Comparing Accuracy of Implant Installation with a Navigation System (NS), a Laboratory Guide (LG), NS with LG, and Freehand Drilling

Abstract

The aim of this study was to compare the accuracy of implant placement by using the conventional freehand method, the surgical guide alone, the dental navigation system alone, and the dental navigation system with a surgical guide. The participants were aged 20 years or older and were requiring dental implant surgery according to an assessment made by a dentist between July 2014 and December 2017. A total of 128 dental implants were inserted, 32 dental implants in each group, and participants with similar or identical age (i.e., 20–50 years or 50 years or above) and missing tooth locations were paired for comparison. Accuracy was measured by overlaying the real position in the postoperative Cone Beam Computerized Tomography (CBCT) on the virtual presurgical placement of the implant in a CBCT image. Using the dental navigation system with a surgical guide could help dentists to position implants more accurately. Total, longitudinal, and angular error deviation were significantly different (p < 0.0001). The same level of accuracy could be obtained for the different jaws and tooth positions. The one-way analysis of variance (ANOVA) showed that the total, longitudinal, and angular errors differed significantly (p < 0.0001). A comparison of the four dental implant surgical methods indicated that the combination of a dental implant navigation system and a surgical guide kit achieved the highest accuracy in terms of the different tooth positions and jaws.

Accuracy assessment of dynamic computer–aided implant placement: a systematic review and meta-analysis

“…Nevertheless, it should be taken into account that 4 of the 5 clinical studies [43,44,50,51] were conducted by the same research group. A similar situation was found for several systems (AqNavi system [49,59,62], Iris-100 system [47,52], and ImplaNav [46,53]) since most published studies were performed by the same authors. X-guide (X-Guide, X-Nav Technologies, LLC, Lansdale, Pa) had the largest cohort of patients (almost 500 cases with more than 700 implants placed) [48], and some clinical data was also available for AqNavi (AQNavi, TITC Ltd, Kaohsiung, Taiwan) and ImplaNav (ImplaNav; BresMedical, Sydney, Australia), as they each had at least one clinical study.…”

“…Figure 2 shows the complete flowchart of the study selection process. Of the 24 articles, 10 reported on clinical studies involving humans [43][44][45][46][47][48][49][50][51][52] and 14 reported on preclinical "in vitro" studies [53][54][55][56][57][58][59][60][61][62][63][64][65][66]. The types of studies included for each system can be observed in Table 2.…”

“…3. The main limitations detected in the nonrandomized clinical studies were limited sample sizes, which may hamper the generalization of the results [45,49,50], and that some articles did not specify whether the outcomes were assessed by an independent blinded researcher [20,[46][47][48]. Regarding the included RCT, the main limitations were associated with the allocation concealment and the blinding of the outcome assessor [47,52].…”

Robótica na cirurgia odontológica: Revisão integrativa

“…A aplicação da robótica na cirurgia se mostrou eficaz em implantodontia, no tratamento de câncer de cabeça e pescoço, tratamento de neuralgia do trigêmeo e tratamento de pequenas lesões no seio piriforme e osteotomias, de acordo com os estudos de Reddy et al (2015) e Mazerolle et al (2018). Além das aplicações práticas já citadas, Sun et al (2020), Ghai, et al (2018) e Kim et al (2016) também ressaltam a eficácia da robótica no planejamento cirúrgico, através do VSP (Virtual Surgical Planning) e da impressão 3D de modelos anatômicos.…”

“…As cirurgias com a presença de robôs são indicadas em diversos tipos de procedimentos na odontologia, principalmente em intervenções complexas que necessitam de uma alta precisão ou de resultados funcionais e estéticos superiores às cirurgias convencionais, ou intervenções nas quais antes o procedimento não era possível, como pode-se ver nas citações de autores como Sun et al (2020), Alfouzan et al (2018), Gulati et al (2015), Reddy et al(2015) e Kumar et al (2016).…”