Reducing errors in guided implant surgery to optimize treatment outcomes

Abstract

Clinical considerations and treatment criteria in implant placement are constantly evolving. Prosthetically driven implant surgery has become the standard of care to improve short and long‐term functional and esthetic outcomes. Therefore, implant position and angulation are planned according to the available bone, anatomical structures, and the requirements of the future prosthetic superstructure. In parallel with these developments, significant progress has been made in data imaging and different software technologies to allow the integration of data within a digital file format. Digitalization in implant surgery enables optimal planning of implant position, as well as the ability to transfer this planning to the surgical field—a process defined as “computer‐supported implant planning and guided surgery.” The aims of the present review are as follows: (a) to critically appraise the indications and potential “added value” of guided implant surgery, elaborating the main differences between dynamic and static guidance; and (b) to discuss the most important clinical considerations relevant for the different steps of the workflow that might influence the surgical outcome and to offer recommendations on how to avoid or reduce process errors in order to optimize treatment outcomes.

Can computer‐assisted implant surgery improve clinical outcomes and reduce the frequency and intensity of complications in implant dentistry? A critical review

“…There are many ways that increased accuracy is expected to influence clinical outcomes. Some authors have suggested that CAIS could reduce intraoperative complications by helping the surgeon avoid damaging sensitive anatomic structures such as the mandibular nerve and the sinus, as well as avoid proximity to roots of neighboring teeth 4 . Some have suggested CAIS could reduce the invasiveness, complexity, and duration of surgical interventions, while others have reported increasing patients’ satisfaction and acceptance 5 .…”

Comparison of the accuracy of immediate implant placement using static and dynamic computer-assisted implant system in the esthetic zone of the maxilla: a prospective study

“…Though the drill and surgical site’s motion are tracked in real-time, the CBCT images are undertaken with a registration device before the surgery. Therefore, the calibration must be performed before drilling with every change of drills to ensure accuracy in implant drilling and placement [ 25 ]. Compared to a static system, a dynamic navigation system has an inherently reasonable learning curve to allow for proficiency to be achieved [ 34 ].…”

“…However, there were only 12 patients involved. Generally, two types of the CAIS technique have been introduced in the previous literature, described as static and dynamic guidance systems [25]. The static approach utilizes a pre-manufactured surgical template to guide drills and implants sequentially to the ideal planned position.…”

It is all about peri‐implant tissue health

“…Apart from numerous other potential advantages, the implementation of guided implant surgery also offers the benefit of ensuring an adequate cleansability, thus contributing to the maintenance of peri‐implant health. Chackartchi et al 16 contribute a state‐of‐the‐art review in this volume on “computer‐supported implant planning and guided surgery” that should encourage clinicians to revisit the potential advantages of this digital workflow.…”