Interactive imaging for implant planning.
Explore the source record for details and available documents.
Belgium↗
Biomedical subjects
Daniel Van Steenberghe
Publications and source records attributed to Daniel Van Steenberghe.
Bone augmentation by means of a stiff occlusive titanium barrier.
It has already been shown that occlusive titanium barriers have osteoconductive properties. These barriers, however, cover only a limited surface area and have only been used in animal experiments. The aim of this study was to evaluate bone neogenesis under a pre-shaped titanium barrier placed over the top of the rabbit skull and the top of highly resorbed edentulous upper-jaw bone in patients. Computed tomography (CT) scans made it possible to pre-shape the titanium barrier according to individual bone shape in human experiments. On the rabbit skull, tissue augmentation of up to 6 mm 1 year after barrier placement was observed, while the original thickness of skull bone was on average between 1.5 and 2.5 mm. The bone, which remained histologically immature for 1 year, grew systematically along the titanium surface, illustrating its osteoconductivity. Even after removal of the barrier, on average, 75.3 and 59.4% of the newly created tissue volume was maintained after 3 and 9 months, respectively. Clinical observations on 10 consecutive patients showed that, in those (5/10) in which the barrier remained unexposed for several months, an increase of the jawbone height and width of up to 16 mm could be observed when the barrier was removed after 12-18 months. As in the rabbits at barrier removal, the bone demonstrated a limited degree of mineralization as ascertained from biopsies. This newly formed osteoid tissue allowed the insertion of 33 screw-shaped titanium implants which in most cases (30/33) successfully osseointegrated to support a fixed prosthesis. The surrounding marginal bone level remained stable even up to 5 years after implant placement. Both animal and clinical data demonstrate that guided bone neogenesis under a subperiosteally placed titanium barrier can reach large volumes.
Adult↗
Accuracy of drilling guides for transfer from three-dimensional CT-based planning to placement of zygoma implants in human cadavers.
The accuracy of surgical drilling guides was assessed for placement of zygoma implants. Six zygoma fixtures of length 45 mm (Nobel Biocare, Göteborg, Sweden) were placed in three formalin-fixed human cadavers using surgical drilling guides. The fabrication of these custom-made drilling guides was based on three-dimensional computerized tomography (3D-CT) data for the maxillary-zygomatic complex. The installation of the implants was simulated preoperatively using an adopted 3D-CT planning system. In addition, anatomical measurements of the zygomatic bone were performed on the 3D images. The preoperative CT images were then matched with postoperative ones in order to assess the deviation between the planned and installed implants. The angle between the planned and actually placed implants was < 3 degrees in four out of six cases. The largest deviation found at the exit point of one of the six implants was 2.7 mm. The present study showed that the use of surgical drilling guides should be encouraged for zygoma implant placement because of the lengths of the implants involved and the anatomical intricacies of the region.
Adult↗