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Journal of Prosthetic Dentistry

Accuracy of digitally fabricated drilling guide to form screw-access channels in cement-retained implant prostheses: A randomized clinical trial

  • Soohyun Bae
    Affiliations
    Graduate student, Department of Prosthodontics, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
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  • Hang-Nga Mai
    Affiliations
    Research Professor, Institute for Translational Research in Dentistry, Kyungpook National University, Daegu, Republic of Korea

    Lecturer, Dental School of Hanoi University of Business and Technology, Hanoi, Vietnam
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  • Du-Hyeong Lee
    Correspondence
    Corresponding author: Dr Du-Hyeong Lee, Department of Prosthodontics, School of Dentistry, Institute for Translational Research in Dentistry, Kyungpook National University, 2175 Dalgubeoldae-ro, Jung-Gu, Daegu 41940, REPUBLIC OF KOREA
    Affiliations
    Associate Professor, Department of Prosthodontics, School of Dentistry, Institute for Translational Research in Dentistry, Kyungpook National University, Daegu, Republic of Korea
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Published:September 18, 2022DOI:https://doi.org/10.1016/j.prosdent.2022.07.015

      Abstract

      Statement of problem

      Accurate intraoral preparation of screw channels in cement-retained implant prostheses could be a treatment challenge for tilted or badly positioned implants.

      Purpose

      The purpose of this randomized clinical trial was to evaluate screw channel accuracy for retrieving cement-retained implant prostheses by using a digitally fabricated drilling guide.

      Material and methods

      Twenty-four participants requiring removal of cement-retained implant prostheses were recruited and consecutively assigned to 1 of 2 groups. In the first group, drilling guides were fabricated by using an intraoral scan, computer-aided design (CAD), and 3D printing to facilitate screw channel preparation (guide group). In the second group, screw channel preparation was based on panoramic radiographs without a drilling guide (freehand group). Screw channel accuracy was evaluated with a 3D analysis and subsequently compared with the ideal shape of the screw channel for linear deviation at coronal and apical levels, angular deviation, surface loss deviation, and volume loss deviation. The ideal shape of the screw-access channel was based on the Ø2.2-mm cylinder image marked along the long axis of the implant. The Mann-Whitney U and Kruskal-Wallis tests were used for statistical analyses (α=.05).

      Results

      The drilling guide group showed higher dimensional accuracy than the freehand group for angular deviation (9.45 degrees versus 15.69 degrees; P=.014) and surface loss deviation (7.40 mm versus 9.53 mm; P=.001), especially when the implant was tilted more than 30 degrees. The deviation values of the screw channels were not significantly different according to implant tilt in either group (P>.05).

      Conclusions

      Digitally fabricated drilling guides for intraoral preparation of screw channels in cement-retained implant prostheses can improve accuracy and provide a less-destructive screw channel.
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      References

