A randomized controlled study on the accuracy of free‐handed, pilot‐drill guided and fully guided implant surgery in partially edentulous patients

Younes, Faris; Cosyn, Jan; Bruyckere, Thomas De; Cleymaet, Roberto; Bouckaert, Eline; Eghbali, Aryan

doi:10.1111/jcpe.12897

Cited by 133 publications

(225 citation statements)

References 35 publications

(72 reference statements)

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“…Fr. Similar clinical studies conducted with static guides and in partial edentulousness reported 6.99° (Younes et al, 2018) and 9.8° (Nickenig et al, 2010). In our study, Pi yielded a mean AD of 5.71°, comparable to the 5.95° reported in the study of Younes et al (2018).…”

Section: Discussionsupporting

confidence: 88%

“…Dynamic systems offer real-time visualization during surgery, but their accuracy is lower than that of static systems (Jung et al, 2009). Furthermore, they are expensive and occupy considerable space (Younes et al, 2018), and their use is not always straightforward (Jorba-Garcia, Figueiredo, Gonzalez-Barnadas, Camps-Font, & Valmaseda-Castellon, 2019).…”

Section: Introductionmentioning

confidence: 99%

“…The accuracy of tooth-supported guides for partial edentulous cases (Arisan, Karabuda, & Ozdemir, 2010) is another under-discussed aspect, while it is safe to assume that partial edentulousness is a frequent reason for dental implantation. Finally, remarkably few RCTs are available on template-based dental implant surgery in general (Vercruyssen et al, 2014;Younes et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

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Guidance means accuracy: A randomized clinical trial on freehand versus guided dental implantation

Barootchi¹,

Antal

Major

et al. 2020

Clinical Oral Implants Res

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Objectives: A randomized clinical trial was conducted to compare all three known static guided surgery protocols (pilot, partial, and full) with each other and with freehand surgery in terms of accuracy, under the same conditions. Material and Methods:A total of 207 implants of the same brand and type were placed in 101 partially edentulous volunteers in need of implantation in the mandible or maxilla or both. All cases were digitally planned, and the comparison of the planned and actual implant positions was performed using a medical image analysis software with dedicated algorithms. The primary outcome variable was angular deviation (AD, degrees). The secondary outcome variables were coronal global deviation (CGD, mm), apical global deviation (AGD, mm), and voxel overlap (VO, %).Results: AD showed stepwise improvement in significant steps as the amount of guidance increased. The highest mean AD (7.03° ± 3.44) was obtained by freehand surgery and the lowest by fully guided surgery (3.04° ± 1.51). As for the secondary outcome variables, all guided protocols turned out to be significantly superior to freehand surgery, but they were not always significantly different from each other. Conclusions:As for the comparison that this study sought to perform, it can be said that the static guided approach significantly improves the accuracy of dental implant surgery as compared to freehand surgery. Furthermore, the results suggest that any degree of guidance yields better results than freehand surgery and that increasing the level of guidance increases accuracy. K E Y W O R D Scomputer-assisted surgery, dental implants, oral surgical procedures, prosthodontics, randomized controlled trial This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Guidance means accuracy: A randomized clinical trial on freehand versus guided dental implantation

Barootchi¹,

Antal

Major

et al. 2020

Clinical Oral Implants Res

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“…Advantages of guided implant surgery have been amply discussed in the dental literature. Higher accuracy is achievable with FG and PG guided surgery compared to FH surgery (Younes et al, ), which translates in a more correct implant positioning and thus lower risk of biological and/or technical complications (Canullo et al, ; Cassetta et al, ; Jacobs et al, ). Other benefits may be a lower morbidity due to the possibility of a flapless and thus less invasive surgery, a shorter treatment time and a better understanding of both the pre‐operative surgical site and the eventual prosthetic outcome (Buser et al, ; Ruppin et al, ; Tahmaseb et al, ).…”

Section: Discussionmentioning

confidence: 99%

“…To the best of our knowledge however, this is the first cost-effectiveness analysis on guided implant surgery. Although the clinical effectiveness of guided surgery has been widely described (Ersoy, Turkyilmaz, Ozan, & McGlumphy, 2008;Ozan et al, 2009;Schneider, Marquardt, Zwahlen, & Jung, 2009;Tahmaseb et al, 2014;Vercruyssen et al, 2014;Younes et al, 2018), no studies have addressed the question if the advantages of guided surgery outweigh the additional cost or not. For FG surgery, 10% extra operational cost is needed to reduce the AGD by 54% when compared to FH surgery.…”

Section: Discussionmentioning

confidence: 99%

A randomized controlled trial on the efficiency of free‐handed, pilot‐drill guided and fully guided implant surgery in partially edentulous patients

Younes

Eghbali

Bruyckere

et al. 2019

Clinical Oral Implants Res

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Objectives To compare the effectiveness of free‐handed (FH), pilot‐drill guided (PG) and fully guided (FG) implant surgery by means of the apical global deviation (AGD) in relation to the additional financial cost and time spent. Materials and methods Thirty‐three partially edentulous patients in need of ≥2 implants in the posterior maxilla were randomly allocated to one of the following treatment groups: FH, PG and FG. Eleven patients (mean age 57; eight females; altogether 26 implants) were treated by FH surgery, 11 (mean age 53; seven females; altogether 24 implants) by PG surgery and 10 (mean age 60; six females; altogether 21 implants) by FG surgery. The accuracy in implant positioning was assessed by comparing the actual implant position to its planned position with the AGD as the main measure of effectiveness. Cost analysis included data on time investment (pre‐ and per‐operative) and operational cost. The efficiency of PG and FG surgery was assessed by means of the incremental cost‐effectiveness ratio (ICER), defined as the extra investment that is needed per unit reduction in AGD when compared to FH surgery. Results FG surgery was most effective (mean AGD: 0.97 mm) and FH surgery was least effective (mean AGD: 2.11 mm) in terms of surgical accuracy. As a result, 5/26 implants had to be restored with a cement‐retained restoration following FH surgery, although screw‐retention was planned for all implants in every group. The total time investment did not differ significantly between the 3 groups (p = 0.811). A significant additional cost per implant was found for PG and FG as compared to FH surgery pointing to 8.29% (€176.54) and 10.45% (€222.52), respectively (p < 0.001). The ICER revealed an additional cost of €5.48 and €4.12 per per cent reduction in AGD for PG and FG surgery, respectively. Conclusion The extra operational cost for guided implant surgery is acceptable and clinically justified since cementation can be avoided. FG surgery is the most efficient surgical approach, even though the absolute operational cost is higher when compared to PG and FH surgery.

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Digital Integration of Implant Surgery Workflow

Kernitsky,

DiBattista

2023

Practical Periodontal Diagnosis and Treatment Planning

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A randomized controlled study on the accuracy of free‐handed, pilot‐drill guided and fully guided implant surgery in partially edentulous patients

Abstract: When perfect implant positioning is required, FG surgery should be considered the gold standard approach.

Cited by 133 publications

References 35 publications

Guidance means accuracy: A randomized clinical trial on freehand versus guided dental implantation

Guidance means accuracy: A randomized clinical trial on freehand versus guided dental implantation

A randomized controlled trial on the efficiency of free‐handed, pilot‐drill guided and fully guided implant surgery in partially edentulous patients

Digital Integration of Implant Surgery Workflow

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