Methods: Two identical sets of 5 plastic maxillary models with complete dentition but with a different arrangement of teeth were used for comparison. Four TADs (A.C.E., ACE Surgical Supply CO., Inc., Brockton, MA) were placed in each maxillary model, between the cuspids and 1st bicuspids and between the 2nd bicuspids and 1st molars bilaterally. In the 2D group, periapical radiographs and pre-fabricated wire guides were used for planning and placement of TADs, whereas surgical guides fabricated from cone beam computed tomography (CBCT) data were used for the 3D group. The precision of TAD placement was evaluated according to its horizontal and vertical position, and its angulation. The incidence of TADs contacting the adjacent roots was also recorded. The data was analyzed using two-sample t-tests at the significance level of α = .05.
Results: The fit of the 3D surgical guides were compromised and adjustments were made until adequate fit and stability were established. No significant difference was found in the horizontal position between the 2D and 3D groups. While a significant difference was noted in the vertical position, TADs in both groups were at the clinically acceptable position. The TAD angulation control was significantly better in the 3D group. However, the incidence of TADs contacting the adjacent roots was similar in both groups.
Conclusion: The 3D technique has a potential in improving the precise planning and placement of TADs. However, more research is warranted to assure the proper fit and the stability of computer-aided design/computer-aided manufacturing (CAD/CAM) surgical guide.
NIH grant #1R15DE017625