Accuracy of static computer-assisted implant placement in anterior and posterior sites by clinicians new to implant dentistry: in vitro comparison of fully guided, pilot-guided, and freehand protocols

Abduo, Jaafar; Lau, Douglas

doi:10.1186/s40729-020-0205-3

Cited by 41 publications

(34 citation statements)

References 28 publications

(84 reference statements)

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“…In an in vitro study by Abdou and Lau, implant location exhibited no influence on the accuracy of fully guided protocol. There was no decrease in the achieved accuracy, whether it was an anterior implant or posterior implant [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

Does the macro design of an implant affect the accuracy of template-guided implantation? A prospective clinical study

Schnutenhaus

Edelmann²,

Rudolph

2021

Int J Implant Dent

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Background An implant prosthesis aims to ensure the best possible rehabilitation of function and esthetics following tooth loss. Template-guided insertion is used to achieve an optimal position of the implant with regard to prosthetic restorability, bone availability, and condition of the surrounding soft tissues. The accuracy of template-guided implant placement is subject to various influencing factors. The clinically achievable accuracy depending on the macro design of the implant body was investigated in this prospective clinical study. Material and methods In this prospective clinical study, 20 implants were placed in 20 patients. The implant had a pronounced conical outer geometry (Conelog ProgressiveLine, Camlog Wimsheim, Germany). Data from a study using an implant with a distinct cylindrical outer geometry were used as a comparison group (Conelog ScrewLine, Camlog, Wimsheim, Germany). The clinically achieved implant position was compared with the planned position. Results The evaluation of the two-dimensional deviations in direction resulted in the following mean values (standard deviation) at the shoulder: 0.42 mm (0.33) in the buccolingual direction, 0.27 mm (0.25) in the mesiodistal direction, and 0.68 mm (0.55) in the apicocoronal direction. The mean angular deviation was 4.1° (2.3). The three-dimensional (3D) deviation was 0.94 mm (0.53) at the shoulder and 1.36 mm (0.62) at the apex of the implant. Significant differences between implants with different macro designs were found in the apicocoronal direction. In connection to this, a significant 3D deviation was found at the implant shoulder. Conclusions Significant differences in height were found between the groups. The study had shown that the macro design of an implant has no influence on accuracy in all other directions. Overall, the implants showed a high level of accuracy and a low variation in values. The values were in the range determined by the template-guided insertion system in numerous other investigations. This provides good predictability of prosthetic rehabilitation. Trial registration German Register for Clinical Studies (DRKS-ID: DRKS000018939). Date of registration: November 11, 2019.

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Section: Discussionmentioning

confidence: 99%

Does the macro design of an implant affect the accuracy of template-guided implantation? A prospective clinical study

Schnutenhaus

Edelmann²,

Rudolph

2021

Int J Implant Dent

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“…Besides that, discrepancies were usually smaller in in vitro studies than those in clinical studies, considering the disturbing factors like bad vision, movement of patients, and limited operating time [ 19 ]. Dental implant surgery uses global technological advances to enable the best possible dental care [ 20 ]. For example, there are first approaches of robotic surgery, which have been proven for both simple and complex clinical cases [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of implant placement accuracy in two different preoperative digital workflows: navigated vs. pilot-drill-guided surgery

et al. 2021

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Background The aim of the study is to evaluate the accuracy of a new implant navigation system on two different digital workflows. Methods A total of 18 phantom jaws consisting of hard and non-warping plastic and resembling edentulous jaws were used to stimulate a clinical circumstance. A conventional pilot-drill guide was conducted by a technician, and a master model was set by using this laboratory-produced guide. After cone beam computed tomography (CBCT) and 3D scanning of the master models, two different digital workflows (marker tray in CBCT and 3D-printed tray) were performed based on the Digital Imaging Communication in Medicine files and standard tessellation language files. Eight Straumann implants (4.1 mm × 10 mm) were placed in each model, six models for each group, resulting in 144 implant placements in total. Postoperative CBCT were taken, and deviations at the entry point and apex as well as angular deviations were measured compared to the master model. Results The mean total deviations at the implant entry point for MTC (marker tray in CBCT), 3dPT (3d-printed tray), and PDG (pilot-drill guide) were 1.024 ± 0.446 mm, 1.027 ± 0.455 mm, and 1.009 ± 0.415 mm, respectively, and the mean total deviations at the implant apex were 1.026 ± 0.383 mm, 1.116 ± 0.530 mm, and 1.068 ± 0.384 mm. The angular deviation for the MTC group was 2.22 ± 1.54°. The 3dPT group revealed an angular deviation of 1.95 ± 1.35°, whereas the PDG group showed a mean angular deviation of 2.67 ± 1.58°. Although there were no significant differences among the three groups (P > 0.05), the navigation groups showed lesser angular deviations compared to the pilot-drill-guide (PDG) group. Implants in the 3D-printed tray navigation group showed higher deviations at both entry point and apex. Conclusions The accuracy of the evaluated navigation system was similar with the accuracy of a pilot-drill guide. Accuracy of both preoperative workflows (marker tray in CBCT or 3D-printed tray) was reliable for clinical use.

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“…Various procedures for static guided implant placement have been established. For example, templates are used in which only the pilot drilling is carried out in a guided manner until the implant has been completely prepared and placed using the template [ 12 ]. It has been shown, however, that every single step in the digital workflow can lead to inaccuracies [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Accuracy of Dynamic Computer-Assisted Implant Placement: A Systematic Review and Meta-Analysis of Clinical and In Vitro Studies

Schnutenhaus

Edelmann²,

Knipper³

et al. 2021

JCM

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The aim of this systematic review and meta-analysis is to analyze the accuracy of implant placement using computer-assisted dynamic navigation procedures. An electronic literature search was carried out, supplemented by a manual search. The literature search was completed in June 2020. The results of in vitro and clinical studies were recorded separately from each other. For inclusion in the review, the studies had to examine at least the prosthetically relevant parameters for angle deviation, as well as global deviation or lateral deviation at the platform of the implant. Sixteen of 320 articles were included in the investigation: nine in vitro and seven clinical studies. The meta-analysis showed values of 4.1° for the clinical studies (95% CI, 3.12–5.10) and 3.7° for the in vitro studies (95% CI, 2.31–5.10) in terms of the angle deviation. The global deviation at the implant apex of the implant was 1.00 mm for the clinical studies (95% CI, 0.83–1.16) and 0.91 mm for the in vitro studies (95% CI, 0.60–1.12). These values indicate no significant difference between the clinical and in vitro studies. The results of this systematic review show a clinical accuracy of dynamic computer-assisted navigation that is comparable to that of static navigation. However, the dynamic navigation systems show a great heterogeneity that must be taken into account. Moreover, currently there are few clinical data available. Therefore, further investigations into the practicability of dynamic navigation seem necessary.

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Accuracy of static computer-assisted implant placement in anterior and posterior sites by clinicians new to implant dentistry: in vitro comparison of fully guided, pilot-guided, and freehand protocols

Cited by 41 publications

References 28 publications

Does the macro design of an implant affect the accuracy of template-guided implantation? A prospective clinical study

Does the macro design of an implant affect the accuracy of template-guided implantation? A prospective clinical study

Comparison of implant placement accuracy in two different preoperative digital workflows: navigated vs. pilot-drill-guided surgery

Accuracy of Dynamic Computer-Assisted Implant Placement: A Systematic Review and Meta-Analysis of Clinical and In Vitro Studies

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