This technique describes a novel approach for planning and augmenting a large bony defect using a... more This technique describes a novel approach for planning and augmenting a large bony defect using a titanium mesh (TiMe). A 3-dimensional (3D) surgical model was virtually created from a cone beam computed tomography (CBCT) and wax-pattern of the final prosthetic outcome. The required bone volume (horizontally and vertically) was digitally augmented and then 3D printed to create a bone model. The 3D model was then used to contour the TiMe in accordance with the digital augmentation. With the contoured / preformed TiMe on the 3D printed model a positioning jig was made to aid the placement of the TiMe as planned during surgery. Although this technique does not impact the final outcome of the augmentation procedure, it allows the clinician to virtually design the augmentation, preform and contour the TiMe, and create a positioning jig reducing surgical time and error.
Abstract AbstractThe objective of this ex vivo cadaver study was to determine the accuracy of con... more Abstract AbstractThe objective of this ex vivo cadaver study was to determine the accuracy of cone beam computed tomography(CBCT) and 3D stereolithographic(STL) model in identifying and measuring the anterior loop length(ANLL) of the mental nerve. A total of 12 cadavers (24 mental nerve plexus) were used for this study. Standardized CBCT scans of each mandible were obtained both with and without radiographic contrast tracer injected into the mental nerve plexus. STL models of the two acquired CBCT images were made. ANLL were measured using CBCT, STL and anatomy. The measurements obtained from the CBCT images and STL models were then analyzed and compared with the direct anatomic measurements. Paired sample t-test was used. P values less than .05 was considered statistically significant. The mean difference between CBCT and anatomic measurement was 0.04mm and not statistically significant (p= .332) while the mean difference between STL and anatomic measurement was 0.4mm and statistically significant (p=.042). There was also a statistical significant difference between CBCT and STL (p=.048) with the mean difference of 0.35mm. Therefore, CBCT is an accurate and reliable method in determining and measuring the ANLL while the STL over or underestimated the ANLL by as much as 1.51mm and 1.83mm respectively.
Angulated screw channel system abutments (ASCs) have recently been introduced to address the prob... more Angulated screw channel system abutments (ASCs) have recently been introduced to address the problem with visible screw access that may compromise esthetics. ASCs allow the screw access to be modified up to 25 degrees relative to the implant axis. However, a widened channel, which may cause thinning of the facial ceramic, is needed at the implant screw head to allow for proper engagement of the screwdriver. This technical report introduces a custom titanium insert design, the Satoshi Sakamoto (SS) abutment. The SS abutment consists of a custom titanium metal insert and zirconia coping in which the access hole is located in an esthetic position with an ASC system. The SS abutment results in a crown with more normal crown dimensions that also provides more space for the soft tissues. This SS abutment design allows clinicians to obtain screw-retained restorations with optimal esthetics and mechanical strength.
This technique describes a novel approach for planning and augmenting a large bony defect using a... more This technique describes a novel approach for planning and augmenting a large bony defect using a titanium mesh (TiMe). A 3-dimensional (3D) surgical model was virtually created from a cone beam computed tomography (CBCT) and wax-pattern of the final prosthetic outcome. The required bone volume (horizontally and vertically) was digitally augmented and then 3D printed to create a bone model. The 3D model was then used to contour the TiMe in accordance with the digital augmentation. With the contoured / preformed TiMe on the 3D printed model a positioning jig was made to aid the placement of the TiMe as planned during surgery. Although this technique does not impact the final outcome of the augmentation procedure, it allows the clinician to virtually design the augmentation, preform and contour the TiMe, and create a positioning jig reducing surgical time and error.
Lateral approach sinus grafting has become a routine and predictable surgical method of augmentin... more Lateral approach sinus grafting has become a routine and predictable surgical method of augmenting the pneumatized sinus for implant placement. Outlining the lateral window access can be a challenging task for the clinician to envision and execute. Improper extension and access to the maxillary sinus can prevent proper placement of graft materials and lead to complications. The purpose of this report was to demonstrate a technique that will allow the precise planning of the lateral approach using radiographic information and 3-dimensional (3D) software to 3D-print a surgical guide.
