title: Computer-assisted template-guided custom-designed 3D-printed implant placement with custom-designed 3D-printed surgical tooling: an in-vitro proof of a novel concept.
abstract: OBJECTIVE
  The aim of this study was to introduce a new concept for computer-assisted template-guided placement of a custom 3D-designed/3D-printed implant with congruent custom 3D-designed/3D-printed surgical tooling and to test the feasibility and accuracy of this method in-vitro.
  
  
  METHODS
  One partially edentulous human mandibular cadaver was scanned with a cone-beam computed tomography (CBCT) system and intra-oral scan system. The 3D data of this cadaver were imported in specialized software and used to analyse the region of a missing tooth. Based on the functional and anatomical parameters, an individual implant with congruent surgical tooling and surgical guided template was designed and 3D-printed. The guided osteotomy was performed, and the custom implant inserted. To evaluate the planned implant position in comparison with the placed implant position, the mandible with implant was scanned again with the CBCT system and software matching was applied to measure the accuracy of the procedure.
  
  
  RESULTS
  The angular deflection with the planned implant position was 0.40°. When comparing the 3D positions of the shoulder, there is a deviation of 0.72 mm resulting in an apical deviation of 0.72 mm.
  
  
  CONCLUSIONS
  With the use of currently available technology, it is very well feasible to create in a virtual simulation a custom implant with congruent custom surgical tooling and to transfer this to a clinical setting. However, further research on multiple levels is needed to explore this novel approach.
authors.affiliation: Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Research Institute Move, Amsterdam, The Netherlands.
authors.forename: David
authors.initials: D
authors.lastname: Anssari Moin
authors.affiliation: Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Research Institute Move, Amsterdam, The Netherlands.
authors.forename: Wiebe
authors.initials: W
authors.lastname: Derksen
authors.affiliation: Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Research Institute Move, Amsterdam, The Netherlands.
authors.forename: Hugo
authors.initials: H
authors.lastname: Waars
authors.affiliation: Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Research Institute Move, Amsterdam, The Netherlands.
authors.forename: Bassam
authors.initials: B
authors.lastname: Hassan
authors.affiliation: Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Research Institute Move, Amsterdam, The Netherlands.
authors.forename: Daniel
authors.initials: D
authors.lastname: Wismeijer
mesh_terms: D017076:Computer-Aided Design; D054893:Cone-Beam Computed Tomography; D015921:Dental Implants; D017267:Dental Prosthesis Design / Q000379:methods*; D006801:Humans; D066298:In Vitro Techniques; D007576:Jaw, Edentulous, Partially / Q000000981:diagnostic imaging; D066330:Printing, Three-Dimensional
chemical_list: D015921:Dental Implants
keywords: CT imaging; biomaterials; material sciences; surgical techniques