Complications of CAD/CAM Fabricated Surgical Template for Static Computer-Aided Implant Surgery

Purpose: Surgical templates produced by digital simulation and CAD/CAM allow for three-dimensional control of implant placement. However, due to clinical limitations, there are complications during the use of the template. The purpose of this study was to summarize the complications associated with the use of surgical templates for static computer-aided implant surgery. Methods: Complications were collected during the observation period, and then their implant sites were reanalyzed with simulation software. Results: There were 104 cases during the observation period, 5 cases had complications. Mechanical complications were observed in four cases, including three cases in which the frame of the template fractured during implant placement surgery and one case in which the sleeve fell off the surgical template. In one case, there was an error in the planned position. All cases were mandibular molar cases, and all cases of frame fracture were at the free end defect site. All cases had a Hounsfield unit of more than 700 at the implant site, and some of them had a significantly small jaw opening. Conclusion: Although the spread of CAD/CAM surgical templates has made it possible to avoid problems caused by the position of the implant, it has been difficult to avoid fractures in cases of mandibular free end defects with high Hounsfield unit.

The Relationship between Implant Size and Success Rate in Computer Guided Implant Surgery

Guided implant surgery gained acceptance and credit in implant dentistry. The aim of this study is to find out and evaluate the relationship between implant size and success rate following computed tomography scan guided implant surgery. Sixty-four (36 females, 28 males) completely and partially edentulous patients aged between 42 and 65 years old were participated and fulfilled the inclusion criteria of the study. Two hundred and seventeen dental implants (length: 10, 11.5, and 13 mm;Diameter: 3.3, 3.75, and 4.2 mm) were placed using computed tomography scan guided implant surgery, 117 implants were placed in the maxilla, while 100 implants were placed in the mandible. The implants were evaluated for clinical parameters at 2, 4, and 12 weeks intervals after installation. The overall success rate was 95.4%. Clinical stability of the implant size (Diameter 3.3 mm, Length 10 mm) was the least as compared to other dimensions (P ≤ 0.05). Medium and large size implants (Diameter 3.75 and 4.2 mm, Length 11.5 and 13 mm) were the highest success rate in implant surgery. Implants width (diameter 3.3 mm) and length (10 mm) are best avoided in guided computed tomography surgery as compared with other implant sizes especially in atrophic bony areas. Computer-guided implant surgery remains exciting. Watchful planning and precise stability of the surgical guide are mandatory for successful protocol. Further investigations should be performed to assess such technique among dental patients from satisfactory point of view. Intensive cooperation between dentists and software engineering discipline should be aimed to maximize the success of such technique.