ObjectivesGuided implant surgery (GIS) is performed with drilling guides that are produced on the virtual tooth model using CAD/CAM technology. The prerequisite for this workflow is the alignment of patients cone beam computed tomography CBCT and surface scan (registration). Dental restorations may cause deteriorating imaging artifacts in CBCT data, which in turn can have an impact on the registration process. The influence of the user and the preprocessing of data and of image artifacts on the registration accuracy were examined.Material and Methods CBCT data and intraoral surface scans of 36 patients were used for virtual implant planning in coDiagnostiX (Dentalwings, Montreal, Canada). CBCT data were reconstructed to a three‐dimensional anatomical model with the default settings provided by the software and also manually by four different examiners. Subsequently, the CBCT and intraoral surface models were registered by each examiner with the help of anatomical landmarks. Patients' data were subdivided into four groups (A–D) according to the number of metallic restorations: A = 0–2 restorations, B = 3–5 restorations, C = 6–8 restorations and D > 8 restorations. After registration, the distances between CBCT and dental surface models were measured. Linear regression models were used to assess the influence of the segmentation, the examiner and to the number of restorations (P < 0.05).ResultsThe deviations between surface scan and CBCT models accounted to 0.54 mm (mean). The mean deviations were 0.69 mm (max. 24.8 mm) and 0.4 mm (max. 9.1 mm) for default and manual segmentation, respectively. Mean deviations of 0.36 mm (Group A), 0.43 mm (Group B), 0.67 mm (Group C) and 1.01 mm (Group D) were recorded.The segmentation (P = 0.000), the user (P = 0.0052) and the number of restorations (P = 0.0337) had a significant influence on the registration accuracy.ConclusionsThe deviation between CBCT and surface scan model resulting from inaccurate registration is transferred to the surgical field and results in a deviation between the planned and actual implant position. The registration accuracy in commercial virtual implant planning software is significantly influenced by the preprocessing of imported data, by the user and by the number of restorations resulting in clinically non‐acceptable deviations encoded in drilling guides.

Objectives:The purpose of this prospective cohort study was to evaluate computerguided implant surgery with tooth-supported drill guides based on CBCT scans and intraoral scanning. Materials and methods:For partially edentulous patients, a prosthetic and surgical planning was completed in the guided surgery software (coDiagnostiX) and drill guides were 3D-printed accordingly. Three months after implant placement, an intraoral scan of the implant's position was used to evaluate the accuracy of placement using the coDiagnostiX treatment evaluation tool. Deviations were reported in degrees and in distance at implant's entry point and apex. Several risk factors, which might influence the accuracy, were evaluated separately: treated jaw, flap design, prior augmentations, amount of unrestored teeth, crowding, location of implants, cortical interference, and implant's length and diameter.

Objectives: Working Group 5 was assigned the task to review the current knowledge in the area of digital technologies. Focused questions on accuracy of linear measurements when using CBCT, digital vs. conventional implant planning, using digital vs.conventional impressions and assessing the accuracy of static computer-aided implant surgery (s-CAIS) and patient-related outcome measurements when using s-CAIS were addressed. Materials and methods:The literature was systematically searched, and in total, 232 articles were selected and critically reviewed following PRISMA guidelines. Four systematic reviews were produced in the four subject areas and amply discussed in the group. After emendation, they were presented to the plenary where after further modification, they were accepted.Results: Static computer-aided surgery (s-CAIS), in terms of pain & discomfort, economics and intraoperative complications, is beneficial compared with conventional implant surgery. When using s-CAIS in partially edentulous cases, a higher level of accuracy can be achieved when compared to fully edentulous cases. When using an intraoral scanner in edentulous cases, the results are dependent on the protocol that has been followed. The accuracy of measurements on CBCT scans is software dependent. Conclusions:Because the precision intraoral scans and of measurements on CBCT scans and is not high enough to allow for the required accuracy, s-CAIS should be considered as an additional tool for comprehensive diagnosis, treatment planning, and surgical procedures. Flapless s-CAIS can lead to implant placement outside of the zone of keratinized mucosa and thus must be executed with utmost care. K E Y W O R D Saccuracy, computer-aided surgery, cone beam computed tomography, intraoral scans, oral implantology, patient-reported outcome measures sidering standardized conditions, and (b) it is crucial to address the software version and used scan protocol for further studies to create a reliable database for accurate statistical analyses.Although in clinical practice, single unit restorations are being performed using a digital workflow, there is a need for further research to conclude if it is a predictable and reliable procedure when compared to the conventional workflow.• There is a lack of literature about the accuracy of different intraoral scan bodies in terms of geometry, dimension, material, and surface characteristics. More studies regarding these aspects should be conducted.• In studies using scan bodies, design, and characteristics should be defined to make studies comparable.• Regarding multiple implant-supported restorations for partially dentate or edentulous cases, different scanning protocols should be developed and compared.The influence of distance between scan bodies, length and geometry of the edentulous span, mucosal morphology, and on the accuracy of digital impressions should be studied.The aim of this systematic review was to identify studies that assessed the accuracy of linear measurements of bone dimensions related to implant...

Objective To systematically evaluate the scientific literature for patient‐reported outcome measures (PROMs) in static computer‐aided implant surgery (s‐CAIS). Methods A PICO strategy was executed using an electronic (MEDLINE, EMBASE, CENTRAL), plus manual search up to 15‐06‐2017 focusing on clinical studies investigating s‐CAIS with regard to patients’ pain & discomfort, economics and/or intra‐operative complications. Search strategy was assembled from multiple conjunctions of MeSH Terms and unspecific free‐text words. Assessment of risk of bias in selected studies was made at a “trial level” applying the Cochrane Collaboration Tool and the Newcastle–Ottawa Assessment Scale, respectively. Results The systematic search identified 112 titles. Seventy abstracts were screened, and 14 full texts were included for analysis. A total of 484 patients were treated with s‐CAIS for placement of 2,510 implants. Due to the heterogeneity of the included studies, meta‐analyses could not be performed. Conclusions The number of identified studies investigating s‐CAIS for PROMs was low. Scientifically proven recommendations for clinical routine cannot be given at this time; however, the number of clinical complications with s‐CAIS seems to be negligible and comparable to conventional implant surgery. s‐CAIS may offer a beneficial treatment option in edentulous cases if a flapless approach is applicable. Nevertheless, the economic effects in terms of time efficiency and treatment costs are unclear. Clinical investigations with well‐designed RCTs investigating PROMs with standardized parameters are compellingly necessary for the field of s‐CAIS.

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