Guidance means accuracy: A randomized clinical trial on freehand versus guided dental implantation

Barootchi, Shayan; Antal, Márk; Major, László; Kiscsatári, Ramóna; Braunitzer, Gábor; Piffkò, József

doi:10.1111/clr.13578

Cited by 85 publications

(102 citation statements)

References 25 publications

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“…Clinically, a fully guided surgery protocol might be recommended to minimize the deviation. Two RCT studies comparing different guided surgery protocol also reported that fully guided surgery protocol showed better results in comparison with the cases using a surgical guide plate only at pilot drill [29,30].…”

Section: Discussionmentioning

confidence: 96%

Influence of bone condition on implant placement accuracy with computer-guided surgery

et al. 2020

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Background The impact of the jaw bone condition, such as bone quantity and quality in the implant placement site, affecting the accuracy of implant placement with computer-guided surgery (CGS) remains unclear. Therefore, this study aimed to evaluate the influence of bone condition, i.e., bone density, bone width, and cortical bone thickness at the crestal bone on the accuracy of implant placement with CGS. Methods A total of 47 tissue-level implants from 25 patients placed in the posterior mandibular area were studied. Implant placement position was planned on the simulation software, Simplant® Pro 16, by superimposing preoperative computed tomography images with stereolithography data of diagnostic wax-up on the dental cast. Implant placement surgery was performed using the surgical guide plate to reflect the planned implant position. The post-surgical dental cast was scanned to determine the position of the placed implant. Linear and vertical deviations between planned and placed implants were calculated. Deviations at both platform and apical of the implant were measured in the bucco-lingual and mesio-distal directions. Intra- and inter-observer variabilities were calculated to ensure measurement reliability. Multiple linear regression analysis was employed to investigate the effect of the bone condition, such as density, width, and cortical bone thickness at the implant site area, on the accuracy of implant placement (α = 0.05). Result Intra- and inter-observer variabilities of these measurements showed excellent agreement (intra class correlation coefficient ± 0.90). Bone condition significantly influenced the accuracy of implant placement using CGS (p < 0.05). Both bone density and width were found to be significant predictors. Conclusions Low bone density and/or narrow bucco-lingual width near the alveolar bone crest in the implant placement site might be a risk factor influencing the accuracy of implant placement with CGS.

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Section: Discussionmentioning

confidence: 96%

Influence of bone condition on implant placement accuracy with computer-guided surgery

et al. 2020

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“…In addition, the drilling procedure executed in post‐extraction sockets augmented the distance from sleeve to the bone, and this fact has been also related with inaccuracy of the guided surgery 26 . Despite these factor, the degree of deviation showed in this study was within the range found by other clinical studies, 19,23,25 and it is likely that factors such as the use of tooth ‐supported guides guide, the installation of the implants in the anterior region and the method of making the guide by association of tomography with oral scanning may have reduced the effects of alteration in the accuracy of the guided surgery 21 by the factors mentioned above.…”

Section: Discussionmentioning

confidence: 48%

“…One of the parameters that may influenced the accuracy of the guided surgery is the degree of the perforation that the clinician can performed using the guides 19 . The surgery is considered fully guided whenever a 3D printed surgical stent is used to prepare the implant site with proper surgical drills and the implant is installed with the stent in position 13 .…”

Section: Introductionmentioning

confidence: 99%

“…The surgery is considered fully guided whenever a 3D printed surgical stent is used to prepare the implant site with proper surgical drills and the implant is installed with the stent in position 13 . A modification of this technique involves performing a partially guided surgery, during which the stent is used only to facilitate site perforation with one or more drills 19 . Although it can be logically assumed that in ridges, fully guided surgery will outperform partially guided surgery, 20,21 there is a lack of scientific evidence and a clinical consensus of which type of surgery is best for post‐extraction sockets; since in these cases, the partially guided procedure enables intra‐surgical manual verification of the direction of the perforations and implants installation and provided more tactile sensations of the insertion torque during the implants placement 22 .…”

Section: Introductionmentioning

confidence: 99%

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Impact of fully or partially guided surgery on the position of single implants immediately placed in maxillary incisor sockets: A randomized controlled clinical trial

Kraft¹,

Frizzera

Freitas³

et al. 2020

Clin Implant Dent Rel Res

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The aim of this study was to compare the deviation of the implant position after placement in single maxillary incisor post-extraction sockets between fully and partially guided surgery. Materials and methods: Twenty-four patients with a failing maxillary incisor were randomly allocated into two groups: the partially guided surgery (PGS, n = 12) group or fully guided surgery (FGS, n = 12) group. Clinical analyses, intra-oral scans, and computed tomography scans (CT) were initially performed to define the virtual positioning of the implants and fabrication of the 3D printed surgical guides. A narrow, 3.5 × 16 mm implant was placed in each socket. In this moment, the insertion torque (IT) was assessed and resonance frequency analysis (RFA) was performed. All patients received an immediate provisional without occlusal contacts. Another CT scan was performed after the procedures to compare the implant position with the virtually planned position. Results: Significant deviations occurred at the implant apex, according to the global and facial-palatal analyses, in comparison to its cervical position. The PGS group also presented a larger deviation in the MD position. No statistical differences between the groups were detected, however, there was a tendency of lower angular deviation in the PGS group. Conclusions: While there was a slight deviation from the virtually planned position of the implant to the actual position and a tendency of lower angular deviation in the PGS group, there was no difference among groups regarding its position and primary stability.

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“…However, the main challenge for the prosthetic treatment team (dentist, dental technician) in the implementation of a fully digital All-on-X workflow is to transfer the final implant position to the definitive restoration. The deviations between the virtually planned and the real implant position must be balanced out even with guided implantation [ 18 – 25 ].…”

Section: Introductionmentioning

confidence: 99%

The Digital Abutment Check: An Improvement of the Fully Digital Workflow

Hinz

Ellmann²,

Wegner

et al. 2020

Case Reports in Dentistry

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By using modern digitalization techniques, an existing denture can be digitized and aid the provision of a new implant-supported denture according to a fully digital workflow. This includes fully navigated implant surgery and results in an immediately provided prosthetic restoration. However, even with the current digital workflow, it is challenging to achieve a definitive prosthetic restoration in a single treatment session. In order to achieve a definitive denture in as few treatment sessions as possible, we have implemented the digital abutment test. This test modified the existing data set and determined the final restoration. In the present case, the preexisting maxillary removable complete denture was converted into a fixed immediate restoration using the fully digital workflow. The workflow is divided into two treatment phases, each with three treatment sessions, where part of the second phase involves an innovative digital abutment check. The illustrated case shows an effective use of current digital possibilities. Special attention was also paid to a minimally invasive course of therapy.

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Guidance means accuracy: A randomized clinical trial on freehand versus guided dental implantation

Cited by 85 publications

References 25 publications

Influence of bone condition on implant placement accuracy with computer-guided surgery

Influence of bone condition on implant placement accuracy with computer-guided surgery

Impact of fully or partially guided surgery on the position of single implants immediately placed in maxillary incisor sockets: A randomized controlled clinical trial

The Digital Abutment Check: An Improvement of the Fully Digital Workflow

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