In-vitro evaluation of the tolerance of surgical instruments in templates for computer-assisted guided implantology produced by 3-D printing

Clin Oral Implants Res. 2015 Mar;26(3):320-5. doi: 10.1111/clr.12327. Epub 2014 Jan 18.


Objective: The aim of this in-vitro study was to compare the tolerance of surgical instruments in surgical guides produced by 3-D printing, without metal sleeves to a surgical guide with conventional metal sleeves from two different manufacturers.

Materials and methods: Lateral movements of drill tips caused by tolerance between the sleeve and drill key and between the drill key and the drill were recorded after application of a standardized force to the surgical instruments. Four groups were tested: Control 1 (C1): metal sleeve from commercially available surgical system 1; Test 1 (T1): 3-D-printed sleeve for surgical system 1; Control 2 (C2): metal sleeve from commercially available surgical system 2. Test 2 (T2): 3-D-printed sleeve for surgical system 2.

Results: The mean total lateral movement was 0.75 mm (0.5-1.04 mm) in the C1 group and 0.91 mm (0.54-1.34 mm) in the C2 group. The mean amount of movement from tolerance between sleeve and drill-guiding key was 0.31 mm (range 0.22-0.41 mm) in C1 and 0.42 mm (range 0.29-0.56 mm) in C2. This lateral movement was in mean reduced by 0.24 mm (32%) in T1 and by 0.39 mm (43%) in T2 group. This reduction was statistically significant in both groups (P < 0.001).

Conclusion: The tolerance of surgical instruments and the lateral movements of the drills were significantly reduced by the use of 3-D printing with reduced sleeve diameter. This reduction could improve the overall accuracy in computer-assisted template-guided implant dentistry. The lateral movement of the drill can be further reduced by using a shorter drill and a higher drill key. This can be considered during implant planning and CAD/CAM of surgical guides.

Keywords: 3-D printing; dental implants; guided surgery.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Dental Implantation, Endosseous / instrumentation*
  • Equipment Design
  • In Vitro Techniques
  • Printing, Three-Dimensional*
  • Surgery, Computer-Assisted*
  • Surgical Instruments*