Accuracy of Computer-Assisted Dynamic Navigation as a Function of Different Intraoral Reference Systems: An In Vitro Study

Abstract

The aim of this in vitro study was to determine whether the process chain influences the accuracy of a computer-assisted dynamic navigation procedure. Four different data integration workflows using cone-beam computed tomography (CBCT), conventional impressions, and intraoral digitization with and without reference markers were analyzed. Digital implant planning was conducted using data from the CBCT scans and 3D data of the oral models. The restoration of the free end of the lower jaw was simulated. Fifteen models were each implanted with two new teeth for each process chain. The models were then scanned with scan bodies screwed onto the implants. The deviations between the planned and achieved implant positions were determined. The evaluation of all 120 implants resulted in a mean angular deviation of 2.88 ± 2.03°. The mean 3D deviation at the implant shoulder was 1.53 ± 0.70 mm. No significant differences were found between the implant regions. In contrast, the workflow showed significant differences in various parameters. The position of the reference marker affected the accuracy of the implant position. The in vitro examination showed that precise implantation is possible with the dynamic navigation system used in this study. The results are of the same order of magnitude that can be achieved using static navigation methods. Clinical studies are yet to confirm the results of this study.

Accuracy of a dynamic navigation system for dental implantation with two different workflows and intraoral markers compared to static‐guided implant surgery: An in‐vitro study

“…The results of this investigation confirmed the suitability of the Denacam dCAIS system regarding accuracy in oral implant surgery as previous investigations already demonstrated (Edelmann et al, 2021; Schnutenhaus et al, 2021; Spille et al, 2021). The present study was conducted to investigate the accuracy in three different regions with two different dCAIS workflows and to compare it with the gold standard method of sCAIS (Gargallo‐Albiol et al, 2020).…”

“…The camera observes the position of the handpiece in relation to the marker and shows on a screen the positional and axial corrections which have to be performed in order to realize the virtually planned implant position. First in‐vitro investigations and one clinical study showed promising results regarding the accuracy (Duré et al, 2021; Edelmann et al, 2021; Schnutenhaus et al, 2021; Spille et al, 2021). One interesting issue of this novel technique for guided surgery is represented by the different workflows that can be used to include the reference elements into the software for planning: The reference element can either be placed and fixed during CBCT acquisition with thermoplastic material, or this matrix can virtually be placed into a pre‐existing CBCT, then 3D‐printed and fixed on the patient's teeth during surgery.…”

Autonomous Robotic Surgery for Immediately Loaded Implant-Supported Maxillary Full-Arch Prosthesis: A Case Report

“…First, the CBCT scan errors were determined by voxel size, exposure time, field of view, and metal artifacts, which influenced the initial data acquisition [ 31 ]. Similar to the dynamic dental implant navigation system, the placement and fixation of the marker were affected by the marker type, fabrication, and position using the robotic surgery system [ 32 ]. In addition, the robot arm has intrinsic errors, and the average positioning accuracy (trueness) is 0.156 mm, provided by the manufacturer.…”

Accuracy of Dental Implant Placement with Dynamic Navigation—Investigation of the Influence of Two Different Optical Reference Systems: A Randomized Clinical Trial

“…The mouth opening, possible movements of the patient and the possibly restricted view of the surgical field in the posterior region can have an influence on the accuracy [27]. The material of the reference markers used can lead to artifacts and thus have an influence on the accuracy [28] as well as the positioning of the fiducial markers themselves [29]. Another possible source of inaccuracies are the individual steps of the digital workflow, which can add up [11].…”