Volume 03 Issue 03-2023
8
International Journal of Advance Scientific Research
(ISSN
–
2750-1396)
VOLUME
03
I
SSUE
03
Pages:
08-15
SJIF
I
MPACT
FACTOR
(2021:
5.478
)
(2022:
5.636
)
(2023:
6.741
)
OCLC
–
1368736135
A
BSTRACT
On the study research was aimed to increase the treatment outcome and reduce the number of
complications of dental implant surgery based on using navigating system that is error free and gives high
prognosis of getting primary stability of an implant. The prospective study involved 12 patients aged 30 to
65 years. The patients were treated as outpatients at the Department of Oral surgery and dental
implantology of the Tashkent state dental institute. Dental implant navigation system is worthy of
recommendation. In accordance with the developed criteria for evaluating the effectiveness, it was found
that the statically computer-assisted approach improves the accuracy of implant placement.
K
EYWORDS
Surgical guide, R2GATE system, primary stability, 3D templates.
I
NTRODUCTION
Journal
Website:
http://sciencebring.co
m/index.php/ijasr
Copyright:
Original
content from this work
may be used under the
terms of the creative
commons
attributes
4.0 licence.
Research Article
PRIMARY STABILIZATION OF DENTAL IMPLANTS
ACCORDING TO BONE STRUCTURE
Submission Date:
March 13, 2023,
Accepted Date:
March 18, 2023,
Published Date:
March 23, 2023
Crossref doi:
https://doi.org/10.37547/ijasr-03-03-02
Sofiya Ravshanbekovna Mamarasulova
Postgraduate Student, Master’s Degree At
The Department Of Oral Surgery And Dental Implantology At The
Tashkent State Dental Institute, Tashkent, Uzbekistan
Gulmirakhon Ravshanbek Qizi Iminjonova
Assistant At The Department Of Therapeutic Dentistry At The Andijan State Medical Institute, Andijan,
Uzbekistan
Volume 03 Issue 03-2023
9
International Journal of Advance Scientific Research
(ISSN
–
2750-1396)
VOLUME
03
I
SSUE
03
Pages:
08-15
SJIF
I
MPACT
FACTOR
(2021:
5.478
)
(2022:
5.636
)
(2023:
6.741
)
OCLC
–
1368736135
Today’s is one of the most dynamic
sections of
dentistry dealing with the treatment of
edentulous of various origins is dental implant
surgery. Since the fundamental discoveries at the
institutes of Lund and Gothenburg, clinicians and
scientists have been continuously working to find
the optimal size, micro and macrostructure, the
optimal number of implants to be installed,
surgical protocols, the timing of implantation
with subsequent prosthetics. The indications for
the use of dental implants have expanded. [8]
To increase the treatment outcome and reduce
the number of complications, many approaches
based on different principles and varying degrees
of complexity have been proposed.
Data collection, planning, implementation of high-
precision interventions using Navigating systems
are currently the leading directions in dentistry
[1].
It is known that the prognosis of the result of a
dental implant operation directly depends on
many factors, such as the location of the implant
relative to adjacent teeth, other implants,
anatomical structures (mandibular canal,
maxillary sinus), characteristics of bone tissue in
the area of the implant [2]. Under favorable
conditions, the intervention does not cause any
special problems for the doctor and risks for the
patient. However, in those clinical situations
where the operating conditions are unfavorable,
there are extended defects in the dentition, or
complete adentia of the jaw, the risk of
complications increases [3].
The manufacture of an orthopedic structure and
the rehabilitation of the patient is the main goal of
the intervention, it requires high accuracy in the
installation of implants. For this, classical surgical
templates are traditionally used, which are an
orthopedic guideline for implantation, indicating
only the axial direction preferred by the
orthopedist for installing a future crown or
support for various kinds of structures. [1,6]
The main disadvantages of the classic guides is
that its manufacture does not take into account
the topography of the bone base (the physical
parameters of the alveolar process, its angular
direction, the presence of anatomical formations).
This means that the doctor intraoperatively
changes the parameters set by the template,
which leads to complexity at the stage of
prosthetics and increases the risk of
complications in the long-term period, up to the
loss of the implant and adjacent bone[4,6].
