Virtually fabricated guide for placement of the C-tube miniplate.

Abstract

INTRODUCTION: This paper introduces a virtually planned and

stereolithographically fabricated guiding system that will allow the clinician to

plan carefully for the best location of the device and to achieve an accurate

position without complications. METHODS: The scanned data from preoperative

dental casts were edited to obtain preoperative 3-dimensional (3D) virtual models

of the dentition. After the 3D virtual models were repositioned, the 3D virtual

surgical guide was fabricated. A surgical guide was created onscreen, and then

these virtual guides were materialized into real ones using the

stereolithographic technique. RESULTS: Whereas the previously described guide

required laboratory work to be performed by the orthodontist, our technique is

more convenient because the laboratory work is done remotely by computer-aided

design/computer-aided manufacturing technology. Because the miniplate is firmly

held in place as the patient holds his or her mandibular teeth against the

occlusal pad of the surgical guide, there is no risk that the miniscrews can

slide on the bone surface during placement. The software program (2.5-dimensional

software) in this study combines 2-dimensional cephalograms with 3D virtual

dental models. This software is an effective and efficient alternative to 3D

software when 3D computed tomography data are not available. CONCLUSIONS: To

confidently and safely place a miniplate with screw fixation, a simple customized

guide for an orthodontic miniplate was introduced. The use of a custom-made,

rigid guide when placing miniplates will minimize complications such as vertical

mislocation or slippage of the miniplate during placement.