Accuracy of Edentulous Computer-Aided Implant Surgery as Compared to Virtual Planning: A Retrospective Multicenter Study

Abstract

Purpose: To evaluate the accuracy of computer-aided dental implant positions obtained with mucosal-supported templates as compared to Three-Dimensional (3D) planning. Materials and methods: One-hundred implants were inserted into 14 edentulous patients using the All-on-4/6 protocol after surgical virtual planning with RealGUIDE, 3DIEMME, and Geomagic software. After 6 months, three-dimensional neck (V) and apex (S) spatial coordinates of implants and angle inclination displacements as compared to virtual plans were evaluated. Results: The S maxilla coordinates revealed a significant discrepancy between clinical and virtual implant positions (p-value = 0.091). The V coordinates showed no significant differences (p-value = 0.71). The S (p-value = 0.017) and V (p-value = 0.038) mandible coordinates showed significant discrepancies between the clinical and virtual positions of the screws. Implant evaluation showed a 1-mm in average of the horizontal deviation in the V point and a 1.6-mm deviation in the S point. A mean 5° angular global deviation was detected. The multivariate permutation test of the S (p-value = 0.02) confirmed the difference. Greater errors in the mandible were detected as compared to the maxilla, and a higher S discrepancy was found in the posterior jaw compared to the anterior section of both the mandible and maxilla. Conclusions: Computer-aided surgery with mucosal-supported templates is a predictable procedure for implant placement. Data showed a discrepancy between the actual dental implant position as compared to the virtual plan, but this was not statistically significant. However, the horizontal and angle deviations detected indicated that flap surgery should be used to prevent implant positioning errors due to poor sensitivity and accuracy in cases of severe jaw atrophy.

Digital Smile Designed Computer-Aided Surgery versus Traditional Workflow in “All on Four” Rehabilitations: A Randomized Clinical Trial with 4-Years Follow-Up

“…The present study involves the use of a mucosal-supported surgical templates, and Gallardo et al in 2016 and Vinci et al in 2020 confirmed that this is a predictable procedure for implant placement [ 25 , 29 ].…”

“…The main disadvantages of guided surgery, as already described in 2009 by Schneider et al, Vinci et al in 2020 and D’Haese et al in 2009 are [ 24 , 25 , 33 ]: A potential damage to the bone due to insufficient irrigation; The inability to visualize the surgical anatomical landmarks; The increased risk of error in implant positioning with increasing degrees of maxillary bone atrophy; A disparity between the virtual plan and the actual position of the implant in the oral cavity at the end of the surgery; Difficulty in positioning the surgical template both during the CBCT Scan and during the surgical procedures. …”

“…Schneider et al in 2009 and Vinci et al in 2020, and other authors, showed the efficacy and accuracy of computer-assisted implant surgery [ 24 , 25 ].…”

Effect of Desktop Scanning Protocol on Accuracy of Guided Implant Placement in Completely Edentulous Patients

“…(27) It was then seated in place and stabilized against the upper denture. (28) Fixation of the guide then took place by the help of the anchor pins for guide stabilization during surgical procedures to minimize implant deviation. (29) Drilling was intermittent and under copious irrigation to reduce heat generation; a problem encountered while using surgical guides.…”

Evaluation of Neurosensory Deficits Following the Use of Computer Assisted Surgical Guide for Inferior Alveolar Nerve Bypass versus Inferior Alveolar Nerve Lateralization (Randomized Controlled Trial)

“…surgical planning was provided in both virtual and 3D environments, thus allowing the surgery to be performed virtually in an accurate prosthesis-driven manner and exact transition of virtual planning by computer-aided surgical stent. (15)(16)(17) Therefore, this current study was designed to assess neurosensory defi cits following implant placement by inferior alveolar nerve bypass with aid of computed assisted surgical guide versus inferior alveolar nerve lateralization (IANL) by using Piezosurgery device.…”