Comparison Between a Computer-Aided Surgical Template and the Free-Hand Method

Chen, Suya; Ou, Qianmin; Lin, Xuefeng; Wang, Yan

doi:10.1097/id.0000000000000915

Cited by 19 publications

(20 citation statements)

References 27 publications

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“…With the advances in implant surface treatment, clinicians hardly suffer from failures after implant surgery [ 1 ], and now they seek to improve accuracy of the procedure. Placing the implants exactly where they were virtually planned provides a lot of clinical benefits [ 2 , 3 ]. Clinicians can avoid the anatomical structures which should not be invaded, i.e., the mandibular canal or the mental foramen, and it becomes possible to deliver the prefabricated prosthesis according to the virtually placed implant position immediately after the surgery.…”

Section: Introductionmentioning

confidence: 99%

Accuracy of Dental Implant Placement by a Novel In-House Model-Free and Zero-Setup Fully Guided Surgical Template Made of a Light-Cured Composite Resin (VARO Guide®): A Comparative In Vitro Study

Song

Kim

et al. 2021

Materials

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Background: This in vitro study mainly aimed to compare VARO Guide® to the surgical guide fabricated by CAD/CAM (NAVI Guide®) in terms of accuracy and efficacy of the implant surgery held in the dentiform model. Methods: Twenty surgeons, 10 dentists in the beginner group and 10 dentists in the expert group, participated in the study. Each surgeon conducted fully guided surgery in dentiform models twice, once with VARO Guide® (VG surgery) and the other time with a conventional type of templates, NAVI Guide® (NG surgery). Based on the superimposition of presurgical and postsurgical STL files, the positional deviations between the virtually planned and actually placed implants and the time spent on presurgical preparation and surgical procedures were estimated and compared. Results: All dimensional deviations were similar between the two groups (p > 0.05), and there was no significant difference between the expert and beginner groups regardless of the guide system. The total procedure time (mean (median)) of the VG surgery (26.33 (28.58) min) was significantly shorter than that of the NG surgery (378.83 (379.35) min; p < 0.05). While the time spent only for the fully guided implant surgery (from the start of the surgical guide sitting onto the dentiform model to the final installation of the implant fixture) was comparable (p > 0.05), the presurgical preparation time spent on virtual implant planning and surgical guide fabrication in the VG surgery (19.63 (20.93) min) was significantly shorter compared to the NG surgery (372.93 (372.95) min; p < 0.05). Conclusions: Regardless of experience, both VG and NG surgery showed reliable positional accuracy; however, the total procedure time and the preparation time were much shorter in the VG surgery compared to the NG surgery.

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Section: Introductionmentioning

confidence: 99%

Accuracy of Dental Implant Placement by a Novel In-House Model-Free and Zero-Setup Fully Guided Surgical Template Made of a Light-Cured Composite Resin (VARO Guide®): A Comparative In Vitro Study

Song

Kim

et al. 2021

Materials

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“…Dental implant placement guided by dynamic or static navigation is more accurate than the freehand technique [ 4 , 14 , 47 , 48 ]. In digital implant planning, 3-D imaging of the implant site is integrated into a planning software, and the implant is virtually placed.…”

Section: Resultsmentioning

confidence: 99%

“…When comparing freehand with static and dynamic navigation-guided implant placement, either type of navigation allows for more accurate placement than the freehand technique [4,47,48,[54][55][56][57][58]. A mean difference in angular deviation of − 5.54°and an apical deviation of 0.83 mm were calculated in a meta-analysis comparing navigation-guided vs. freehand placement [4]. Static and dynamic navigation techniques seem to be comparable in accuracy [51].…”

Section: Accuracy Of Implant Placementmentioning

confidence: 99%

“…Throughout their history, many dental implants were placed using the freehand method. Although an experienced surgeon can achieve good results with this method, the use of static or dynamic navigation is well established and seems to improve the outcome in terms of placement accuracy, while protecting vulnerable adjacent structures [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

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Indications for 3-D diagnostics and navigation in dental implantology with the focus on radiation exposure: a systematic review