It is known that the use of navigation systems and
positioner templates to increase the accuracy of
intraosseous implantation is not a new
development. Specialists used this method
earlier, using software, computing and technical
means available at that time [9,11]
At the moment, the potential of the total volume
of the above-mentioned tools allows you to
perform calculations and produce positioner
templates with high accuracy. Some major
manufacturers of endosseous implant systems
use the principle of automated design systems in
data collection, calculations and production of
surgical templates. However, the software is not
Volume 03 Issue 03-2023
10
International Journal of Advance Scientific Research
(ISSN
–
2750-1396)
VOLUME
03
I
SSUE
03
Pages:
08-15
SJIF
I
MPACT
FACTOR
(2021:
5.478
)
(2022:
5.636
)
(2023:
6.741
)
OCLC
–
1368736135
open to add-ons, and the systems are designed to
be used only with the manufacturer's implants, or
updates to the database of physical virtual models
are carried out by the software manufacturer,
which limits the practitioner's choice and
preferences. In addition, the programs have a
weak diagnostic potential, as well as limited
computational and functional capabilities [5,6]
M
ATERIALS AND METHODS
The prospective study involved 12 patients aged
30 to 65 years. The patients were treated as
outpatients at the Department of Oral surgery and
dental implantology of the Tashkent state dental
institute. Of these, 6 patients in whom treatment
planning and surgery for the installation of
osseointegrated implants were carried out using
the traditional free-hand method constituted the
control group. 6 patients made up the main group,
where statically virtually assisted surgery was
used to plan and perform the operation (Fig. 1).
6
6
Main group
Control group
Age
quantity
Chart Title
female
male
Volume 03 Issue 03-2023
11
International Journal of Advance Scientific Research
(ISSN
–
2750-1396)
VOLUME
03
I
SSUE
03
Pages:
08-15
SJIF
I
MPACT
FACTOR
(2021:
5.478
)
(2022:
5.636
)
(2023:
6.741
)
OCLC
–
1368736135
Fig.1. Distribution of patients by groups
The study included somatically healthy patients
or those with a compensated somatic status, with
a diagnosis of primary or secondary, partial or
complete adentia of the upper or lower jaw, who
were shown orthopedic rehabilitation with the
support of the structure on osseointegrable
implants.
The
exclusion
criteria
were
contraindications to dental implantation.
At the stage of patient selection, a set of diagnostic
measures was carried out to determine the
presence of indications and contraindications for
dental implantation.
A general clinical examination was carried out,
the examination of patients began with a survey:
identified complaints, timing and causes of tooth
loss, anamnesis of life, as well as the presence of
somatic pathology. The external examination
included visual assessment of the face, palpation
of regional lymph nodes and soft tissues of the
face. In the oral cavity, the teeth, mucosa were
examined membranes of the oral cavity, gums,
alveolar processes and palate, were evaluated the
state of oral hygiene, determined the form of bite,
localization dentition defects. After clinical and
instrumental
examination
patients
were
recommended treatment plans that included
dental implantation. In order to plan implant
treatment within the framework of the presented
research, all patients underwent cone-beam
computed tomography with a scanning field
10*8.5 cm on Pax i3D-Smart device (Vatech,
South Korea). The image capture area included
the mandible and maxilla, as well as the alveolar
bays of the maxillary sinuses. Tomographic data
were obtained in the form DICOM files on CDs,
flash drives or email, which were subsequently
Total amount of patients
Male
Female
0
2
4
6
8
10
12
Age
30
45
50
Chart Title
Total amount of patients
Male
Female
Volume 03 Issue 03-2023
12
International Journal of Advance Scientific Research
(ISSN
–
2750-1396)
VOLUME
03
I
SSUE
03
Pages:
08-15
SJIF
I
MPACT
FACTOR
(2021:
5.478
)
(2022:
5.636
)
(2023:
6.741
)
OCLC
–
1368736135
processed in a specialized program Ez3D Plus.
When performing computed tomography, this
device simultaneously automatically reproduced
panoramic zonograms of the jaws (OPTG), which
were analyzed in comparison with CBCT to
evaluate the effectiveness of the latter. It is
important to note that obtaining two x-rays at
once studies in a single scan has significantly
optimized radiation exposure to the patient.
