• The Journal of Korean Academy of Prosthodontics
• /
• v.59 no.4
• /
• pp.478-486
• /
• 2021

This report demonstrates a method of generating a chair-side and computer-aided template for implant surgery based on the Top-Down and restoration-driven concept. Compared to the traditional CAD-CAM process which requires multiple steps to be taken between dental clinic and laboratory, this alternative procedure, VARO guide system (VARO Guide, CAD, Pre-Guide, VARO-mill, NeoBiotech, Seoul, South Korea) enables accurate and patient-friendly implant surgery as well as immediate provisional restoration in a single visit. First, bite-registration at centric jaw relation and CBCT were taken using the Pre-Guide. The CBCT data was then reorganized directly through the chair-side CAD, and we could determine the most appropriate 3-dimensional position of implant. The STL file was extracted and put into the chair-side CAM (VARO-mill) to fabricate a VARO. This surgical guide allowed the implants to be accurately positioned into the planned sites within an hour.

• The Journal of Korean Academy of Prosthodontics
• /
• v.56 no.1
• /
• pp.8-16
• /
• 2018

Purpose: The purpose of this study is to evaluate the accuracy of surgical stent according to the supported type. Materials and methods: 5 sets of dental models which have tooth supported edentulous area and tooth-tissue supported edentulous area were made. Dental model were scanned with model scanner, and CBCT was taken. CT data and model scan data were overlapped using In2Guide software, implant were virtually planned in the software. Surgical stents are fabricated by 3D printing. The implant fixture were installed using the surgical stent, CBCT were retaken. CBCT before surgery and after surgery were overlapped, and the differences (angle difference, coronal difference, apical difference) were evaluated using statistical analysis. Results: In the assessment of the accuracy of surgical guides according to arch type, there are no statistically significant differences between maxilla and mandible. In the case of support type, tooth supported stents showed lower angle difference and length difference than tooth-tissue supported stents, which are statistically significant. Conclusion: Arch type does not affect the accuracy of surgical stents. But tooth support stents are more accurate than tooth-tissue support stents in the case of angle and length difference.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.37 no.3
• /
• pp.147-156
• /
• 2021

There are various treatment options such as conventional complete denture, hybrid prosthesis and implant-supported fixed prosthesis for fully edentulous patients. In case of implant-supported fixed prosthesis, compared to removable prosthesis, it is difficult to place the implant in the correct position considering the anatomical contours of the final prosthesis. In this case, a full mouth rehabilitation with implant-supported fixed prosthesis was performed for a patient who required extraction of all remaining teeth due to dental caries and chronic periodontitis. In the implant placement stage, the implant was placed in the desired position using a surgical guide fabricated considering the anatomical contours of the final prosthesis, and the function and esthetics were evaluated through correction and re-fabrication of the fixed provisional restoration. A final restoration of porcelain fused to gold prosthesis was delivered to the patient based on the provisional restoration. To cope with complications such as loosening of screws and fracture of porcelain, a screw-retained type prosthesis was fabricated for the posterior part and a screw-cement-retained type prosthesis for the anterior part. As a result, the patient showed an improved prognosis in terms of functional and esthetics after the final prosthesis was delivered.

• The Journal of Korean Academy of Prosthodontics
• /
• v.59 no.1
• /
• pp.97-106
• /
• 2021

Dental implants should be placed at ideal sites for implant-supported restorations. For a patient with insufficient residual ridge, mouth preparation including surgical intervention can be indicated to establish a soft and hard tissue environment favorable for a definitive prosthesis. Prosthodontic design based on computer-guided surgery and computer-aided design-computer-aided manufacturing (CAD-CAM) provides a visual blueprint allowing a clinician to assess the necessity of such a surgical intervention beforehand. In this case, a definitive restoration was planned and made via a CAD-CAM system according to the patient's oral status before treatment, simulated surgical interventions and serial provisional restorations. Based on the planning, a guided template was made and the implants were installed with bone augmentation using the template. Customized abutments, the first and the second provisional restorations were designed and fabricated by CAD-CAM. The definitive restorations were digitally made following the shape of the second provisional prostheses, which were confirmed in the patient's mouth. The patient was satisfied with the masticatory, phonetic and aesthetic functions of these definitive prostheses.

