Digital Accuracy in Comuputer Guided Surgery a Multicentre Prospective Study

Abstract

Background Digital technologies are becoming an irreplaceable assistance for a correct diagnosis and treatment planning of the dental therapy. Modern powerful software are able to match information coming from different sources (CBCT, IOS, lab and face scanners) creating a virtual patient where all the treatment options can be accurately tested. Guided surgery is based on the possibility to use these instruments to transfer the ideal plan directly into the operating theatre. However even in the hands of skilled operators there is always a difference between the position of the implant as determined on the virtual planning and the real position after the surgery. The aim of this multicenter prospective study is to test the advantages of the standardization of the digital workflow on the accuracy of the procedure. Methods 21 patients, for a total of 61 implants, have been treated in three different centers by operators with particular expertise in guided surgery. The accuracy of the procedure has been evaluated matching two files: the first from the pre-treatment virtual planning and the second from the optical impression taken immediately after the surgery. The digital workflow has been standardized using the same software for the planning, the same high quality manufacturing process, intraoral scanner and software for the overlapping procedure. Results All the implants showed an excellent primary stability. No intraoperative complications have been reported. The overlapping of the two files resulted in a mean angular deviation of 2.94°, a mean linear deviation at the platform of 0,73 mm and a mean vertical deviation at the apex of 0.01mm. Conclusions Almost the totality of the cases showed a better accuracy compared with the previous reported data of the literature. These results might be related with the standardization of the process so that following a precise protocol is mandatory for a safe use of this technique.