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

Abstract

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.

Accuracy and primary stability of tapered or straight implants placed into fresh extraction socket using dynamic navigation: a randomized controlled clinical trial

“…The accuracy was 0.86 mm, 0.76 mm, and 2.49° for tapered implants, 0.94 mm, 0.89 mm, and 2.06° for straight implants, demonstrating that both tapered and straight implants were suitable for dynamic navigation assisted immediate implant placement. This was in accordance with previous studies [18,28] comparing these two approaches under static templates in regular cases.…”

“…Many clinicians tend to choose tapered implants because this macrodesign facilitates implant into the prepared hole [16]. Recently, a model study [17] corroborated tapered implants gained better accuracy than straight implants under static surgical guide, due to the vertically fluted tapered drill design and its influence on osteotomy accuracy, while a clinical trial [18] demonstrated straight implant achieved better accuracy at the entry point. To date, the role of implant macrodesign on accuracy in immediate implant placement has not been clarified so far.…”

Comparison of the accuracy of implant placement using different drilling systems for static computer‐assisted implant surgery: A simulation‐based experimental study

“…Tapered implants were found to have less platform, apex and angle deviation than the cylindrical ones. In another clinical study, the implant macro design was shown to only affect the vertical deviation at platform implant 26 . All the implants used in this study were of taper design, but there was a variation in the extent of tapering and some macro design elements such as the design of threads.…”

A comparative retrospective study of different surgical guide designs for static computer‐assisted implant surgery in posterior single edentulous sites

“…An in vitro study from El Kholy, Lazarin, et al (2019) found that in sCAIS, tapered implants (BTL) presented higher accuracy compared to parallel wall implants (TL and BL). However, in a recent prospective clinical study, it was found that implant macrodesign (tapered vs. parallel wall) had no influence on the accuracy of fully guided implant placement in any three‐dimensional direction (Schnutenhaus et al, 2021). Even though there is limited evidence in regard to the effect of implant macrodesign in sCAIS, it is worthwhile noting that the majority of the implants analyzed in the present study's control group were BLT placed with relatively shorter distances to the osteotomy bed, which could lead to a possible over‐interpretation of the results.…”

“…Recent studies have been investigating the effect of different implant macrodesigns and systems in the accuracy of guided implant surgery (El Kholy, Ebenezer, et al, 2019; Schnutenhaus et al, 2021; Yeung et al, 2020). In this study, the overall implant macrodesigns used were BLT (46.3%), TL (37.0%), and BL (16.7%), selected based on the patients’ local soft and hard tissue anatomy.…”