• The Journal of Korean Academy of Prosthodontics
• /
• v.48 no.4
• /
• pp.294-300
• /
• 2010

Purpose: The template-guided implant surgery offers several advantages over the traditional approach. The purpose of this study was to evaluate the accuracy of coordinate synchronization procedure with 5-axis milling machine for surgical template fabrication by means of reverse engineering through universal CAD software. Materials and methods: The study was performed on ten edentulous models with imbedded gutta percha stoppings which were hidden under silicon gingival form. The platform for synchordination was formed on the bottom side of models and these casts were imaged in Cone beam CT. Vectors of stoppings were extracted and transferred to those of planned implant on virtual planning software. Depth of milling process was set to the level of one half of stoppings and the coordinate of the data was synchronized to the model image. Synchronization of milling coordinate was done by the conversion process for the platform for the synchordination located on the bottom of the model. The models were fixed on the synchordination plate of 5-axis milling machine and drilling was done as the planned vector and depth based on the synchronized data with twist drill of the same diameter as GP stopping. For the 3D rendering and image merging, the impression tray was set on the conbeam CT and pre- and post- CT acquiring was done with the model fixed on the impression body. The accuracy analysis was done with Solidworks (Dassault systems, Concord, USA) by measuring vector of stopping’s top and bottom centers of experimental model through merging and reverse engineering the planned and post-drilling CT image. Correlations among the parameters were tested by means of Pearson correlation coefficient and calculated with SPSS (release 14.0, SPSS Inc. Chicago, USA) ($\alpha$ = 0.05). Results: Due to the declination, GP remnant on upper half of stoppings was observed for every drilled bores. The deviation between planned image and drilled bore that was reverse engineered was 0.31 (0.15 - 0.42) mm at the entrance, 0.36 (0.24 - 0.51) mm at the apex, and angular deviation was 1.62 (0.54 - 2.27)$^{\circ}$. There was positive correlation between the deviation at the entrance and that at the apex (Pearson Correlation Coefficient = 0.904, P = .013). Conclusion: The coordinate synchronization 5-axis milling procedure has adequate accuracy for the production of the guided surgical template.

• Journal of Korean Dental Hygiene Science
• /
• v.5 no.2
• /
• pp.53-60
• /
• 2022

Background: This study was aimed at improving the satisfaction of patients with implants placed using an implant surgical guide by analyzing patient satisfaction with the implant procedure carried out using the guide . Methods: We extracted convenient samples from patients with implants who had visited dental hospitals and clinics in Mokpo from March 2 to June 30, 2022. We used 228 copies of the self-report survey for analyses. Results: All items of implant satisfaction were positively correlated with the use of an implant surgical guide. Conclusions:The results of this study showed that implant satisfaction can be increased with the use of implant surgical guides.

• The Journal of Korean Academy of Prosthodontics
• /
• v.59 no.1
• /
• pp.79-87
• /
• 2021

The digital workflow of optical impressions by the intraoral scanner and CADCAM manufacture of dental prostheses is actively developing. The complex process of traditional impression taking, definite cast fabrication, wax pattern making, and casting has been shortened, and the number of patient's visits can also be reduced. Advances in intraoral scanner technology have increased the precision and accuracy of optical impression, and its indication is progressively widened toward the long span fixed dental prosthesis. This case report describes the long span implant case, and the operator fully utilized digital workflow such as computer-guided implant surgical template and CAD-CAM produced restoration after the digital impression. The provisional restoration and customized abutments were prepared with the optical impression taken on the same day of implant surgery. Moreover, the final prosthesis was fabricated with the digital scan while utilizing the same customized abutment from the provisional restoration. During the data acquisition step, stl data of customized abutments, previously scanned at the time of provisional restoration delivery, were imported and automatically aligned with digital impression data using an 'A.I. abutment matching algorithm' the intraoral scanner software. By using this algorithm, it was possible to obtain the subgingival margin without the gingival retraction or abutment removal. Using the digital intraoral scanner's advanced functions, the operator could shorten the total treatment time. So that both the patient and the clinician could experience convenient and effective treatment, and it was possible to manufacture a prosthesis with predictability.

