2011to September2012. These patients were CTscanned with radiographic templates. Then assembled the three dimensional data ofdental model and CT model with the registration technique to get the completeinformation of soft tissue. Simulate implant with Simplant software. According to theplanned implants position, we designed the guiding template with3-matic software.Fabricated the surgical template by RP machine. Under the guidance of the template,we placed40implants and evaluated the clinical effect.2. The fabrication and accuracy of a new implant surgical template withhandpiece guidance apparatus: design and fabricate a new implant surgical templatewith handpiece guidance apparatus to improve the precision of implant placement. Three patients’ CT dates were chosen to be imported in Mimics software toreconstruction. These jaw models were fabricated by the rapid prototyping. Implantsposition was simulated by the Simplant software. The guiding templates weredesigned by3-matic software and fabricated by RP machine. Under the guidance ofthe guiding templates, we drilled holes in the jaw models. Then the models were CTscanned once again. Finally we compared the planed position with actual position ofthe holes in three-dimensional direction to evaluate the accuracy of the template.Results1. Under the guidance of the mucosal supported surgical templates,40implantswere implanted in7cases. The surgical template could guide the direction of theimplants and the final repair effects were satisfactory. The prosthesies fabricated weresuccessfully. The effects of the implant restoration were stability.2. Mean deviations of the12holes in the jaw models were measured, theaverage distance deviations at the entry and apical point of the implant were0.42mm±0.21mm(0.22mm~0.82mm) and (0.75±0.19) mm, and the average axis deviationwas1.93°±1.35°(0.35°~5.40°), the vertical direction deviation was0.25mm±0.11mm(0.15mm~0.53mm).Conclusion1. The registration technique has been used to get the complete information ofsoft tissue. The integration of the restorative determinants into the surgical planning,resulting in predictability of the prosthetic outcome and allowing for production of theprosthesis before surgery. The technology has opened new avenues to clinicians foraccurate and predictable diagnosis, planning, and treatment in a multidisciplinarypatient-based approach.2. The results of vitro experiments verify that the use of implant surgicaltemplate with handpiece guidance apparatus for implants insertion is a method withhigh accuracy. The characteristic of the new implant surgical template is the guidanceof the handpiece. The benefit of this new template is that there is no need to changedrills during surgery. Also, this apparatus is easy to use and were designed to keep theoperative field clear.