title: The impact of the fabrication method on the three-dimensional accuracy of an implant surgery template.
abstract: OBJECTIVE
  The use of a surgical template is a well-established method in advanced implantology. In addition to conventional fabrication, computer-aided design and computer-aided manufacturing (CAD/CAM) work-flow provides an opportunity to engineer implant drilling templates via a three-dimensional printer. In order to transfer the virtual planning to the oral situation, a highly accurate surgical guide is needed. The aim of this study was to evaluate the impact of the fabrication method on the three-dimensional accuracy.
  
  
  METHODS
  The same virtual planning based on a scanned plaster model was used to fabricate a conventional thermo-formed and a three-dimensional printed surgical guide for each of 13 patients (single tooth implants). Both templates were acquired individually on the respective plaster model using an optical industrial white-light scanner (ATOS II, GOM mbh, Braunschweig, Germany), and the virtual datasets were superimposed. Using the three-dimensional geometry of the implant sleeve, the deviation between both surgical guides was evaluated.
  
  
  RESULTS
  The mean discrepancy of the angle was 3.479° (standard deviation, 1.904°) based on data from 13 patients. Concerning the three-dimensional position of the implant sleeve, the highest deviation was in the Z-axis at 0.594 mm. The mean deviation of the Euclidian distance, dxyz, was 0.864 mm.
  
  
  CONCLUSIONS
  Although the two different fabrication methods delivered statistically significantly different templates, the deviations ranged within a decimillimeter span. Both methods are appropriate for clinical use.
authors.affiliation: Department of Prosthodontics (Head: Professor Dr. Manfred Wichmann), Friedrich-Alexander University of Erlangen Nürnberg, Glückstr. 11, 91054 Erlangen, Germany. Electronic address: ragai.matta@uk-erlangen.de.
authors.forename: Ragai-Edward
authors.initials: RE
authors.lastname: Matta
authors.affiliation: Department of Oral and Maxillofacial Surgery (Head: Professor Dr. Dr. Dr. h.c. Friedrich Wilhelm Neukam), Friedrich-Alexander University of Erlangen Nürnberg, Glückstr. 11, 91054 Erlangen, Germany.
authors.forename: Bastian
authors.initials: B
authors.lastname: Bergauer
authors.affiliation: Department of Medical Informatics, Biometry and Epidemiology (Head Professor. Dr. rer. nat. Olaf Gefeller, PhD), Friedrich-Alexander-University of Erlangen Nuremberg, Waldstr. 6, 91054 Erlangen, Germany.
authors.forename: Werner
authors.initials: W
authors.lastname: Adler
authors.affiliation: Department of Prosthodontics (Head: Professor Dr. Manfred Wichmann), Friedrich-Alexander University of Erlangen Nürnberg, Glückstr. 11, 91054 Erlangen, Germany.
authors.forename: Manfred
authors.initials: M
authors.lastname: Wichmann
authors.affiliation: Department of Oral and Maxillofacial Plastic Surgery and Interdisciplinary, Department of Oral Surgery and Implantology (Head: Professor. J.E. Zöller, MD, DMD), University of Cologne, Kerpener Str. 62, 50937 Köln, Germany.
authors.forename: Hans-Joachim
authors.initials: HJ
authors.lastname: Nickenig
mesh_terms: D017076:Computer-Aided Design; D003758:Dental Implantation, Endosseous / Q000379:methods*; D019250:Dental Implants, Single-Tooth; D006801:Humans; D021621:Imaging, Three-Dimensional; D003765:Models, Dental; D010347:Patient Care Planning; D066330:Printing, Three-Dimensional; D012984:Software; D025321:Surgery, Computer-Assisted / Q000379:methods*
keywords: CAD/CAM surgical template; Computer-aided surgery; Dental implant; Guided implant surgery; Stereolithography template; Surgical guide template