Multivariate analysis of causal factors influencing accuracy of guided implant surgery for partial edentulism: a retrospective clinical study

Abstract

Background In dental implant treatment, the placement position of the implant body is important. The hypothesis is that there are factors that have a greater impact than the factors that have been studied so far. Material and Methods The deviation between planned and actually placed implants was measured three-dimensionally by modified treatment evaluation method in 110 patients who underwent implant placement with guided surgery for partial edentulism. Ten factors that seemed to affect errors in placement were selected: the type of tooth, type of edentulism, distance from the remaining teeth, the type of implant, implant length, number of implants, method of guidance, the number of teeth supporting the surgical guide, number of anchor pins, and presence or absence of a reinforcement structure. The effect of each factor that corrected each confounding was calculated using multivariate analysis. Results In this study, 188 implant bodies were set to target, and the errors measurement data of the implant position were as follows: average Angle, 2.5 ± 1.6° (95% CI 2.25–2.69); Base, 0.67 ± 0.37 mm (95% CI 0.62–0.72); and Apex, 0.92 ± 0.47 mm (95% CI 0.86–0.98). As the result of multivariate analysis, larger errors were present in the partially guided group than the fully guided group. The number of teeth supporting the surgical guide significantly influenced the error in placement position. The error caused by the number of anchor pins was significantly different for the Angle. Similarly, the presence of the reinforcement structure influenced the error significantly for the Angle. Conclusions It was suggested that the smaller errors could be present by performing guided surgery with full guidance and devising the design of the guide such as the number of teeth supporting the surgical guide, the setting of the anchor pin, and the reinforcement structure.

Accuracy of commercial 3D printers for the fabrication of surgical guides in dental implantology

“…However, surgical guides supported by only two teeth demonstrated significantly higher deviation values than implants placed using surgical guides supported by four teeth or more. Moreover, Matsumura et al [10] showed that an insufficient number of teeth supporting the guide, or an excess of teeth supporting the guide can influence errors of implant positioning during guided surgery. Balance fit and stability were therefore not sufficient to allow an accurate implant placement.…”

“…The deviation between the planned and effective implant position can be caused by multiple factors. Based on the literature, the error factors can be classified in three categories (i) clinical situation derived factor [8,9], (ii) implant system derived factors [10] and (iii) surgical guide design [11,12] and manufacturing derived factor [13,14]. For example, Putra et al [15] showed in a literature review that guides produced by a conventional method induce a higher angular deviation than a 3D-printed guide.…”

Accuracy of implant placement with computer-aided static, dynamic, and robot-assisted surgery: a systematic review and meta-analysis of clinical trials

“…Similar to the prospective study design, a total of twenty-one retrospective non-RCTs [ 7 , 19 , 25 , 31 – 37 , 41 , 45 , 47 , 48 , 51 , 60 , 62 , 63 , 67 , 70 , 78 ] were assessed using Robin-I. According to Fig.…”

In vitro and in vivo accuracy of autonomous robotic vs. fully guided static computer‐assisted implant surgery

“…On one hand, the clinical outcomes of the fully guided system mainly depended on the operation and experience of surgeons, leading to hand tremors and inaccurate perception easily. 33,34 The intrinsic errors, such as the misfit of the guide or the metal sleeve and drills, affected the accuracy. Additionally, the positioning error of the 3D digital implant guide and interference of the opposing dentition hindering the correct positioning of the drills and implant might cause an operating error.…”

“…There were differences between autonomous robotic implant surgery and fully guided sCAIS in resulting accuracy. On one hand, the clinical outcomes of the fully guided system mainly depended on the operation and experience of surgeons, leading to hand tremors and inaccurate perception easily 33,34 . The intrinsic errors, such as the misfit of the guide or the metal sleeve and drills, affected the accuracy.…”