The objective of this ex vivo cadaver study was to determine the accuracy of cone beam computeriz... more The objective of this ex vivo cadaver study was to determine the accuracy of cone beam computerized tomography (CBCT) and a 3-dimensional stereolithographic (STL) model in identifying and measuring the anterior loop length (ANLL) of the mental nerve. A total of 12 cadavers (24 mental nerve plexus) were used for this study. Standardized CBCT scans of each mandible were obtained both with and without radiographic contrast tracer injected into the mental nerve plexus, and STL models of the two acquired CBCT images were made. The ANLL were measured using CBCT, STL model, and anatomy. The measurements obtained from the CBCT images and STL models were then analyzed and compared with the direct anatomic measurements. A paired sample t test was used, and P values less than .05 were considered statistically significant. The mean difference between CBCT and anatomic measurement was 0.04 mm and was not statistically significant (P = .332), whereas the mean difference between STL models and ana...
Abstract The purpose of this study is to use cone-beam computerized tomography (CBCT) scans with ... more Abstract The purpose of this study is to use cone-beam computerized tomography (CBCT) scans with oblique-transverse reconstruction modality to measure and compare the anterior loop length (AnLL) of the mental nerve between gender & age groups and to compare the difference between the right and left sides. 61 female and 61 male CBCT scans were randomly selected for each age group, age 21-40, 41-60, and 61-80. Both right and left side AnLLs were measured in each subject using i-CATVision™ software to measure AnLLs on the oblique transverse plane using multi-planar reconstruction. The anterior loop was identified in 85.2% of cases with the mean AnLL of the 366 subjects (732 hemimandibles) being 1.46 ± 1.25mm with no statistically significant difference between right and left sides or different gender groups. However, the mean AnLL in 21-40 group (1.89 ± 1.35mm) was larger than the AnLL in 41-60 group (1.35 ± 1.19mm) and 61-80 group.(1.13 ± 1.08mm) In conclusion, when placing implants in close proximity to mental foramina, caution is recommended to avoid injury to the inferior alveolar nerve. No fixed distance anteriorly from the mental foramen should be considered safe. Using CBCT scans with the oblique-transverse method to accurately identify and measure the anterior loop length is of utmost importance in avoiding and protecting its integrity.
ABSTRACT Abstract Replacement of a tooth at in infected site in a high esthetic demanding area is... more ABSTRACT Abstract Replacement of a tooth at in infected site in a high esthetic demanding area is complex and complicated procedure. When adequately planned, an implant and its restoration should be able to maintain the esthetic, biologic, biomechanical, and functional requirements of the site. Meticulous soft and hard tissue evaluation is a prerequisite for the treatment selection. This report represents a detailed descriptive procedure of an immediate implant placement and provisionalization of a maxillary lateral incisor with a chronic buccal infection and a defective buccal plate utilizing a novel approach in harvesting autogenous bone from the mandibular symphysis area with a single vertical incision.
Abstract AbstractThe objective of this ex vivo cadaver study was to determine the accuracy of con... more Abstract AbstractThe objective of this ex vivo cadaver study was to determine the accuracy of cone beam computed tomography(CBCT) and 3D stereolithographic(STL) model in identifying and measuring the anterior loop length(ANLL) of the mental nerve. A total of 12 cadavers (24 mental nerve plexus) were used for this study. Standardized CBCT scans of each mandible were obtained both with and without radiographic contrast tracer injected into the mental nerve plexus. STL models of the two acquired CBCT images were made. ANLL were measured using CBCT, STL and anatomy. The measurements obtained from the CBCT images and STL models were then analyzed and compared with the direct anatomic measurements. Paired sample t-test was used. P values less than .05 was considered statistically significant. The mean difference between CBCT and anatomic measurement was 0.04mm and not statistically significant (p= .332) while the mean difference between STL and anatomic measurement was 0.4mm and statistically significant (p=.042). There was also a statistical significant difference between CBCT and STL (p=.048) with the mean difference of 0.35mm. Therefore, CBCT is an accurate and reliable method in determining and measuring the ANLL while the STL over or underestimated the ANLL by as much as 1.51mm and 1.83mm respectively.
