Abstract:Background: This prospective clinical study aimed to investigate a possible deviation between the digitally planned implant position and the position achieved using dynamic navigation. The aim of the study was to establish clinical effectiveness and precision of implantation using dynamic navigation. Methods: Twenty consecutive patients received an implant (iSy-Implantat, Camlog, Wimsheim, Germany). One screw implant was placed in one jaw with remaining dentition of at least six teeth. The workflow was fully d… Show more
“…In the present case, the deviations at the implant shoulder of teeth 36 and 37 were 0.831 mm and 0.682 mm, respectively; 0.574 mm and 0.867 mm at the implant apical level, respectively; and angular deviations of 3.118° and 2.317°, respectively. The results were consistent with preliminary studies on the accuracy of dynamic navigation surgeries[ 8 , 15 , 17 ].…”
Section: Discussionsupporting
confidence: 91%
“…Computer-assisted dynamic navigation systems (CADNSs) based on cone-beam computed topography (CBCT) navigation have been introduced into the field of dental implantology to improve the accuracy of implant placement and avoid potential complications[ 8 , 9 ]. A CADNS is a surgical navigation system which can design the location of a virtual implant according to CBCT data.…”
BACKGROUND
In atrophic posterior mandibular areas, where the bone height superior to the inferior alveolar nerve (IAN) is less than 6 mm, short implants are not applicable. Conventional alternatives such as IAN transposition and various alveolar bone augmentation approaches are technically demanding and prone to complications.
CASE SUMMARY
Computer-guided dynamic navigation implantation improves the accuracy, predictability, and safety of implant placement. This case report presents a dynamic navigation system-guided trans-IAN implant placement technique, which can successfully treat a posterior mandibular dentition defect when the bone height is only 4.5 mm. The implant was inserted into the buccal side of the IAN and was 1.7 mm away from the IAN. The implantation deviations were controlled within a satisfying range, and the long-term restoration outcome was stable.
CONCLUSION
Dynamic navigation system-guided trans-IAN implant placement might be a recommended technique for patients with extremely insufficient residual bone height and sufficient bone width in the posterior mandibular area.
“…In the present case, the deviations at the implant shoulder of teeth 36 and 37 were 0.831 mm and 0.682 mm, respectively; 0.574 mm and 0.867 mm at the implant apical level, respectively; and angular deviations of 3.118° and 2.317°, respectively. The results were consistent with preliminary studies on the accuracy of dynamic navigation surgeries[ 8 , 15 , 17 ].…”
Section: Discussionsupporting
confidence: 91%
“…Computer-assisted dynamic navigation systems (CADNSs) based on cone-beam computed topography (CBCT) navigation have been introduced into the field of dental implantology to improve the accuracy of implant placement and avoid potential complications[ 8 , 9 ]. A CADNS is a surgical navigation system which can design the location of a virtual implant according to CBCT data.…”
BACKGROUND
In atrophic posterior mandibular areas, where the bone height superior to the inferior alveolar nerve (IAN) is less than 6 mm, short implants are not applicable. Conventional alternatives such as IAN transposition and various alveolar bone augmentation approaches are technically demanding and prone to complications.
CASE SUMMARY
Computer-guided dynamic navigation implantation improves the accuracy, predictability, and safety of implant placement. This case report presents a dynamic navigation system-guided trans-IAN implant placement technique, which can successfully treat a posterior mandibular dentition defect when the bone height is only 4.5 mm. The implant was inserted into the buccal side of the IAN and was 1.7 mm away from the IAN. The implantation deviations were controlled within a satisfying range, and the long-term restoration outcome was stable.
CONCLUSION
Dynamic navigation system-guided trans-IAN implant placement might be a recommended technique for patients with extremely insufficient residual bone height and sufficient bone width in the posterior mandibular area.
“…67 mm at entry point, 0.9 mm at apex and 2.50° of angular deviation) (Stefanelli et al, 2020 ). Edelmann and colleagues experienced mean deviations of 1.83 mm at entry point, 1.95 mm at apex, and 2.7° of angular deviation with another navigation system (Edelmann et al, 2021 ). A recently published systematic review and meta‐analysis on accuracy of surgery reported an average global platform deviation, global apex deviation, and angular deviation of 1.02 mm (95% CI 0.83–1.21), 1.33 mm (95% CI 0.98–1.67), and 3.59° (95% CI 2.09–5.09) and concluded it was clinically acceptable with potential in clinical usage (Wei et al, 2021 ).…”
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“…At the beginning, this technology was adopted from implant dentistry. 13 In the field of endodontics, this technology was demonstrated to be safe, fast and accurate in preparing the access cavity, 14 15 locating calcified canals, [16][17][18] intraosseous anaesthesia, 19 removal of fibre posts from root canals 7 and endodontic microsurgery. 20 21 It has several advantages: (1) reducing time and cost; (2) conducive to cooling and avoiding damage to tissue due to heat production; (3) performing operations with insufficient space; (4) increased safety, accurate and predictability and (5) real-time visualisation of the position and angulation of the drill.…”
IntroductionEndodontic microsurgery is a very important technique for preserving the natural teeth. The outcomes of endodontic microsurgery largely depend on the skill and experience of the operators, especially for cases in which the apices are located far away from the labial/buccal cortical bone. A dynamic navigation system (DNS) could provide a more accurate and efficient way to carry out endodontic microsurgery. This study is devoted to comparing the clinical outcomes of the DNS technique with those of the freehand technique.Methods and analysisSixteen patients will be randomly assigned to one of two groups. For the experimental group, the osteotomy and root-end resection will be performed under the guidance of dynamic navigation. For the control group, these procedures will be performed freehand by an endodontist. The required time to perform these procedures will be used to evaluate the efficiency of the DNS technique. A Visual Analogue Scale will be used to evaluate pain at 1, 3 and 7 days after endodontic microsurgery. Preoperative and postoperative cone beam CT scans will be obtained to evaluate the accuracy of the DNS technique. The global coronal deviations, the apical deviations and the angular deflection will be measured. The root-end resection length deviation, the root-end resection angle deviations, the extent of the osteotomy and the volume change of the buccal cortical bone will also be measured. Periapical radiographs will be obtained to evaluate the outcome at 1 year after microsurgery. The time to execute the study, including follow-ups, will last from 1 June 2022 to 31 December 2025.Ethics and disseminationThe present study has received approval from the Ethics Committee of Peking University School and Hospital of Stomatology. The results will be disseminated through scientific journals.Trial registration numberChiCTR2200059389.
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