Long-term implant-related outcomes show that the survival rate of implants placed into the fibula is acceptable. Radiotherapy negatively impacts survival and success, in particular in the short and medium-term follow-up. Moreover, a relevant peri-implant bone resorption does occur over time and ultimately influences implants success, and it is mainly related to peri-implant gingival mucositis. In this regard skin or connective tissue grafts seem to offer an aid to manage this problem.

Background: Despite the limited number of articles dedicated to its use, augmented reality (AR) is an emerging technology that has shown to have increasing applications in multiple different medical sectors. These include, but are not limited to, the Maxillo-facial and Dentistry disciplines of medicine. In these medical specialties, the focus of AR technology is to achieve a more visible surgical field during an operation. Currently, this goal is brought about by an accurate display of either static or dynamic diagnostic images via the use of a visor or specific glasses. The objective of this study is to evaluate the feasibility of using a virtual display for dynamic navigation via AR. The secondary outcome is to evaluate if the use of this technology could affect the accuracy of dynamic navigation. Case presentation: Two patients, both needing implant rehabilitation in the upper premolar area, were treated with flapless surgery. Prior to the procedure itself, the position of the implant was virtually planned and placed for each of the patients using their previous scans. This placement preparation contributed to a dynamic navigation system that was displayed on AR glasses. This, in turn, allowed for the use of a computer-aided/image-guided procedure to occur. Dedicated software for surface superimposition was then used to match the planned position of the implant and the real one obtained from the postoperative scan. Accuracies, using this procedure were evaluated by way of measuring the deviation between real and planned positions of the implants. For both surgeries it was possible to proceed using the AR technology as planned. The deviations for the first implant were 0.53 mm at the entry point and 0.50 mm at the apical point and for the second implant were 0.46 mm at the entry point and 0.48 mm at the apical point. The angular deviations were respectively 3.05°and 2.19°. Conclusions: From the results of this pilot study, it seems that AR can be useful in dental implantology for displaying dynamic navigation systems. While this technology did not seem to noticeably affect the accuracy of the procedure, specific software applications should further optimize the results.

The trial has been registered and published in ClinicalTrials.gov (ID: NCT04942223).

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Aim: the aim of this in vitro study was to test whether the implant placement accuracy and the operating time can be influenced by the operator’s experience. Materials and methods: sixteen models underwent a (Cone Beam Computer Tomography) CBCT and implant positioning was digitally planned on this. The models were randomly assigned to four operators with different levels of surgical experience. One hundred and twelve implant sites were drilled using a dynamic navigation system and operating times were measured. Based on postoperative CBCTs, dental implants were virtually inserted and superimposed over the planned ones. Two-dimensional and 3D deviations between planned and virtually inserted implants were measured at the entry point and at the apical point. Angular and vertical errors were also calculated. Results: considering coronal and apical 3D deviations, no statistically significant differences were found between the four operators (p = 0.27; p = 0.06). Some vectorial components of the deviation at the apical point and the angular errors of some operators differed from each other. Conclusions: within the limitations of this study, dynamic navigation can be considered a reliable technique both for experienced and novice clinicians.