2021

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Background Dental implants are a common restorative method used to replace missing teeth. Implant placement techniques guided by three-dimensional imaging and navigation are becoming more widely available. Objective The present review focused on the following questions: 1. What are the advantages and disadvantages of 2-D versus 3-D imaging in dental implantology? 2. What are the advantages and disadvantages of freehand implant placement in comparison with navigation-guided implant placement? Methods A systematic review was performed, based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement. The following libraries were searched for relevant literature: PubMed, Embase, Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF) Online, and the Cochrane Library. The risk of bias was assessed using the Scottish Intercollegiate Guidelines Network (SiGN) checklist. A total of 70 studies were included after screening, and the evidence from these was gathered for review. Results Three-dimensional imaging is advantageous in terms of image quality, and it provides a distortion-free evaluation of the implant site. However, it is also associated with higher costs and increased radiation exposure. Dynamic and static navigation are equal in accuracy and are both more accurate compared with the freehand method. No benefit in terms of implant survival could be demonstrated within the first 5 years for any specific method. Discussion A panoramic X-ray with a reference body often provides sufficient imaging and is the primary method for two-dimensional imaging. Cone beam computed tomography with low-dose protocol settings should be used if three-dimensional imaging is needed. Navigational support should be considered in the event of especially complex cases. Conclusion The guidance technique used for implant placement should be decided on an individual basis. With the increasing availability of three-dimensional imaging, there should also be an increase in awareness of radiation exposure.

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“…Different from the traditional free-hand implant placement that overly relies on the clinician’s skill set and experience, computer-assisted, template-guided implantology is driven by final optimal restoration, according to which clinicians address considerations for the most optimal implant position prior to the surgery [ 5 , 6 , 7 ]. The template has been postulated to provide higher precision [ 8 , 9 , 10 , 11 ], which can help to achieve better implant placement with the potential for reduced operative complications [ 12 , 13 , 14 ]. Through digital designing software such as Simplant ® and Nobel Clinician ® , the patient’s cone-beam computed tomography (CBCT) data was overlapping with the intraoral or model three-dimensional data obtained by an optical scanner [ 15 ], so that the clinicians can virtually plan the optimal three-dimensional implant position before the operation.…”

Section: Introductionmentioning

confidence: 99%

A Retrospective Study on the Transferring Accuracy of a Fully Guided Digital Template in the Anterior Zone

Huang

Zhang

2021

Materials

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The accuracy of implant placement with a fully guided digital template can be influenced by many factors, such as arch difference, alveolar bone density, timing of implant placement and open flap. The purpose of this article was to evaluate the factors presumptively affecting the accuracy of implant placement assisted by the fully guided template in the anterior zone. In 40 patients with missing anterior teeth, a total of 52 implants were placed with tooth-borne, fully guided templates after CBCT evaluation, in West China Hospital of Stomatology, Sichuan University. After overlapping the pre-and post-operative DICOM data, measurements were taken in the dental implant planning software (Nobel Clinician®) to calculate linear and angular deviations between virtual placement plan and actual implant placement. Grouping was categorized according to three factors that possibly have an influence on accuracy: arch type (maxilla/mandible), timing of implant placement (immediate/delayed), surgical technique (open flap/flapless). The data was analyzed with independent sample t-test (p < 0.05). The results showed that the apical, coronal, depth and angular mean deviations of implant positions in anterior zone were 1.13 ± 0.39 mm, 0.86 ± 0.33 mm, 0.41 ± 0.66 mm, 3.32 ± 1.65° with the fully guided templates. The accuracy at apex level, coronal level and the angulation were similar between the maxilla and mandible, and the magnitude of all four deviations between immediate and delayed implantation, open flap and flapless technique were small. No statistically significant difference was observed (p > 0.05). Whereas there was significant difference in depth deviation between maxilla and mandible (p < 0.05). Conclusively, the implant site, alveolar bone density, timing of implant placement and surgical techniques merely compromise the implant placement accuracy under the assistance of a fully guided template.

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Comparison Between a Computer-Aided Surgical Template and the Free-Hand Method

Cited by 19 publications

References 27 publications

Accuracy of Dental Implant Placement by a Novel In-House Model-Free and Zero-Setup Fully Guided Surgical Template Made of a Light-Cured Composite Resin (VARO Guide®): A Comparative In Vitro Study

Accuracy of Dental Implant Placement by a Novel In-House Model-Free and Zero-Setup Fully Guided Surgical Template Made of a Light-Cured Composite Resin (VARO Guide®): A Comparative In Vitro Study

Indications for 3-D diagnostics and navigation in dental implantology with the focus on radiation exposure: a systematic review

A Retrospective Study on the Transferring Accuracy of a Fully Guided Digital Template in the Anterior Zone

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