        • Papaspyridakos P.
        • Barizan Bordin T.
        • Kim Y.J.
        • et al.
        Implant survival rates and biologic complications with implant-supported fixed complete dental prostheses: a retrospective study with up to 12-year follow-up.
        Clin Oral Implants Res. 2018; 29: 881-893
        • Schwarz M.S.
        Mechanical complications of dental implants.
        Clin Oral Implants Res. 2000; 11 Suppl 1: 156-158
        • Ahmed A.
        • Maroulakos G.
        • Garaicoa J.
        Acrylic resin guide for locating the abutment screw access channel of cement-retained implant prostheses.
        J Prosthet Dent. 2016; 115: 560-563
        • Daher T.
        • Morgano S.M.
        The use of digital photographs to locate implant abutment screws for implant-supported cement-retained restorations.
        J Prosthet Dent. 2008; 100: 238-239
        • Malpartida-Carrillo V.
        • Tinedo-Lopez P.L.
        • Ortiz-Culca F.
        • Guerrero M.E.
        • Amaya-Pajares S.P.
        Techniques for retrievability and for registering screw access holes in cement-retained implant-supported prostheses: a scoping review of the literature.
        J Prosthet Dent. 2020; 123: 427-433
        • Schwedhelm E.R.
        • Raigrodski A.J.
        A technique for locating implant abutment screws of posterior cement-retained metal-ceramic restorations with ceramic occlusal surfaces.
        J Prosthet Dent. 2006; 95: 165-167
        • Schoenbaum T.R.
        • Chang Y.Y.
        • Klokkevold P.R.
        Screw-access marking: a technique to simplify retrieval of cement-retained implant prostheses.
        Compend Contin Educ Dent. 2013; 34: 230-236
        • Figueras-Alvarez O.
        • Cano-Batalla J.
        An alternative method for registering the abutment screw position of cement-retained implant restorations.
        J Prosthet Dent. 2014; 112: 1304-1305
        • Lee J.H.
        A technique for recording the abutment screw angulation of cement-retained implant prostheses.
        J Prosthet Dent. 2015; 114: 741-742
        • Patil P.G.
        • Patil S.P.
        Occlusal-view photograph of a cement-retained implant prosthesis as a permanent guide for access-hole preparation.
        J Prosthet Dent. 2013; 109: 343-344
        • Buzayan M.M.
        • Mahmood W.A.
        • Yunus N.B.
        A simple procedure for retrieval of a cement-retained implant-supported crown: a case report.
        Quintessence Int. 2014; 45: 125-128
        • Figueras-Alvarez O.
        • Real-Voltas F.
        • Cabratosa-Termes J.
        • Roig M.
        A method for determining the position of the abutment screw of any cement-retained implant-supported prosthesis.
        J Prosthet Dent. 2021; 125: 846-848
        • Doerr J.
        Simplified technique for retrieving cemented implant restorations.
        J Prosthet Dent. 2002; 88: 352-353
        • Kang H.W.
        • Lee D.H.
        Using a guide template with a handpiece sleeve to locate the abutment screw position of a cement-retained implant restoration.
        J Prosthet Dent. 2015; 114: 339-342
        • Tarlow J.L.
        A modified technique to locate the abutment screw access opening of a cemented implant-supported restoration.
        J Prosthet Dent. 2012; 108: 58-59
        • Lee D.H.
        CAD/CAM-fabricated template for locating implant abutment screws in cement-retained anatomic zirconia restorations.
        J Prosthet Dent. 2015; 114: 343-345
        • Lee D.H.
        • Mai H.N.
        • Li L.J.
        • Lee K.W.
        Accuracy of a CAD/CAM-guided template for locating abutment screws for cement-retained implant-supported restorations.
        J Prosthet Dent. 2016; 116: 67-73
        • Mai H.N.
        • Kim K.R.
        • Lee D.H.
        Non-radiological method for fabrication of a screw-channel drilling guide in cement-retained implant restorations using intraoral digital scanning and imaging superimposition: a clinical report.
        J Prosthodont. 2017; 26: 88-92
        • Lee D.H.
        • Li L.J.
        • Mai H.N.
        • Kim K.R.
        • Lee K.W.
        The effect of a CAD/CAM-guided template on formation of the screw-access channel for fixed prostheses supported by lingually placed implants.
        Int J Prosthodont. 2017; 30: 113-115
        • Mai H.N.
        • Kim K.R.
        • Lee D.H.
        Double-step image superimposition technique for fabricating a drilling guide to access the abutment screw in implant prostheses.
        Int J Prosthodont. 2016; 29: 406-408
        • Schriber M.
        • Yeung A.W.K.
        • Suter V.G.A.
        • Buser D.
        • Leung Y.Y.
        • Bornstein M.M.
        Cone beam computed tomography artefacts around dental implants with different materials influencing the detection of peri-implant bone defects.
        Clin Oral Implants Res. 2020; 31: 595-606
        • Boeddinghaus M.
        • Breloer E.S.
        • Rehmann P.
        • Wöstmann B.
        Accuracy of single-tooth restorations based on intraoral digital and conventional impressions in patients.
        Clin Oral Investig. 2015; 19: 2027-2034
        • Güth J.F.
        • Keul C.
        • Stimmelmayr M.
        • Beuer F.
        • Edelhoff D.
        Accuracy of digital models obtained by direct and indirect data capturing.
        Clin Oral Investig. 2013; 17: 1201-1208
        • Park J.I.
        • Yoon T.H.
        A three-dimensional image-superimposition CAD/CAM technique to record the position and angulation of the implant abutment screw access channel.
        J Prosthet Dent. 2013; 109: 57-60