On cone-beam computed tomography, the state of
the dentoalveolar system and maxillary sinuses
was assessed in the axial, coronary and sagittal
planes in multiplanar mode, as well as on
panoramic reformats.
Standard laboratory diagnostics before dental
implantation was carried out in the Department
of Oral surgery and dental implantology of the
Tashkent state dental institute: general and
biochemical blood tests, markers of hepatitis A, B
and C, syphilis, HIV. All patients signed a
voluntary informed consent protocol drawn up in
accordance with the Helsinki Declaration of the
World Medical Association.
Among patients in the control group, there were
6 women and 6 men. The main group consisted of
6 men and 6 women. The distribution of patients
by sex and age is presented in Table.
Table 1.
Distribution of patients by sex and age in the control group
Age
30
45
50
Male
2
2
2
Female
2
2
2
R
ESULTS AND DISCUSSIONS
The findings of 5 tests obtained using the implant
navigation system (Table 1) In total, 10 implant
positions were matched to preoperative planning
in vitro. In the 5 tests, we observed that increasing
the frequency of use of the system shortened the
operating time. The total, longitudinal, and
angular errors obtained according to the
deviation definition in the 5 tests are listed in
Table 2.
Volume 03 Issue 03-2023
13
International Journal of Advance Scientific Research
(ISSN
–
2750-1396)
VOLUME
03
I
SSUE
03
Pages:
08-15
SJIF
I
MPACT
FACTOR
(2021:
5.478
)
(2022:
5.636
)
(2023:
6.741
)
OCLC
–
1368736135
The average deviation of total, longitudinal, and
angular errors of boreholes created using the
R2GATE system were respectively 1.36 ±0.56
mm,1.66 ± 0.99 mm, and 3.68 ±1.28 in the first
test; 1.26 ±0.45 mm, 1.14 ±0.53 mm, and3.05
±1.08±in the third test; and 1.33 ±0.41 mm,0.84
±0.75 mm, and 2.77 ±1.05±in the fourth test. By
the fifth test, the average deviation provided
information on the implantation accuracy; these
corresponding values in the fifth test were 1.29
±0.55 mm, 0.77 ±0.63 mm, and2.67 ±1.26±. In
addition, the result of the comparison among the
5 tests revealed that the longitudinal and angular
errors, but not the total error, differed
signifificantly among the 5 tests (P <0.0001 for
the longitudinal error and PZ0.0164 for the
angular error). The one way R2GATE and Tukeye
Kramer HSD tests also revealed that the
longitudinal and angular errors differed
significantly among the 5 tests. The deviation of
the total, longitudinal, and angular errors in the
maxilla and mandible (Table 2) , longitudinal, and
angular errors were respectively 1.33 ±0.43 mm,
0.87 ±0.68 mm, and 3.18 ±1.21±in the maxilla and
1.21 ±0.56 mm,1.29 ±0.88 mm, and 2.92 ±1.28±in
the mandible. The same level of accuracy could
be obtained between the maxilla and mandible by
using the R2GATE dental navigation system.
C
ONCLUSION
Analysis and comparison of resource costs in the
manufacture of surgical templates in the study
groups revealed that the use of the proposed
method is much more effective for obtaining
primary stabilization and future orthopedic
design due to advance virtual planning. The
R2GATE dental implant navigation system is
Volume 03 Issue 03-2023
14
International Journal of Advance Scientific Research
(ISSN
–
2750-1396)
VOLUME
03
I
SSUE
03
Pages:
08-15
SJIF
I
MPACT
FACTOR
(2021:
5.478
)
(2022:
5.636
)
(2023:
6.741
)
OCLC
–
1368736135
worthy of recommendation. In accordance with
the developed criteria for evaluating the
effectiveness, it was found that the statically
computer-assisted approach improves the
accuracy of implant placement, but requires more
time to manufacture the positioner template.
R
EFERENCES
1.
Ortin T, Champleboux G, Bianchi S, Buatois
H, Coudert JL. Precision of transfer of
preoperative planning for oral implants
based on cone-beam CT- scan images
through a robotic drilling machine. //Clin
Oral Implants Res.- 2002, -
№13(6)
-P.651-
656.
