Accuracy of Guided Implant Surgery in 25 Edentulous Arches: A Laboratory Observational Study

Abstract

Purpose: To assess the accuracy of template-guided implant surgery for edentulous arches. Materials and Methods: The stone master casts of 25 edentulous arches treated with either 4 or 6 implants with CBCT generated template-guided surgery were included in this observational cohort study. The stone casts generated from the surgical templates (group one) prior to implant placement were digitized into Standard Tesselation (STL) files with a reference scanner. For comparison, the stone master casts derived from intraoral complete-arch impressions after implant placement (group two) were also digitized. The resultant STL files were superimposed and best-fit-alignment algorithm was used to quantify the 3D deviations present between the two groups. Descriptive statistics were computed for all categorical variables. Due to the presence of nonindependent samples between maxillary and mandibular casts, a mixed-effects model was used. Results: Deviations between the implant analogs of the stone casts representing digitally planned versus actually placed implants were found. The mean root-meansquare error (RMSE) between all 25 arches was found to be 0.2 mm (SD ± 0.15). The mean RMSE between presurgical and postsurgical maxillary stone casts were 0.19 ± 0.15 mm, while between mandibular stone casts were 0.21 ± 0.16 mm and were not significant (p = 0.67). The mean RMSE between presurgical and postsurgical stone casts arches with 4 versus 6 implants were found to be significant (p = 0.01). Conclusions: According to the results of the study and based on the amount of 3D deviations between the digitally planned implant positions and the actually placed implants, template-guided surgery is a safe treatment modality for implant placement in edentulous arches.

Prosthetically‐Driven Full‐Mouth Implant‐Supported Prostheses Using Guided Surgical Implant Planning with Composite Resin Markers: A Case Report

“…Static computer‐guided surgery for the treatment planning of edentulous patients frequently includes a dual CBCT scan procedure 8,9 . The conventional technique requires one CBCT of the patient with a radiographical guide or existing complete denture with radiographic markers positioned in the patient's mouth and a second CBCT of the radiographical guide or existing complete denture itself 3,8,9 . Previous authors have described variations of the conventional technique incorporating intraoral scanning technologies and requiring only one CBCT 22 .…”

“…Dental implant planning software programs are contingent on alignment accuracy of a patient's digital files 3,8,9 . In completely edentulous arches, radiopaque markers placed on intraoral devices or removable complete dentures have been recommended in a double CBCT scan protocol, which enables dataset alignment 8,9 . Static computer‐guided implant placement software programs allow the alignment of the dataset using an iterative closest point (ICP) algorithm 8,9 .…”

“…In completely edentulous arches, radiopaque markers placed on intraoral devices or removable complete dentures have been recommended in a double CBCT scan protocol, which enables dataset alignment 8,9 . Static computer‐guided implant placement software programs allow the alignment of the dataset using an iterative closest point (ICP) algorithm 8,9 . The algorithm also uses the root mean square (RMS) function to quantify 3D discrepancies between 2 aligned files aiming to assist superimposition accuracy 9,10,11 …”

“…Static computer‐guided implant placement software programs allow the alignment of the dataset using an iterative closest point (ICP) algorithm 8,9 . The algorithm also uses the root mean square (RMS) function to quantify 3D discrepancies between 2 aligned files aiming to assist superimposition accuracy 9,10,11 …”

Complete Digital Workflow for Mandibular Full‐Arch Implant Rehabilitation in 3 Appointments

“…Digital dental technology innovation and implementation is rapidly growing, and its clinical applications in implant dentistry translate into the so‐called digital workflow 1–5 . This workflow includes digital 3‐dimensional (3D) imaging, computer‐guided implant placement, digital impressions with intraoral scanner (IOS) systems, and computer‐aided design/computer‐aided manufacturing (CAD/CAM) 1–5 …”