In-office fabrication of surgical guides using

16221 DLP 3D printing and planning software:

A clinical report.
IMPLANT THERAPY Strisca Stanislav, Sirbu Dumitru, Popovici Vadim, Marusev Pavel
OUTCOMES; SURGICAL
STATE UNIVERSITY OF MEDICINE AND PHARMACY “NICOLAE TESTEMIŢANU”
ASPECTS PRIVATE DENTAL CLINIC SRL”OMNI DENT”

Abstract Results

Contemporary planning software allows to plan the desired implant placement and to fabricate a low
cost in-office surgical. The aim of this study was to evaluate the feasibility and accuracy of in-office
surgical guides produced using Implant Studio 2018 software (3Shape Dental Systems, Copenhagen,
Denmark) and desktop 3D printer (Moonray, S100). A 55-year-old female patient presented to our
clinic, with the chief concern being replacement of the missing lateral upper and lower teeth. In 3Shape
Implant Studio 2018, virtual wax-up of missing teeth was performed, implants were placed in a
prosthetically driven position. Surgical guides were designed and exported into RayWare software and
subsequently 3D printed using MoonRay S100. In the case reported, angular difference between the
planned and placed implant positions ranged from 0.37-5.64 degrees mesiodistally and 1.44-7.23
degrees bucco-lingually. In-office fabricated surgical guides using contemporary implant software and
desktop 3D printers show similar accuracy to laboratory manufactured guides.
In the case reported, detailed measurements and analysis of each implant revealed that the
mesiodistal and bucco-lingual deviations ranged from 0.15-0.97 mm and 0.42-1.04 mm,
respectively. Angular difference between the planned and placed implant positions ranged from
0.37-5.64 degrees mesiodistally and 1.44-7.23 degrees bucco-lingually. Similar results were
previously shown by Edelman et al, these deviations are acceptable and can be well tolerated
when compared to a free-hand implant placement method. There will always be minor differences
between actual and planned implant position which may be the result of inaccuracies of CBCT-
scans, various anatomical structures, bone density, precision in guide fitting, surgeon’s skills, etc.
The main advantage of in-office guided surgery is the possibility to predictably obtain and
reproduce surgical guides with high accuracy at a low cost. The planning software enables to
create a consistent workflow for every implant procedure.

Printed surgical guides

Guide planning

6 months postop Superimposition measurement

Background and Aim Conclusion

In order to provide a successful long-term outcome, a proper positioning of implants is essential.
Ideally, implants should be placed in native bone with at least of 1.5 mm on both buccal and lingual
aspects, also in a prosthetically driven position. Various techniques have been developed to
predictably improve the practitioner’s ability to place implants accurately [1,2]. Contemporary planning
software allows to plan the desired implant placement and to fabricate a low cost in-office surgical.
In-office fabricated surgical guides using contemporary implant software and desktop 3D printers show
similar accuracy to laboratory manufactured guides. The main benefit of in-office guided surgery is
mainly to reduce the time and costs for a surgical guide fabrication. Although this workflow can provide
an accurate outcome, clinicians should get adequate training in order to become familiar with implant
planning software and the fabrication of 3D printed surgical guides.

The aim of this study was to evaluate the feasibility and accuracy of in-office surgical guides produced
using Implant Studio 2018 software (3Shape Dental Systems, Copenhagen, Denmark) and desktop 3D
printer (Moonray, S100).

Methods and Materials References

A 55-year-old female patient presented to our clinic, with the chief concern being replacement of the missing 1. Arisan V, Karabuda ZC, Ozdemir T. Accuracy of two stereolithographic guide systems for computer-aided implant

lateral upper and lower teeth. Using Trios 3 scanner, dental arches were scanned and later superimposed placement: a computed tomography-based clinical comparative study. J Periodontol 2010;81:43-51.

onto the CBCT-scan using a three-point registration method. In 3Shape Implant Studio 2018, virtual wax-up 2. Nikzad S, Azari, A. A novel stereolithographic surgical guide template for planning treatment involving a mandibular

of missing teeth was performed, implants were placed in a prosthetically driven position. Surgical guides dental implant. J Oral Maxillofac Surg 2008; 66:1446-54

were designed and exported into RayWare software and subsequently 3D printed using MoonRay S100. A
total number of 14 Dentium implants were inserted using a flapless approach in the upper jaw (7 implants)
and with a minimally invasive flap elevation in the lower jaw (7 implants). At 6 months, a CBCT-scan was
performed to evaluate osseointegration of dental implants. Post- implant insertion STL model was generated
in 3D Slicer and then was superimposed with pre- surgical plan to evaluate distance and angulation
differences. During follow-up period no implant were lost.

Presented at