Computer-aided planning and manufacturing surgical guides in accordance with CB(CT) images may help clinicians place implants. Rigid screw fixation of a single guide incorporating metal sleeves and a special drill kit further minimizes deviations.
The use of mucosa-supported single SLA guides for flapless implant placement may help reduce the surgery duration, pain intensity, related analgesic consumption and most other complications typical in the post-implant surgery period. However, there are particular drawbacks in both guide types and further studies are required to confirm the prosthodontic conformity and long-term success of implants placed using computer-assisted techniques.
NDIs can be used with confidence where a regular diameter implant is not suitable. MBL around NDIs occurred predominantly within 2 years of loading and was minimal thereafter. Further studies are required to clarify the possible risks associated with smoking and posterior placement.
In this clinical trial, adjunct use of diode laser did not yield any additional positive influence on the peri-implant healing compared with conventional scaling alone.
Objectives
The aim of this split‐mouth randomized controlled clinical trial was to compare the deviations of planned and placed implants placed by the assistance of a micron tracker‐based dynamic navigation device or freehand methods.
Material and methods
A thermoplastic fiducial marker was adapted on the anterior teeth, and cone‐beam computerized tomography was used for imaging. A minimum of one implant was planned for each side of the posterior maxilla, and the dynamic navigation device or freehand method was randomly used for surgical insertion. Deviations were measured by matching the planning data with a final CBCT image. Linear deviations (mm) between the planned and placed implants were the primary outcome. The results were analysed by generalized linear mixed models (p < .05). (NCT03471208).
Results
A total of 92 implants were placed to 32 volunteers, and 86 implants were included in the final analysis. For the linear deviations, mean of differences (Δ) was 0.72mm (Standard deviation (SD): 0.26); (95% Confidence interval (CI): 0.39–1.02) in the shoulder of the implants (p < .001) and 0.69mm (SD: 0.36); (95% CI: 0.19–1.19) in the tip of the implants (p < .001). For the angular deviations, Δ was 5.33° (SD: 1.63); (95% CI: 7.17–3.48); (p < .001).
Conclusions
The navigation technique can be used to transfer virtual implant planning to the patient's jaw with increased accuracy.
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