2.
Fortin T, Champleboux G, Lormée J,
Coudert JL. Precise dental implant
placement in bone using surgical guides in
conjunction
with
medical
imaging
techniques. //J. Oral Implantol.-2000,-
№26(4)
-P.300-303.
3.
Fortin T, Isidori M, Bouchet H. Placement
of posterior maxillary implants in partially
edentulous patients with severe bone
deficiency using CAD/CAM guidance to
avoid sinus grafting: a clinical report of
procedure. //Int J Oral Maxillofac
Implants. -2009,-
№24(1)
-P.96-102.
4.
Francesco A. Valente, B. Andrea Sbrenna,
C. Claudio Buoni, CAD CAM drilling guides
for transferring CT-based digital planning
to flapless placement of oral implants in
complex cases, Computer-Assist. //Radiol.
Surg. 1. -2006,- P.-413-415.
5.
Ganz, S.D., Presurgical planning with CT-
derived fabrication of surgical guides.//J.
Oral Maxillofac. Surg.-
№63 i
Suppl. l.-P.59-
71.
6.
Gwen R.J. Swennen , Filip A.C. Schutyser
Jarg-Erich Hausamen Three- Dimensional
Cephalometry: A Color Atlas and Manual
Springer-Verlag Berlin Heidelberg -2006,-
p.7
7.
H.V. Oosterwyck, J.V. Sloten, J. Duyck, J.V.
Cleynenbreugel, B. Puers, I. Naert,
Computer-aided, pre-surgical analysis for
oral rehabilitation, in: A.N. Natali (Ed.).//
Dental Biomechanics, Taylor & Francis, -
2003,- p. 52-68.
8.
Hoffmann J, Westendorff C, Gomez-Roman
G, Reinert S. Accuracy of navigation-
guided socket drilling before implant
installation compared to the conventional
free-hand method in a synthetic
edentulous lower jaw model.// Clin Oral
Implants Res. -2005,-
№16(5)
-P.609-614
9.
Holst S, Blatz MB, Eitner S. Precision for
computer-guided implant placement:
using 3D planning software and fixed
intraoral reference points. //J Oral
Maxillofac Surg - 2007, -
№65,
- p.393-399
10.
Hounsfield G.N. Computed Medical
Imaging// Nobel Lectures in Physiology or
Medicine 1971
—
1980.
—
World Scientific
Publishing Co.,- 1992.
—
p. 568
—
586
11.
Huh YJ, Choi BR, Huh KH, Yi WJ, Heo MS,
Lee SS, Choi SCHn-vitro study on the
accuracy of a simple-design CT-guided
stent for dental implants.// J.Imaging Sei
Dent. -2012, -
№42(3)
-P. 139-46
Volume 03 Issue 03-2023
15
International Journal of Advance Scientific Research
(ISSN
–
2750-1396)
VOLUME
03
I
SSUE
03
Pages:
08-15
SJIF
I
MPACT
FACTOR
(2021:
5.478
)
(2022:
5.636
)
(2023:
6.741
)
OCLC
–
1368736135
12.
J.C.Davenport, R.M. Basker, J.R.Heath, J.P.
Ralph,P-0 Glantz. Need and demand for
treatment.// BRITISH DENTAL JOURNAL.-
2005,- VOL. 189.-
№7,
-p.364-368.
13.
Jabero, M. and Sarment, D.P., Advanced
surgical guidance technology: A review.
//Implant Dent. -Vol.15 i2.-P. 135-142.
14.
Johansson B, Friberg B, Nilson H. Digitally
planned, immediately loaded dental
implants with prefabricated prostheses in
the reconstruction of edentulous maxillae:
a 1-year prospective, multicenter study. //
Clin Implant Dent Relat Res.- 2009 -
№11(3)
-P. 194-200.
15.
Jung R.E., Schneider D., Ganeles J.,
Wismeijer D., Zwahlen M., Hammerle C.H.,
Tahmaseb A. Computer technology
application in surgical implant dentistry: a
systematic review // Int J Oral Maxillofac
Implants
—
2009
—№24
-P.92-109.
