title: Accuracy of a cone beam computed tomography-guided surgical stent for orthodontic mini-implant placement.
abstract: OBJECTIVE
  To validate the accuracy of a cone-beam computed tomography (CBCT)-guided surgical stent for orthodontic mini-implant (OMI) placement by quantitatively evaluating the difference between CBCT-prescribed and actual position of mini-implants in preoperative and postoperative CBCT images.
  
  
  METHODS
  A surgical stent was fabricated using Teflon-Perfluoroalkoxy, which has appropriate biological x-ray attenuation properties. Polyvinylsiloxane impression material was used to secure the custom-made surgical stent onto swine mandibles. CBCT scanning was done with the stent in place to virtually plan mini-implants using a three-dimensional (3D) software program. An appropriate insertion point was determined using 3D reconstruction data, and the vertical and horizontal angulations were determined using four prescribed angles. A custom-designed surveyor was used to drill a guide hole within the surgical stent as prescribed on the CBCT images for insertion of 32 OMIs. The mandibles with a surgical stent in place were rescanned with CBCT to measure the deviations between the virtual planning data and surgical results.
  
  
  RESULTS
  The difference between the prescribed and actual vertical angle was 1.01 ± 7.25, and the horizontal difference was 1.16 ± 6.08. The correlation coefficient confirms that there was no intrarater variability in either the horizontal (R  =  .97) or vertical (R  =  .74) vectors.
  
  
  CONCLUSIONS
  The surgical stent in this study guides mini-implants to the prescribed position as planned in CBCT. Since the statistical difference was not significant, the surgical stent can be considered to be an accurate guide tool for mini-implant placement in clinical use.
authors.affiliation: Department of Oral and Maxillofacial Radiology, Kangdong Sacred Heart Hospital, Hallym University Medical Center, Seoul, Korea.
authors.forename: Jae-Jung
authors.initials: JJ
authors.lastname: Yu
authors.forename: Gyu-Tae
authors.initials: GT
authors.lastname: Kim
authors.forename: Yong-Suk
authors.initials: YS
authors.lastname: Choi
authors.forename: Eui-Hwan
authors.initials: EH
authors.lastname: Hwang
authors.forename: Janghyun
authors.initials: J
authors.lastname: Paek
authors.forename: Seong-Hun
authors.initials: SH
authors.lastname: Kim
authors.forename: John C
authors.initials: JC
authors.lastname: Huang
mesh_terms: D000818:Animals; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D015921:Dental Implants; D007091:Image Processing, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D008334:Mandible / Q000000981:diagnostic imaging / Q000601:surgery; D052280:Orthodontic Anchorage Procedures / Q000295:instrumentation* / Q000592:standards; D011138:Polytetrafluoroethylene / Q000737:chemistry; D011145:Polyvinyls / Q000737:chemistry; D012833:Siloxanes / Q000737:chemistry; D012984:Software; D015607:Stents / Q000592:standards*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D013552:Swine; D014584:User-Computer Interface
chemical_list: D015921:Dental Implants; D011145:Polyvinyls; D012833:Siloxanes; C034183:vinyl polysiloxane; D011138:Polytetrafluoroethylene