Rafael Gama’s scientific contributions

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Publications (1)


3D virtual patient-Magnetically retained printed stackable system for implant guided placement: Case report
  • Article

June 2024

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83 Reads

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2 Citations

Journal of Esthetic and Restorative Dentistry

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Rafael Gama

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Objective The aim of this report is to present the complete workflow of 3D virtual patient for planning and performing implant surgery with magnetically retained 3D‐printed stackable guides. Clinical Considerations A 3D‐printed stackable system was proposed based on bone, dental, and facial references. Initially, a 66‐year‐old male patient was digitalized through photographs, cone beam computed tomography, and intraoral scans (Virtuo Vivo, Straumann). All files were merged to create a 3D virtual patient in the planning software (coDiagnostiX, Straumann). Sequential stackable guides were designed, printed, and cured. Magnets were inserted into connectors, and the interim protheses received color characterization. Four mounted guides were produced for the specific purposes of pin fixation, bone reduction, implant placement, and immediate provisionalization. After surgery and healing period, patient digital data were updated. Final implant positions were compared to planned values and inconsistencies were clinically acceptable. The mean angular deviation was 5.4° (3.2–7.3) and mean 3D discrepancies were of 0.90 mm (0.46–1.12) at the entry point and 1.68 mm (1.00–2.20) at implant apex. Case follow‐up revealed stability, patient's comfort, and no intercurrences. Conclusion Magnetically retained stackable guides provide treatment accuracy and reduce surgical and prosthetic complications. The projected virtual patient enhances decision‐making and communication between the multidisciplinary team and the patient, while decreases time and costs. Clinical Significance Bidimensional diagnosis and freehand implant placement have limitations and outcomes often rely on professionals' expertise. Performing facially driven virtual planning improves treatment predictability. This approach promotes function, esthetic harmony, and patient satisfaction. Implant guided surgery and 3D printed prostheses constitute a reproducible digital workflow that can be implemented into clinical practice to optimize dental care.

Citations (1)


... 1 In the case of full arch rehabilitation on an edentulous mandible, whether on a healed ridge or following the extraction of hopeless teeth, the use of guided surgery can be advantageous in overcoming the limitations of bidimensional diagnosis, freehand implant placement, and the experience of the professionals involved. 2 Therefore, this workflow is also particularly suitable for edentulous and complex cases, which often require multiple procedures, such as bone reduction to establish an appropriate prosthetic space and emergence profile. 2 The treatment workflow for virtual implant planning and guided implant placement is based on volumetric bone image data, which are typically obtained through cone-beam computed tomography (CBCT) and exported as DICOM files (Digital Imaging and Communications in Medicine). Additionally, surface scans of soft tissue and teeth are typically obtained through an intraoral scanner (IOS) and exported as monochromatic standard tessellation language (STL) files or colored Polygon File Format/Object File Format (PLY/OBJ) files. ...

Reference:

Effect of magnetic resonance imaging protocol on decision-making for positioning of dental implants in edentulous cases
3D virtual patient-Magnetically retained printed stackable system for implant guided placement: Case report
  • Citing Article
  • June 2024

Journal of Esthetic and Restorative Dentistry