Virtual variation simulation of CAD/CAM template-guided surgeries performed on human cadavers: Part II

Kero, Timo; Pettersson, Andreas; Fäldt, Jenny; Andersson, Matts; Gillot, Luc; Cannas, Bernard; Näsström, Karin; Söderberg, Rikard

doi:10.1016/S0022-3913(10)60089-3

« Previous Next »Journal of Prosthetic Dentistry
Volume 104, Issue 1 , Pages 48-55, July 2010

Virtual variation simulation of CAD/CAM template-guided surgeries performed on human cadavers: Part II

Timo Kero, MSc
- PhD student, Department of Product and Production Development, Chalmers University of Technology, Göteborg, Sweden
- Corresponding author: Mr Timo Kero, Chalmers University of Technology, Department of Product and Production Development, Division of Product Development, Hörsalsvägen 7A, SE-412 96 Göteborg, SWEDEN, Fax: +46 31 772 13 75
Andreas Pettersson, BSc
- PhD student, Section for Image and Functional Odontology, Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden; University Paris
Jenny Fäldt, PhD
- Senior Scientist, Division of Early Development, Nobel Biocare AB, Göteborg, Sweden
Matts Andersson, PhD
- Head, Division of Early Development, Nobel Biocare AB, Göteborg, Sweden
Luc Gillot, DDS
- Clinical Instructor, Laboratory of Anatomy, Odontological Faculty, University Paris Descartes, Descartes, Paris, France
Bernard Cannas, DDS
- Clinical Instructor, Laboratory of Anatomy, Odontological Faculty, University Paris Descartes, Descartes, Paris, France
Karin Näsström, PhD
- Department Chair, Section for Image and Functional Odontology, Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden; University Paris
Rikard Söderberg, PhD
- Professor, Head of Department of Product and Production Development, and Director, Wingquist Laboratory, Chalmers University of Technology, Göteborg, Sweden

Statement of problem

CAD/CAM template-guided surgery has gained attention as a method of improving the predictability of dental implant placement. However, due to possible variations during the manufacturing process and in the robustness of the template design, a virtual prediction of the potential positioning of the implants is needed.

Purpose

The purpose of this study was to perform virtual variation simulations on virtually planned implant placements and to compare them with corresponding results from actual surgeries performed on human cadavers in a previous study.

Material and methods

Seventeen computer-aided plans were used for virtual variation simulation of surgeries conducted on 17 human cadavers and 145 implants placed in the cadavers. For each surgery, 10,000 virtual surgeries were performed, resulting in 1,450,000 implant placements. The results from the virtual variation simulations were statistically compared with the results from the actual surgeries. The Mann-Whitney U test was used to compare the implant distributions (α=.05).

Results

In the maxillae, the difference between the simulated average mean of the mean and the compared surgical average of the median was 0.22 mm (apex) and −0.35 mm (hex), and for the mandible, the corresponding values were −0.19 mm (apex) and −0.69 mm (hex). The simulated average mean of the range compared to the mean range of the maximum deviation results from the surgeries of the maxillae was 2.96 mm (apex) and 0.44 mm (hex), and 2.3 mm (apex) and 0.26 mm (hex) for the mandible. The implant distributions between the simulations and the surgeries were significantly different at both the hex (P<.001) and apex (P<.001).

Conclusions

The implant distributions were neither static nor normally distributed. Thus, within the limitations of this study, the definitive geometrical variations of the implants were not static, as they depend on the individual anatomy of the jaws and the ability to place the CAD/CAM-guided surgical template in the proper position. (J Prosthet Dent 2010;104:48-55)