Date Published: June 6, 2019
Publisher: Springer International Publishing
Author(s): Andrejus Surovas.
Modern dental treatment with standard screw-type implants leave some cases unaddressed in patients with extreme jaw bone resorption. Custom-made subperiosteal dental implant could be an alternative treatment modality to sinus lift, nerve lateralization or zygomatic implant techniques. Subperiosteal dental implants were utilized for many years to treat such patients. A combination of traditional subperiosteal implant designs with current advancements in 3D imaging, design and printing allow to reduces treatment time and provides abutments for prostheses in cases where other techniques do not provide satisfactory results. The data manipulation and design software are important aspects in the manufacturing of custom implants. Programs that are specialized for industrial or medical design typically cost tens of thousands of US dollars. In this work I establish and test steps for design and production of a custom medical device (subperiosteal implant) from patient computed tomography (CT) data. Work stages to be defined are: selection of necessary software, CT data processing, 3D virtual model creation, modeling technique for custom implant and data file preparation for printing. Patient CT data was successfully converted into a watertight STL (Standard Tessellation Language) model of the maxilla. Error corrections and design were completed using freely available programs from Autodesk Inc.. The implant was produced in Ti64 (a type 5 titanium alloy) using three-dimensional (3D) printing DMLS (direct metal laser sintering) process. The avoidance of high cost software makes this treatment modality more accessible to smaller clinics or mid-size production facilities and subsequently more available to patients.
As populations age, the need for dental treatment of partially or fully edentulous patients increases. Nowadays, seniors often are socially and physically active and expect a high quality of life. One important aspect of such quality of life is healthy dentition, or at least non-removable teeth prostheses. Dental treatment plans often include implant placement, which in turn requires sufficient bone quantity. However, elderly people usually do not have the amount of bone required for standard root form implant placement. Moreover, elderly patients are poor candidates for bone augmentation due to their decreased metabolic rate and decreased regenerative capacity . When bone augmentation is not possible, implant placement is no longer an option.
Define a digital workflow from CT scan to printed implantElucidate variables affecting the quality of the end product—i.e., the implantDetermine the possibility of completing this task using freely available software
Patient CT data was successfully converted into a meshed surface (.stl) model of the maxilla using Slicer 3D, an open source software program.
Custom dental implants have their niche in modern dental practice, serving patents with advanced maxillary or mandibular bone resorption. This type of medical device can be designed using freely available or inexpensive software tools from CT scans and produced by current 3D manufacturing technology to the required precision and fit. Numerous factors have to be taken into account by medical device designers as implant modeling quality is affected by the following:CT scan data qualitySegmentation software algorithms and settingsmodeling software output qualityError repair software algorithms