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Updated: Jun 14, 2025

Designing CAD/CAM Surgical Guides for Maxillary Reconstruction Using an In-house Approach
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Modified Surgical Guide for Root Sectioning in the Socket Shield Technique-In Vitro Study.

João Manoel de Mello Vasconcellos1, Daniel Valvassori Pereira1, Gisele Lie Fukuoka2

  • 1Faculdade São Leopoldo Mandic, São Paulo, Brazil.

Journal of Esthetic and Restorative Dentistry : Official Publication of the American Academy of Esthetic Dentistry ... [Et Al.]
|September 4, 2024
PubMed
Summary

Printed surgical guides improve root sectioning in the socket shield technique. These guides facilitate critical root division, enhancing predictability and maintaining root remnant thickness for successful outcomes.

Keywords:
CAD‐CAM guidebone preservationdental implantspartial extractionroot preparationsocket‐shield

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Area of Science:

  • Dental surgery
  • Implantology
  • Biomaterials

Background:

  • The socket shield technique is a recognized method for preserving alveolar bone during tooth extraction.
  • Accurate root sectioning is crucial for the success of the socket shield technique, but can be challenging.
  • Existing methods for root sectioning may lack precision, potentially affecting outcomes.

Purpose of the Study:

  • To evaluate the effectiveness of 3D-printed surgical guides for root sectioning in the socket shield technique.
  • To compare guided root sectioning with freehand methods in an in vitro setting.
  • To assess the impact of surgical guides on root remnant dimensions.

Main Methods:

  • An in vitro typodont model of the maxilla was used.
  • Two types of printed surgical guides (buccal sleeve and buccal orientation slit) were tested.
  • Root sectioning was performed using an ultrasonic tip with and without guides, with cone beam computed tomography (CBCT) imaging for analysis.

Main Results:

  • Both guided techniques significantly increased root width compared to freehand sectioning (p < 0.0001).
  • Group B (buccal orientation slit) showed a significant reduction in root remnant length compared to the control (p < 0.0043).
  • No significant difference in outcomes was observed between the two guided techniques.

Conclusions:

  • 3D-printed surgical guides effectively facilitate root sectioning in the socket shield technique.
  • Guided sectioning helps achieve desired root remnant width and length, improving predictability.
  • The use of surgical guides enhances safety by preventing soft tissue damage and ensuring adequate root remnant thickness (>1.5 mm).