Assessment of metal sleeve-free 3D-printed implant surgical guides

Objectives. The aim of the present study was to investigate the adaptation and guide hole tolerance of metal sleeve-free computer-assisted implant surgical guides fabricated with 3D printers. Methods. An implant surgical guide for full-guided implant placement was designed with a total of eight different guide holes. Ten implant surgical guides (n=10) were fabricated from the same design with each of five in-office 3D printers (D1, FOR, ONE, PER, and ZEN) using compatible printing materials. Ten surgical guides fabricated by the manufacturer of the implant company were used as the control group (CON). The adaptation of the surgical guides was evaluated by the replica technique. The tolerance of the guide holes was evaluated by measuring the degree of diversion with guide drills. Results. CON and D1 showed superior internal adaptation with a gap distance of less than 1 mm. The mean degree of diversion of the guide holes ranged from 3.45 degrees for ZEN to 6.55 degrees for PER. The tolerances of CON (4.70 degrees) and D1 (4.50 degrees) did not differ at the level of statistical significance at alpha = 0.05. Significance. The characteristics of implant surgical guides were evaluated per se. None of the 3D printers fabricated superior implant surgical guides to those produced by the manufacturer with regard to the internal fit and guide tolerance. However, the potential for the routine clinical use of in-office 3D printers was demonstrated. Further studies are required to determine how the guide hole tolerance and the angular deviation between the preplanned and actual implant positions are related. (C) 2019 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.