• Journal of the Korean Orthopaedic Association
• /
• v.53 no.6
• /
• pp.466-477
• /
• 2018

Orthopaedics is an area where 3-dimensional (3D) printing technology is most likely to be utilized because it has been used to treat a range of diseases of the whole body. For arthritis, spinal diseases, trauma, deformities, and tumors, 3D printing can be used in the form of anatomical models, surgical guides, metal implants, bio-ceramic body reconstruction, and orthosis. In particular, in orthopaedic oncology, patients have a wide variety of tumor locations, but limited options for the limb salvage surgery have resulted in many complications. Currently, 3D printing personalized implants can be fabricated easily in a short time, and it is anticipated that all bone tumors in various surgical sites will be reconstructed properly. An improvement of 3D printing technology in the healthcare field requires close cooperation with many professionals in the design, printing, and validation processes. The government, which has determined that it can promote the development of 3D printing-related industries in other fields by leading the use of 3D printing in the medical field, is also actively supporting with an emphasis on promotion rather than regulation. In this review, the experience of using 3D printing technology for bone tumor surgery was shared, expecting orthopaedic surgeons to lead 3D printing in the medical field.

• Journal of the Korean Academy of Esthetic Dentistry
• /
• v.32 no.2
• /
• pp.54-68
• /
• 2023

Treatment planning of edentulous patient with digital method is materialized by designing the surgical guide. When designing the surgical guide, we first implement the shape of the final prosthesis in the virtual space and then materialize the implantation plan based on this. However, it is challenging to make surgical guides for edentulous patients as their lack of both the reference for the arrangement of teeth and interocclusal relationship makes it hard to envision the shape of the final prosthesis. If there exists good partial or complete dentures or residual teeth, its teeth arrangement can be used as a reference for the virtual final prosthesis and the subsequent surgical guide. If such a reference is absent or unsatisfactory, a process of manufacturing a complete denture for diagnostic purposes and verifying it on patient's mouth is necessary and use it as a new reference for the virtual final prosthesis. But even if a surgical guide is produced through the reference from the thorough reflection of the virtual final prosthesis, when we use it in the surgical field, the intraoral condition of the patient may make the implants deviated from planned in the surgical guide. In the worst case, if the positioning of the surgical guide on the mouth is incorrect, it can lead to a catastrophic error that displaces all the implant, in which case the guided surgery would be much worse than the non-guided one. In this article, we will discuss how to obtain references of tooth arrangements in a timely manner and align or register them into a unified coordinate system in digital space, and also introduce how to transfer such an implantation plan from the virtual world into the patient's mouth of real world with minimum error. And lastly, I would like to express my opinion on the establishment of a rational and systematic protocol of guided surgery of the edentulous patients.

• The Journal of Korean Academy of Prosthodontics
• /
• v.57 no.3
• /
• pp.271-279
• /
• 2019

There are several unfavorable conditions regarding alveolar bone condition that may compromise the denture patient's satisfaction. Chewing efficiency may not be satisfactory when alveolar bone is deficient, and the denture stability could hardly be achieved when alveolar bone shape is irregular. Implant overdenture can be useful to provide satisfactory denture experience compared to conventional denture. The attachment for implant overdenture can be classified into bar attachment and solitary attachment. When the positions of the implants are in the mandibular anterior region, bar attachment may be favorable to obtain a rigid support of the entire denture. When implants are distributed both on anterior and posterior region, a solitary attachment could be considered for ease of removal and maintenance. This report presents implant overdenture cases with the patients that had unilateral mandibular alveolar bone atrophy conditions. Different abutments were chosen based on the individual patient's mandibular alveolar bone condition and the treatments were successful in terms of patient satisfaction.