Accuracy of Free Hand Dental Implant Placement in a Private Dental College Setup - A Radiographic Analysis

Abstract

BACKGROUND The factors that influence the implant accuracy are the anatomy of the patient, the experience of the practitioner and the surgical approach. However, the relative importance of each factor is poorly understood. Favourable function, occlusion, aesthetics and implant loading patterns can be obtained by optimal positioning. The experience of the surgeon is of utmost importance for the skill of placing a dental implant with proper angulation. The purpose of this retrospective study was to determine the increased accuracy obtained in performing freehand surgical placement of implants. METHODS This study was conducted in the Department of Implantology. A total of 1216 postoperative periapical radiographs from which single implant placement with adjacent straight root morphology was collected from the department in the period of June 2019 to June 2020 and checked for angulation, practitioner’s experience and the site of placement. Mesio-distal angulation was calculated. Statistical analysis was performed using the SPSS method. RESULTS The results showed accuracy in angulation and positioning of implants increased with an increase in experience of the dental surgeon (oral surgeons, prosthodontists, periodontists). Within the limitations of the study, it showed that the freehand dental implant placement angulation was less than a degree for experienced surgeons. The postgraduates had a better understanding and orientation of the angulation than the undergraduates. Moreover, the difficult site was the second and third quadrant to assess the angulation properly. CONCLUSIONS With proper assessment of the anatomy and with experience freehand dental implant placement shows significant results with less angulation which can be prosthetically accepted. KEY WORDS Free Hand Surgery, Guided Surgery, Angulation Of Implants.

Influence of antagonist tooth on mandibular implant positioning during surgery among Indians

“…During free-hand surgery, practitioners need to consider the risk of approaching the root of an adjacent tooth. A study examining the relationship between the experience of the guide and implant angulation found that practitioners with less than 5 years of experience accounted for 9.3% of cases with 0-degree angulation, while those with 5-10 years and more than 10 years of experience accounted for 37.1% and 53.6%, respectively, of cases with 0-degree angulation [ 27 ]. From the above data analysis, it is apparently revealed that the accuracy of freehand placement is optimal especially in the posterior zones, considering that the opposing tooth angulation and occlusal patterns are taken into considerations thus the implant can be positioned in a 3D optimal position.…”