Janghyun Paek1, Do-Min Jeong2, Yong Kim3, Seong-Hun Kim4, Kyu-Rhim Chung5, Gerald Nelson6. 1. Clincal fellow, Department of Prosthodontics, School of Dentistry, Kyung Hee University, Seoul, Korea. 2. Director, Division of Periodontology, Department of Dentistry, National Medical Center of Korea, Seoul, Korea. 3. Research assistant, Department of Orthodontics, School of Dentistry, Kyung Hee University, Seoul, Korea. 4. Associate professor and chairman, Department of Orthodontics, School of Dentistry, Kyung Hee University, Seoul, Korea. Electronic address: bravortho@gmail.com. 5. Professor and chairman, Department of Orthodontics, School of Medicine, Ajou University, Suwon, Korea. 6. Clinical professor and chair, Division of Orthodontics, Department of Orofacial Science, University of California San Francisco, San Francisco, Calif.
Abstract
INTRODUCTION: This paper introduces a virtually planned and stereolithographically fabricated guiding system that will allow the clinician to plan carefully for the best location of the device and to achieve an accurate position without complications. METHODS: The scanned data from preoperative dental casts were edited to obtain preoperative 3-dimensional (3D) virtual models of the dentition. After the 3D virtual models were repositioned, the 3D virtual surgical guide was fabricated. A surgical guide was created onscreen, and then these virtual guides were materialized into real ones using the stereolithographic technique. RESULTS: Whereas the previously described guide required laboratory work to be performed by the orthodontist, our technique is more convenient because the laboratory work is done remotely by computer-aided design/computer-aided manufacturing technology. Because the miniplate is firmly held in place as the patient holds his or her mandibular teeth against the occlusal pad of the surgical guide, there is no risk that the miniscrews can slide on the bone surface during placement. The software program (2.5-dimensional software) in this study combines 2-dimensional cephalograms with 3D virtual dental models. This software is an effective and efficient alternative to 3D software when 3D computed tomography data are not available. CONCLUSIONS: To confidently and safely place a miniplate with screw fixation, a simple customized guide for an orthodontic miniplate was introduced. The use of a custom-made, rigid guide when placing miniplates will minimize complications such as vertical mislocation or slippage of the miniplate during placement.
INTRODUCTION: This paper introduces a virtually planned and stereolithographically fabricated guiding system that will allow the clinician to plan carefully for the best location of the device and to achieve an accurate position without complications. METHODS: The scanned data from preoperative dental casts were edited to obtain preoperative 3-dimensional (3D) virtual models of the dentition. After the 3D virtual models were repositioned, the 3D virtual surgical guide was fabricated. A surgical guide was created onscreen, and then these virtual guides were materialized into real ones using the stereolithographic technique. RESULTS: Whereas the previously described guide required laboratory work to be performed by the orthodontist, our technique is more convenient because the laboratory work is done remotely by computer-aided design/computer-aided manufacturing technology. Because the miniplate is firmly held in place as the patient holds his or her mandibular teeth against the occlusal pad of the surgical guide, there is no risk that the miniscrews can slide on the bone surface during placement. The software program (2.5-dimensional software) in this study combines 2-dimensional cephalograms with 3D virtual dental models. This software is an effective and efficient alternative to 3D software when 3D computed tomography data are not available. CONCLUSIONS: To confidently and safely place a miniplate with screw fixation, a simple customized guide for an orthodontic miniplate was introduced. The use of a custom-made, rigid guide when placing miniplates will minimize complications such as vertical mislocation or slippage of the miniplate during placement.