الفهرس 
REVIEW OF LITERATUREOnly 14 pages are availabe for public view
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Abstract
The present study assessed the accuracy of implant placement using fully guided and tooth-supported surgical guides printed by two different Direct light printing technology DLP based printer and fused deposition material printer FDM.
Sixteen implants were divided into 2 groups, eight implants in each group, DLP and FDM group then inserted in lower posterior bounded edentulous. All patients undergo preoperative clinical examination, dental impressions were taken for study cast then scanned by optical scanner for soft tissue registration and with the DICOM of CBCT for bone anatomy, both were imported in Real guide software for implant planning and surgical guide design. The designed were planned for tooth supported fully guided surgical guide. The surgical guide designs exported as STL file to be imported in CAD software for preparing the STL file for printing. Guides for DLP technology printed by Formlab 2 printer and for FDM Chifron printer from Anycubic following the recommended instructions for each printer to avoid deformity or errors and sleeves from Neo biotech implant.
The surgery was performed using Neo Navi guide for implant system specific surgical guide and implants were inserted according to drilling sequences corresponding to the pre-planned height and width of bone, after the surgery immediately patients were scanned. both pre-operative and postoperative CBCT scan were imported in software OnDemand for alignment of the pre -planned implant position and the actual placed implants after alignment using the fusion module then one data set exported from on-demand then imported in the Real guide software with the STL file of the pre- planned implant. It was obtained pre-operative implant outline exactly were planned previously with CBCT image of the implant superimposed, from these superimpositions the differences between planned and placed implants were measured by using variables in horizontal, vertical deviations, buccolingual dimensions, angular deviations, all deviations we measured at implant platform and apex, another deviation was measured using Pythagorean equation for 3D global deviation.
The results were insignificant in horizontal deviation at implant apex and platform and show insignificant difference in angular deviations between DLP and FDM groups but there was significant difference in vertical deviation in mesiodistal and buccolingual dimensions at platform and apex deviation and 3D global deviation between both groups. where FDM group shows higher measurements and deviation.
According to the statistical results and within the limitations of this study, the following conclusions were drawn, the surgical guide printed by FDM printer show significant vertical deviations in mesiodistal and buccolingual compared to DLP printed guides. There was significance difference in 3D global deviation of implants placed by FDM printed guide than implants placed by DLP printed guide.
Additive manufactured surgical guides can provide high accuracy in implant position, within the range of clinically acceptable outcomes. Further clinical studies are needed to evaluate and compare different printers in a larger variety of clinical situations.
CONCLUSIONS
Within the limitations of our in vivo study, we conclude:
• Within the range of clinically acceptable outcomes both DLP and FDM printers can produce fully guided surgical guides with high implant placement accuracy.
• Surgical guides manufactured by DLP printer showed more accuracy with less vertical deviation in implant placement in both mesio-distal and buccolingual dimensions and in 3D global deviation than the FDM guide.
• Both DLP and FDM guides have high accuracy with minimum angular deviation and horizontal deviation in mesiodistal and buccolingual dimension for implant placement.
RECOMMENDATIONS
• Larger sample size is recommended.
• More complex situations involving multiple missing teeth and unfavorable bone type and density.
• Verification of accuracy between DLP and FDM for anterior implant guided surgery.
• Further clinical studies are needed to evaluate and compare different printers in a larger variety of clinical situations.