Background The insertion of dental implants by means of computer‐assisted template‐based surgery is an established method. Purpose To investigate the accuracy of a newly developed sleeve‐designed template and to evaluate differences between maxillary and mandibular implants as well as anterior versus posterior area. Materials and Methods Any partially edentulous patients requiring at least one implant to be planned on three‐dimensional cone beam computed tomography scan, according to a computer‐assisted template‐based protocol, were consecutively enrolled at two centers. Any potential implant position was considered eligible for the present trial. Outcome measures were: implant failure, complications, and accuracy. Results A total of 39 patients with 119 implants were evaluated. No patients dropped out during the study period (mean follow‐up 12.4 ± 7.1 months). Three implants failed at centre two, whereas, one complication was experienced at centre one (limited access in posterior area). Differences were not statistically significant (P > .05). The mean deviations were 0.53 ± 0.46 mm (range 0.05‐3.38 mm; 95% CI 0.32‐0.48 mm) in the horizontal plan (mesio‐distal); 0.42 ± 0.37 mm (range 0.0‐1.53 mm; 95% CI 0.26‐0.40 mm) in the vertical plan (apico‐coronal); and 1.43 ± 1.98° (range 0.03‐11.8°; 95% CI 0.31‐1.01°) in angle. Differences between centers were compared using the nonparametric Mann‐Whitney U test (P > .05). More accurate results were found for anterior implants in both horizontal plan and angle. Conclusion This study showed good precision in all the parameters measured. The results were thus in a range equal to or better than the mean precision found in numerous clinical trials described in the literature. Posterior implants were less accurate because of the use of open sleeves template.
Purpose: To compare virtual planning accuracy of novel computer-assisted, template-based implant placement techniques, which make use of CAD/CAM stereolithographic surgical templates with or without metallic sleeves. Furthermore, to compare open versus closed sleeves for templates without metallic sleeves. Materials and methods: Any partially edentulous patients requiring at least one implant to be placed according to a computer-assisted template-based protocol were enrolled. Patients were randomized according to a parallel group design into two arms: Surgical template with or without metallic sleeves. Three deviation parameters (angular, horizontal, vertical) were defined to evaluate the discrepancy between the planned and placed implant positions. Results: No implants failed, and no complications were experienced. Forty-one implants were placed using surgical templates with metallic sleeves while 49 implants were placed with a surgical template without metallic sleeves. Of these, 16 implants were placed through open sleeves and 33 through closed sleeves. There was a statistically significant difference in angle (p = 0.0212) and in the vertical plan (p = 0.0073) with lower values for implants placed with a surgical template without metallic sleeves. In the test group, close sleeves were more accurate compared with open sleeves in angle (p = 0.0268) and in horizontal plan (p = 0.0477). Conclusion: With the limitations of the present study, surgical templates without metallic sleeves were more accurate in the vertical plan and angle compared to the conventional template with metallic sleeves. Open sleeves should be used with caution in the molar region only in case of reduced interarch space. Further research is needed to confirm these preliminary results.
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