Computerized navigation for immediate loading of dental implants with a prefabricated metal frame: a feasibility study.
OBJECTIVE
To study the probability of using Image Guided Implantology (IGI) for planning and execution of a dental plan of 3 implants in a geometric pattern that fits a prefabricated metal frame accurately, simulating provisional restoration in immediate loading.


METHODS
Ten mandible models were imaged by standard computed tomography. Three implants, two in the premolar and one in the molar area on each side of the jaws, were planned by use of the IGI system (Image Navigation Ltd, Moshav Ora, Israel). Two millimeter drilling and subsequent 3 millimeter widening drilling was performed with the real-time computerized navigation technology in the 120 sampling sites. In each step, parallel pins were inserted, and metal gauging frames with preplanned holes of incremental diameters and in the predefined geometric pattern were placed on the pins to evaluate the precision of fit.


RESULTS
Full success was obtained in fitting all three 3-mm pins, with frames having clearance of 0.5 or 1 mm, and in matching pairs of pins 2 or 3 mm in diameter at clearances of 0.5 mm or greater. With more constrained clearances, matching of all 3 pins was 80% and 95% successful with 2-mm pins (clearance of 0.25 and 0.5 mm, respectively) and 60% and 95% successful with 3-mm pins (clearance of 0 and 0.25 mm, respectively). Some laterality bias was observed.


CONCLUSIONS
This preliminary study shows that the IGI system enables accurate planning of implant number and location to be achieved together with planning for a prefabricated metal frame for immediate loading.
Department of Oral and Maxillofacial Surgery, Hebrew University-Hadassah, Jerusalem, Israel. nard@cc.huji.ac.il
Nardy
N
Casap
Amir
A
Laviv
Alon
A
Wexler
D003198:Computer Simulation; D003722:Dental Alloys; D003724:Dental Arch / Q000000981:diagnostic imaging / Q000601:surgery; D015921:Dental Implants; D018772:Dental Marginal Adaptation / Q000592:standards; D017267:Dental Prosthesis Design; D019094:Dental Prosthesis, Implant-Supported; D003794:Dental Restoration, Temporary; D005240:Feasibility Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D057893:Immediate Dental Implant Loading / Q000295:instrumentation / Q000379:methods; D008334:Mandible / Q000000981:diagnostic imaging / Q000601:surgery; D008953:Models, Anatomic; D010347:Patient Care Planning; D025321:Surgery, Computer-Assisted / Q000295:instrumentation / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods
D003722:Dental Alloys; D015921:Dental Implants