Facilitate™ is a computer guided planning tool for efficient, accurate and predictable implant treatment based on a 3D visualization of the patient's anatomy, including vital structures, implants, abutments and teeth. Facilitate is based on the successful SimPlant™ software from Materialise Dental™. The summaries present the Facilitate™ techniques and its advantages in various situations.
Assessment of correlation between computerized tomography values of the bone and cutting torque values at implant placement: A clinical study
Purpose: Initial implant stability in the bone is a prerequisite for immediate and early loading protocols. This study was performed in order to analyze if computer tomography (CT) analysis can predict a suitable implant treatment protocol. CT values were compared with the cutting torque values required for seating a self-tapping implant.
Materials and methods: Totally 56 implants were placed in maxillary and mandibulary bone in 13 patients. เท short, a radiographic template was placed on the alveolar ridge of each patient before CT scan. Implant placement was simulated using the SimPlant Software (Materialise, Leuven, Belgium). A custommade stereolitographic drill guide, the Surgiguide, was produced based on the same software data, to assure drilling at the planned implant positions. Implant sites were then prepared using the Surgiguide and a 3 mm diameter wide twist drill. During seating of the implants, the cutting torque values were measured using the drilling unit.
CT scan (Aquilion Multi TSX-101/4A; Toshiba) was obtained at 120 kv, 100 mA with 1.0 mm slice thickness and table increment, 1.0 second scan time and FC30 reconstruction algorithm. SimPlant imaging data was processed with ImageMaster 101. The Hounsfield units were analysed in an area defined as 1 mm from the simulated implant. At surgery a bone achored stereolitographic guide was used with stainless steel tubes as drilling guide holes (Materialise). The cutting torque value required to seat the implants into the prepared site was registered in Ncm.
Examination of correlation between CT values (Hounsfield units) and cutting torque values was performed with Pearson's correlation coefficient
Result: A statistically significant correlation of the CT and cutting torque values during implant placement was found (P< 0.01, correlation coefficient 0.77).
Discussion and conclusion: The classical 4 grades of defining bone quality by Lekholm and Zarb does not have the required reproducibility or objectivity. New techniques constantly evolve and information from CT scan processed in preoperative virtual planning programs are being developed. This study was performed to evaluate the relationship of CT and cutting torque values.
A strong correlation between CT and cutting torque values was found in this clinical study. The results indicate that it is possible to quantify initial implant stability and bone quality by analysis of CT. The combined CT scan and SimPlant planning makes the treatment more reliable and predictable. This is of particular importance in the maxillary molar areas where implant survival seems to be lower than at other sites, and where implant placement requires particular attention due to restricted amount and density of bone.
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