Customized root-analogue dental implants - Procedure and errors associated with image acquisition, treatment, and manufacturing technology in an experimental study on a cadaver dog mandible

J Mech Behav Biomed Mater. 2022 Sep;133:105350. doi: 10.1016/j.jmbbm.2022.105350. Epub 2022 Jul 1.

Abstract

The global market for dental implants is constantly evolving. To overcome the limitations of conventional strategies - invasive surgeries and bone loss around the implant-, new approaches, namely the development of CAD/CAM customized implants, are emerging as promising solutions for replacing missing teeth, thus avoiding destruction of bone by drilling it. Despite the efforts that are being carried out, the designing, including image acquisition, and manufacturing efficacy of such rehabilitation therapy is not easily found in the literature. In this sense, this research work aimed to assess the errors associated with the image acquisition, treatment and manufacturing of Customized Root-Analogue Implants (CRAI). The experimental procedure, carried out in a dog cadaveric mandible, encompassed the image acquisition and treatment and the subsequent manufacturing of four different CRAI. Two Image acquisition methods (CBCT and X-ray), and different software for their treatment were used, and the final CRAI were manufactured by Computer Numerical Control. Results revealed the CBCT scan allowed to properly visualize the original teeth contours. However, all the obtained teeth geometries presented smaller surface areas when compared to the original teeth indicating however a systematic predictable error. On the other hand, when comparing the surface area of the digital and the manufactured teeth, very small differences were observed, which indicates that the CNC manufacturing technique is a promising solution for such applications. When placing the produced CRAI in the dog mandible it was possible to observe a lack of congruency between the CRAI and bone, mainly due to image acquisition process errors and the destruction of the periodontal ligament during the soft tissues removal process. Thus, CBCT images seem to be a feasible route to design root-analogue implants, and, if needed, a compensation strategy for the systematic image acquisition error may be implemented.

Keywords: CAD/CAM; Cone-beam computed tomography; Customized root-analogue implant (CRAI); Zirconia.

MeSH terms

  • Animals
  • Cadaver
  • Computer-Aided Design
  • Dental Implants*
  • Dogs
  • Humans
  • Mandible / diagnostic imaging
  • Mandible / surgery
  • Technology

Substances

  • Dental Implants