This technique describes a novel approach for planning and augmenting a large bony defect using a... more This technique describes a novel approach for planning and augmenting a large bony defect using a titanium mesh (TiMe). A 3-dimensional (3D) surgical model was virtually created from a cone beam computed tomography (CBCT) and wax-pattern of the final prosthetic outcome. The required bone volume (horizontally and vertically) was digitally augmented and then 3D printed to create a bone model. The 3D model was then used to contour the TiMe in accordance with the digital augmentation. With the contoured / preformed TiMe on the 3D printed model a positioning jig was made to aid the placement of the TiMe as planned during surgery. Although this technique does not impact the final outcome of the augmentation procedure, it allows the clinician to virtually design the augmentation, preform and contour the TiMe, and create a positioning jig reducing surgical time and error.
Abstract AbstractThe objective of this ex vivo cadaver study was to determine the accuracy of con... more Abstract AbstractThe objective of this ex vivo cadaver study was to determine the accuracy of cone beam computed tomography(CBCT) and 3D stereolithographic(STL) model in identifying and measuring the anterior loop length(ANLL) of the mental nerve. A total of 12 cadavers (24 mental nerve plexus) were used for this study. Standardized CBCT scans of each mandible were obtained both with and without radiographic contrast tracer injected into the mental nerve plexus. STL models of the two acquired CBCT images were made. ANLL were measured using CBCT, STL and anatomy. The measurements obtained from the CBCT images and STL models were then analyzed and compared with the direct anatomic measurements. Paired sample t-test was used. P values less than .05 was considered statistically significant. The mean difference between CBCT and anatomic measurement was 0.04mm and not statistically significant (p= .332) while the mean difference between STL and anatomic measurement was 0.4mm and statistically significant (p=.042). There was also a statistical significant difference between CBCT and STL (p=.048) with the mean difference of 0.35mm. Therefore, CBCT is an accurate and reliable method in determining and measuring the ANLL while the STL over or underestimated the ANLL by as much as 1.51mm and 1.83mm respectively.
Angulated screw channel system abutments (ASCs) have recently been introduced to address the prob... more Angulated screw channel system abutments (ASCs) have recently been introduced to address the problem with visible screw access that may compromise esthetics. ASCs allow the screw access to be modified up to 25 degrees relative to the implant axis. However, a widened channel, which may cause thinning of the facial ceramic, is needed at the implant screw head to allow for proper engagement of the screwdriver. This technical report introduces a custom titanium insert design, the Satoshi Sakamoto (SS) abutment. The SS abutment consists of a custom titanium metal insert and zirconia coping in which the access hole is located in an esthetic position with an ASC system. The SS abutment results in a crown with more normal crown dimensions that also provides more space for the soft tissues. This SS abutment design allows clinicians to obtain screw-retained restorations with optimal esthetics and mechanical strength.
This technique describes a novel approach for planning and augmenting a large bony defect using a... more This technique describes a novel approach for planning and augmenting a large bony defect using a titanium mesh (TiMe). A 3-dimensional (3D) surgical model was virtually created from a cone beam computed tomography (CBCT) and wax-pattern of the final prosthetic outcome. The required bone volume (horizontally and vertically) was digitally augmented and then 3D printed to create a bone model. The 3D model was then used to contour the TiMe in accordance with the digital augmentation. With the contoured / preformed TiMe on the 3D printed model a positioning jig was made to aid the placement of the TiMe as planned during surgery. Although this technique does not impact the final outcome of the augmentation procedure, it allows the clinician to virtually design the augmentation, preform and contour the TiMe, and create a positioning jig reducing surgical time and error.
Lateral approach sinus grafting has become a routine and predictable surgical method of augmentin... more Lateral approach sinus grafting has become a routine and predictable surgical method of augmenting the pneumatized sinus for implant placement. Outlining the lateral window access can be a challenging task for the clinician to envision and execute. Improper extension and access to the maxillary sinus can prevent proper placement of graft materials and lead to complications. The purpose of this report was to demonstrate a technique that will allow the precise planning of the lateral approach using radiographic information and 3-dimensional (3D) software to 3D-print a surgical guide.
