Implant surgery time and complication rates reduce with CAD/CAM customisation, study says
A new study has found that customising dental implant treatment using CAD/CAM technology has a number of advantages.
The study, published in the Journal of Implantology, posits that CAD/CAM technology brings the world of digital dentistry into the surgery, offering reduced treatment times as well as the likelihood of postoperative complications.
But the researchers, from the University of Bologna, Italy, and a private practice in Bologna, warned that the adoption of CAD/CAM technology does not remove the need for corrections entirely.
Benefits and warnings
The study examined surgical outcomes from nine patients before concluding that CAD/CAM technology allows for exact rendering and visualisation during implant treatment.
The technology brings significant benefits but clinicians must be aware of the need for corrections before it can be adopted as the new standard of care, they said.
The study looked at nine patients scheduled for dental implant surgery and requiring the use of titanium mesh to form a solid implantation site.
In all cases, CAD/CAM was used to achieve a pre-surgical virtual rendition of the implant area, as well as the use of 3D printing to create the titanium mesh.
The researchers examined the ability to place the implants as planned via the computer model, bone regeneration and timing of exposed titanium mesh.
During the six- to 18-month observation period following placement, the researchers found that in all patients the implant position was well matched with the virtual rendition and there were sufficient increases in bone.
However, problems were found with the titanium mesh.
Three patients experienced four- to six-week premature mesh exposure.
A four- to six-week mesh delay was found in three others, and one patient needed the mesh completely removed earlier than anticipated.
Although these complications did not affect the overall success of the implant surgery, they did cause a higher risk for infection.
The researchers also noted that the higher costs of using CAD/CAM could hinder its use.
Nevertheless, the study concluded that using CAD/CAM technology brings many benefits overall.
‘Many advantages were observed: the possibility to project and visualise the bone augmentation needed for implants placement, the reduction in surgical time thanks to the CAD/CAM manufactured titanium mesh, the preoperative evaluation of the least amount bone that needs to be harvested, the reduction of postoperative morbidity due to above mentioned reasons and finally the possibility to position implants according to the programmed treatment planning based on both prosthetic and surgical evaluations’, the study authors stated.
‘However, due to the possibility of mesh exposure correlated to the stiffness of the mesh and to the learning curve of the digital mesh projecting, a cautious approach to this procedure should be suggested to avoid postoperative infections that can jeopardise the desired bone augmentation.’
The full text of the article, ‘Prosthetically CAD/CAM-Guided Bone Augmentation of Atrophic Jaws Using Customized Titanium Mesh: Preliminary Results of an Open Prospective Study’ appears in the Journal of Oral Implantology [2018, 44(2)], and is available online here.