The Influence of Surgical Experience and Bone Density on the Accuracy of Static Computer-Assisted Implant Surgery in Edentulous Jaws Using a Mucosa-Supported Surgical Template with a Half-Guided Implant Placement Protocol—A Randomized Clinical Study

Abstract

The aim of our randomized clinical study was to analyze the influence of surgical experience and bone density on the accuracy of static computer-assisted implant surgery (CAIS) in edentulous jaws using a mucosa-supported surgical template with a half-guided implant placement protocol. Altogether, 40 dental implants were placed in the edentulous jaws of 13 patients (novice surgeons: 18 implants, 6 patients (4 male), age 71 ± 10.1 years; experienced surgeons: 22 implants, 7 patients (4 male), age 69.2 ± 4.55 years). Angular deviation, coronal and apical global deviation and grey level measurements were calculated for all implants by a blinded investigator using coDiagnostiX software. 3DSlicer software was applied to calculate the bone volume fraction (BV/TV) for each site of implant placement. There were no statistically significant differences between the two study groups in either of the primary outcome variables. There was a statistically significant negative correlation between angular deviation and both grey level measurements (R-value: −0.331, p < 0.05) and BV/TV (R-value: −0.377, p < 0.05). The results of the study suggest that surgical experience did not influence the accuracy of implant placement. The higher the bone density at the sites of implant placement, the higher the accuracy of static CAIS.

Clinical accuracy of partially guided implant placement in edentulous patients: A computed tomography‐based retrospective study

“…(1.53 mm vs. 1.23 mm, 1.91 mm vs. 1.57 mm, 7.14° vs. 2.86°) (Vercruyssen et al, 2014) but was lower than that produced by experienced surgeons in a recent study (1.53 mm vs. 1.88 mm, 1.91 mm vs. 2.12 mm, 7.14° vs. 7.18°) (Kivovics et al, 2020). This result showed a comparable accuracy of the partially guided system in guiding implant placement in edentulous patients, and the global linear deviations were still within the 2 mm limit recommended by the 6th ITI consensus conference (Wismeijer et al, 2018).…”

Bone Temperature Variation Using a 3D-Printed Surgical Guide with Internal Irrigation

“…For this reason, various strategies have been advocated, including a copious and continuous irrigation, a frequent intermittent drill movement, the renovation of the drill kit after a certain usage and procedures for an improved cooling [16,19]. Other surgical strategies are pilot-drill guided surgery, half-guided surgery with a free-handed implant insertion and an open-flap guided surgery [22,23].…”

Investigation on the application of digital guide templates guided dental implantation in China

“…Lin et al [ 39 ] showed that when the tooth-supported guide template was used in a well-controlled environment, the surgical experience was not the key factor affecting the implant accuracy. Some scholars [ 37 ] studied the influence of surgical experience on the accuracy of the half-guided and the mucosa-supported guide templates and reached the same conclusion. Another study [ 40 ] showed that the depth deviation of the implant had the greatest impact on the surgical experience level (in vitro model experiment).…”

“…Some scholars also pointed out that the tooth position in the surgical area had no significant effect on the accuracy [ 36 ]. Kivovics et al [ 37 ] resulted in a weak and statistically significant negative correlation between BMD and angular deviation, the higher the BMD of the planting regions, the higher the accuracy. A possible interpretation of this result might be that it was more difficult to deviate from the path of the pilot drill in denser bone.…”