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Biomedical subjects

Alon Wexler

Publications and source records attributed to Alon Wexler.

6 recordsLinked to original sources

Application of a surgical navigation system for implant surgery in a deficient alveolar ridge postexcision of an odontogenic myxoma.

PURPOSE: The study's purpose was to describe the application of a surgical navigation system for the treatment-planning and subsequent precise placement of dental implants in a patient, 2 years postexcision of a mandibular odontogenic myxoma. PATIENTS AND METHODS: A 25-year-old male patient presented for rehabilitation of a deficient edentulous ridge at the right mandible following excision of an odontogenic myxoma. The patient was imaged by dental computed tomography while wearing an individually fitted interfacing acrylic splint. Thereafter, computed tomography data were imported to the Image-Guided Implantology system (IGI; DenX Advanced Dental Systems Ltd, Moshav Ora, Israel), and a precise 3-dimensional implant treatment plan was contemplated considering the compromised anatomy and the anticipated prosthesis. RESULTS: Three dental implants were placed using a surgical navigation approach with precise coordination to the presurgical treatment plan and subsequently were restored with a screw-retained fixed prosthesis. At the 1-year follow-up, the implants were osseointegrated and the fixed prosthesis was fully functional. CONCLUSIONS: Computerized navigation is indicated for dental implant surgery in patients with deficient alveolar ridge where coordination of the positioning of the implants to the final prosthesis is difficult.

Adult↗

Navigation surgery for dental implants: assessment of accuracy of the image guided implantology system.

PURPOSE: The purpose of this study is to assess the accuracy of the navigation provided by the Image Guided Implantology system (DenX Advanced Dental Systems, Moshav Ora, Israel), which was designed to guide the surgeon in the placement of dental implants. MATERIALS AND METHODS: Seven jaw models incorporating special ceramic spheres were imaged by dental computerized tomography. The coordinates of these reference ceramic markers were calculated by the Image Guided Implantology and compared with their actual position coordinates as identified on the computed tomography image. RESULTS: The overall mean spatial navigation error was 0.35 +/- 0.14 mm. The 1-tailed probability of any single measurement exceeding 0.75 mm was less than 0.003, and that exceeding 1 mm was less than 0.0001. CONCLUSION: The Image Guided Implantology system provides highly accurate navigation with less than 0.73 mm error, which is acceptable in dental implantology. The accurate reporting of the exact position of the drilling bur should minimize the potential risk of damage to critical anatomic structures. The accurate intraoperative navigation allows the surgeon to precisely transfer the presurgical plan to the patient.

Ceramics↗

Image-guided navigation system for placing dental implants.

Navigation-guided surgery has recently been introduced into various surgical disciplines, including oral and maxillofacial surgery. Since the advent of dental implants, dental computed tomography (CT) scans have been used as a diagnostic tool for preoperative planning, but not as part of the surgical phase. This article explains the principles of computer-assisted surgery and describes the use of a computer-guided navigation system in dental implantology. The system uses preoperative dental CT scans for planning and as an integral part of the surgical procedure. This system allows continuous intraoperative coordination of the implantation phase with the preoperative plan, optimizing the accuracy of implant surgery. Deviations from the planned location of the implants are minimal. Several cases are discussed.

Adult↗

Oral candidiasis prevention in transplantation patients: a comparative study.

AIM: Oral candidiasis occurs commonly in haematopoietic -stem cell transplantation (HSCT) patients carrying a risk of systemic candidemia and mortality. The aim of this pilot study was to design an effective protocol that prevents oral candidiasis and improves tolerability. METHODS: A prospective, randomized, longitudinal study with two treatment groups, (A) chlorhexidine (CHX) and (B) CHX combined with medium-dose amphotericin B (AMB), was performed. The investigators were blinded to the treatment arm. RESULTS: No clinical signs of oral candidiasis were observed in any of the 20 patients. All patients experienced neutropenia and were treated with antibiotics. The duration of antibiotic treatment was longer in group A than that in group B. The difference in systemic anti-fungal treatment was insignificant. Compliance was achieved in both groups, although tolerability was better in group A than that in group B. CONCLUSION: Effective oral anti-fungal prevention based on topical AMB was suggested. CHX mouthwash was also suggested to be effective as a single topical agent for the prevention of oral candidiasis in HSCT patients. The combination of topical CHX and medium-dose AMB-prophylactic protocol may achieve the same level of candidial prevention with better tolerability than that by AMB alone. More research is warranted.

Adult↗

Intraoperative computerized navigation for flapless implant surgery and immediate loading in the edentulous mandible.

Computerized navigation surgery has evolved to facilitate minimally invasive procedures, the gold standard of surgery today. While flapless implant surgery may be clinically beneficial, it has generally been perceived as a blind procedure limited to straightforward cases that do not pose a risk of cortical plate perforation. The objective of this report is to describe a protocol for flapless implant placement in a completely edentulous mandible using computerized navigation surgery. The Image Guided Implantology system (IGI, DenX Advanced Dental Systems) is described. The IGI system provides real-time imaging of the dental drill and transforms flapless implant surgery into a fully monitored procedure. The highly accurate intraoperative navigation enables precise transfer of the detailed presurgical implant plan to the patient. This is particularly valuable in edentulous jaws lacking any indication of the dental arch. The accurate positioning of the implants, based on the presurgical digital plan, allows fabrication of a provisional fixed prosthesis before the implant surgery for immediate postoperative loading. This innovative protocol can enhance prosthodontic-driven placement of implants in a fully monitored flapless surgery.

Dental Implantation, Endosseous↗

Flapless approach for removal of bone graft fixing screws and placement of dental implants using computerized navigation: a technique and case report.

This article presents a technique for the removal of the screws used to fix a bone graft and for the placement of dental implants in a flapless approach that utilizes the tracking technology of a computerized navigation system. A 24-year-old female patient injured in a terrorist bombing suffered from tooth loss and a bone defect in the maxilla. The area was grafted with bone from the chin in preparation for the placement of dental implants. Four months following the grafting procedure, the fixing screws were removed and the dental implants were placed in a flapless approach by the application of a specialized computerized navigation system. This technique emphasizes the potential of computerized navigation approaches in the facilitation of minimally invasive oral surgery.

Adult↗