关键词: 3D printing dental implants digital workflow guided surgery stackable guides virtual patient

来  源:   DOI:10.1111/jerd.13265

Abstract:
OBJECTIVE: The aim of this report is to present the complete workflow of 3D virtual patient for planning and performing implant surgery with magnetically retained 3D-printed stackable guides.
METHODS: A 3D-printed stackable system was proposed based on bone, dental, and facial references. Initially, a 66-year-old male patient was digitalized through photographs, cone beam computed tomography, and intraoral scans (Virtuo Vivo, Straumann). All files were merged to create a 3D virtual patient in the planning software (coDiagnostiX, Straumann). Sequential stackable guides were designed, printed, and cured. Magnets were inserted into connectors, and the interim protheses received color characterization. Four mounted guides were produced for the specific purposes of pin fixation, bone reduction, implant placement, and immediate provisionalization. After surgery and healing period, patient digital data were updated. Final implant positions were compared to planned values and inconsistencies were clinically acceptable. The mean angular deviation was 5.4° (3.2-7.3) and mean 3D discrepancies were of 0.90 mm (0.46-1.12) at the entry point and 1.68 mm (1.00-2.20) at implant apex. Case follow-up revealed stability, patient\'s comfort, and no intercurrences.
CONCLUSIONS: Magnetically retained stackable guides provide treatment accuracy and reduce surgical and prosthetic complications. The projected virtual patient enhances decision-making and communication between the multidisciplinary team and the patient, while decreases time and costs.
CONCLUSIONS: Bidimensional diagnosis and freehand implant placement have limitations and outcomes often rely on professionals\' expertise. Performing facially driven virtual planning improves treatment predictability. This approach promotes function, esthetic harmony, and patient satisfaction. Implant guided surgery and 3D printed prostheses constitute a reproducible digital workflow that can be implemented into clinical practice to optimize dental care.
摘要:
目的:本报告的目的是介绍3D虚拟患者的完整工作流程,以使用磁性保留的3D打印可堆叠导轨来计划和执行植入手术。
方法:提出了一种基于骨骼的3D打印可堆叠系统,牙科,和面部参考。最初,一名66岁的男性患者通过照片进行了数字化处理,锥形束计算机断层扫描,和口腔内扫描(VirtuoVivo,Straumann)。将所有文件合并,以在计划软件(coDiagnostiX,Straumann)。设计了顺序可堆叠导轨,已打印,并治愈。磁铁被插入连接器,临时假体接受了颜色表征。为销钉固定的特定目的生产了四个安装导轨,骨减少,植入物放置,并立即提供。经过手术和愈合期,更新患者数字数据.将最终的植入物位置与计划值进行比较,并且不一致是临床上可接受的。平均角度偏差为5.4°(3.2-7.3),入口点的平均3D差异为0.90mm(0.46-1.12),植入物顶点的平均3D差异为1.68mm(1.00-2.20)。病例随访显示稳定性,病人的安慰,没有插手。
结论:磁性保留的可堆叠导向器提供治疗准确性,并减少手术和假体并发症。投射的虚拟患者增强了多学科团队与患者之间的决策和沟通,同时减少时间和成本。
结论:二维诊断和徒手植入有局限性,结果往往依赖于专业人员的专业知识。执行面部驱动的虚拟计划可提高治疗的可预测性。这种方法促进了功能,审美和谐,患者满意度。植入物引导手术和3D打印假体构成了一个可重复的数字工作流程,可以实施到临床实践中以优化牙科护理。
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