The objective of this ex vivo cadaver study was to determine the accuracy of cone beam computeriz... more The objective of this ex vivo cadaver study was to determine the accuracy of cone beam computerized tomography (CBCT) and a 3-dimensional stereolithographic (STL) model in identifying and measuring the anterior loop length (ANLL) of the mental nerve. A total of 12 cadavers (24 mental nerve plexus) were used for this study. Standardized CBCT scans of each mandible were obtained both with and without radiographic contrast tracer injected into the mental nerve plexus, and STL models of the two acquired CBCT images were made. The ANLL were measured using CBCT, STL model, and anatomy. The measurements obtained from the CBCT images and STL models were then analyzed and compared with the direct anatomic measurements. A paired sample t test was used, and P values less than .05 were considered statistically significant. The mean difference between CBCT and anatomic measurement was 0.04 mm and was not statistically significant (P = .332), whereas the mean difference between STL models and ana...
Abstract The purpose of this study is to use cone-beam computerized tomography (CBCT) scans with ... more Abstract The purpose of this study is to use cone-beam computerized tomography (CBCT) scans with oblique-transverse reconstruction modality to measure and compare the anterior loop length (AnLL) of the mental nerve between gender & age groups and to compare the difference between the right and left sides. 61 female and 61 male CBCT scans were randomly selected for each age group, age 21-40, 41-60, and 61-80. Both right and left side AnLLs were measured in each subject using i-CATVision™ software to measure AnLLs on the oblique transverse plane using multi-planar reconstruction. The anterior loop was identified in 85.2% of cases with the mean AnLL of the 366 subjects (732 hemimandibles) being 1.46 ± 1.25mm with no statistically significant difference between right and left sides or different gender groups. However, the mean AnLL in 21-40 group (1.89 ± 1.35mm) was larger than the AnLL in 41-60 group (1.35 ± 1.19mm) and 61-80 group.(1.13 ± 1.08mm) In conclusion, when placing implants in close proximity to mental foramina, caution is recommended to avoid injury to the inferior alveolar nerve. No fixed distance anteriorly from the mental foramen should be considered safe. Using CBCT scans with the oblique-transverse method to accurately identify and measure the anterior loop length is of utmost importance in avoiding and protecting its integrity.
ABSTRACT Abstract Replacement of a tooth at in infected site in a high esthetic demanding area is... more ABSTRACT Abstract Replacement of a tooth at in infected site in a high esthetic demanding area is complex and complicated procedure. When adequately planned, an implant and its restoration should be able to maintain the esthetic, biologic, biomechanical, and functional requirements of the site. Meticulous soft and hard tissue evaluation is a prerequisite for the treatment selection. This report represents a detailed descriptive procedure of an immediate implant placement and provisionalization of a maxillary lateral incisor with a chronic buccal infection and a defective buccal plate utilizing a novel approach in harvesting autogenous bone from the mandibular symphysis area with a single vertical incision.
Abstract AbstractThe objective of this ex vivo cadaver study was to determine the accuracy of con... more Abstract AbstractThe objective of this ex vivo cadaver study was to determine the accuracy of cone beam computed tomography(CBCT) and 3D stereolithographic(STL) model in identifying and measuring the anterior loop length(ANLL) of the mental nerve. A total of 12 cadavers (24 mental nerve plexus) were used for this study. Standardized CBCT scans of each mandible were obtained both with and without radiographic contrast tracer injected into the mental nerve plexus. STL models of the two acquired CBCT images were made. ANLL were measured using CBCT, STL and anatomy. The measurements obtained from the CBCT images and STL models were then analyzed and compared with the direct anatomic measurements. Paired sample t-test was used. P values less than .05 was considered statistically significant. The mean difference between CBCT and anatomic measurement was 0.04mm and not statistically significant (p= .332) while the mean difference between STL and anatomic measurement was 0.4mm and statistically significant (p=.042). There was also a statistical significant difference between CBCT and STL (p=.048) with the mean difference of 0.35mm. Therefore, CBCT is an accurate and reliable method in determining and measuring the ANLL while the STL over or underestimated the ANLL by as much as 1.51mm and 1.83mm respectively.
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