Effects of autoclave sterilization on the dimensional stability of implant surgical guides: A 3D in vitro analysis.

Abstract

Purpose: Surgical guides are medical devices used in static implant surgery to replicate the prosthetic and surgical implant position planned with computer-assisted software before surgery. Their use reduces invasiveness and improves safety and outcomes of implant surgery, provided that their accuracy is ensured from design to manufacturing and then to clinical usage. One of the factors that may potentially interfere with their accuracy is the sterilization procedure. The present study aimed to analyze how autoclave sterilization affects 3D-printed surgical guide stability.

Materials and methods: Ten 3D-printed surgical guides were scanned before (T0) and after (T1) autoclave sterilization. T0 and T1 scans were compared with the corresponding CAD model in a surface matching software program. Trueness of the intaglio surface, linear and axial deviations of sleeves' housings at T0 and T1 were measured and statistically analyzed by generalized estimated equation (GEE) models to evaluate the effects of the sterilization procedure.

Results: Surface variations, linear and axial deviations of sleeves' housings were found to be significantly (p < 0.05) affected by the sterilization only in combination with the volume or the total surface area of the surgical guides. The magnitude of the T0-T1 differences was small (0.016 mm and 0.035 mm for mean absolute deviation (MAD) at the intaglio surface in contact with teeth or mucosa; 0.009 mm for linear deviation of the central point of sleeves' housings; 0.084° and 0.180° for their axial deviation on the sagittal and frontal planes).

Conclusion: The effects of autoclave sterilization on the stability of 3D-printed surgical guides remain limited and clinically insignificant.