Abstract:Background
An implant prosthesis aims to ensure the best possible rehabilitation of function and esthetics following tooth loss. Template-guided insertion is used to achieve an optimal position of the implant with regard to prosthetic restorability, bone availability, and condition of the surrounding soft tissues. The accuracy of template-guided implant placement is subject to various influencing factors.
The clinically achievable accuracy depending on the macro design of the im… Show more
“…The accuracy was 0.86 mm, 0.76 mm, and 2.49° for tapered implants, 0.94 mm, 0.89 mm, and 2.06° for straight implants, demonstrating that both tapered and straight implants were suitable for dynamic navigation assisted immediate implant placement. This was in accordance with previous studies [18,28] comparing these two approaches under static templates in regular cases.…”
Section: Discussionsupporting
confidence: 94%
“…Many clinicians tend to choose tapered implants because this macrodesign facilitates implant into the prepared hole [16]. Recently, a model study [17] corroborated tapered implants gained better accuracy than straight implants under static surgical guide, due to the vertically fluted tapered drill design and its influence on osteotomy accuracy, while a clinical trial [18] demonstrated straight implant achieved better accuracy at the entry point. To date, the role of implant macrodesign on accuracy in immediate implant placement has not been clarified so far.…”
Objectives To compare the accuracy and primary stability of tapered and straight implants undergoing immediate implant placement with dynamic navigation. Materials and methods Patients with compromised anterior teeth in maxilla were recruited and allocated randomly into (1) tapered implant group (TI group) and (2) straight implant group (SI group). Implants were inserted into fresh sockets with dynamic navigation. Three-dimensional platform deviation, apex deviation, angular deviation, insertion torque value (ITV) and implant stability quotient (ISQ) were recorded. Results Twenty patients with 20 implants were included. The overall platform, apex, and angular deviation were 0.87 ± 0.35 mm, 0.81 ± 0.34 mm, and 2.40 ± 1.31°, respectively. The accuracy was 0.86 ± 0.26 mm, 0.76 ± 0.33 mm, and 2.49 ± 1.54° for TI, and 0.89 ± 0.44 mm, 0.88 ± 0.36 mm, and 2.31 ± 1.01° for SI, with no significant difference (p = 0.85, 0.45, 0.76). Sagittal root position classification (SRP) class I may obtain greater error in numerical values in straight implants (0.97 ± 0.47 mm vs. 0.6 ± 0.16 mm, 0.92 ± 0.36 mm vs. 0.73 ± 0.36 mm, 2.48 ± 1.19° vs. 1.71 ± 0.14°). The overall ISQ was 60.74. ISQ was 60.48 for TI and 60.96 for SI, with no significant difference. Acceptable ITV (> 15 Ncm) was achieved in most of the included patients (SI 7/10, TI 9/10). Conclusions High accuracy and primary stability of immediate implant placement could be achieved both in tapered and straight implants with dynamic navigation systems. Clinical relevance Tapered and straight implants did not reach a consensus on which was better in immediate implant regarding to accuracy and primary stability. Our study demonstrated implant macrodesign did not affect accuracy and primary stability in immediate implant using dynamic navigation.
“…The accuracy was 0.86 mm, 0.76 mm, and 2.49° for tapered implants, 0.94 mm, 0.89 mm, and 2.06° for straight implants, demonstrating that both tapered and straight implants were suitable for dynamic navigation assisted immediate implant placement. This was in accordance with previous studies [18,28] comparing these two approaches under static templates in regular cases.…”
Section: Discussionsupporting
confidence: 94%
“…Many clinicians tend to choose tapered implants because this macrodesign facilitates implant into the prepared hole [16]. Recently, a model study [17] corroborated tapered implants gained better accuracy than straight implants under static surgical guide, due to the vertically fluted tapered drill design and its influence on osteotomy accuracy, while a clinical trial [18] demonstrated straight implant achieved better accuracy at the entry point. To date, the role of implant macrodesign on accuracy in immediate implant placement has not been clarified so far.…”
Objectives To compare the accuracy and primary stability of tapered and straight implants undergoing immediate implant placement with dynamic navigation. Materials and methods Patients with compromised anterior teeth in maxilla were recruited and allocated randomly into (1) tapered implant group (TI group) and (2) straight implant group (SI group). Implants were inserted into fresh sockets with dynamic navigation. Three-dimensional platform deviation, apex deviation, angular deviation, insertion torque value (ITV) and implant stability quotient (ISQ) were recorded. Results Twenty patients with 20 implants were included. The overall platform, apex, and angular deviation were 0.87 ± 0.35 mm, 0.81 ± 0.34 mm, and 2.40 ± 1.31°, respectively. The accuracy was 0.86 ± 0.26 mm, 0.76 ± 0.33 mm, and 2.49 ± 1.54° for TI, and 0.89 ± 0.44 mm, 0.88 ± 0.36 mm, and 2.31 ± 1.01° for SI, with no significant difference (p = 0.85, 0.45, 0.76). Sagittal root position classification (SRP) class I may obtain greater error in numerical values in straight implants (0.97 ± 0.47 mm vs. 0.6 ± 0.16 mm, 0.92 ± 0.36 mm vs. 0.73 ± 0.36 mm, 2.48 ± 1.19° vs. 1.71 ± 0.14°). The overall ISQ was 60.74. ISQ was 60.48 for TI and 60.96 for SI, with no significant difference. Acceptable ITV (> 15 Ncm) was achieved in most of the included patients (SI 7/10, TI 9/10). Conclusions High accuracy and primary stability of immediate implant placement could be achieved both in tapered and straight implants with dynamic navigation systems. Clinical relevance Tapered and straight implants did not reach a consensus on which was better in immediate implant regarding to accuracy and primary stability. Our study demonstrated implant macrodesign did not affect accuracy and primary stability in immediate implant using dynamic navigation.
“…Tapered implants were found to have less platform, apex and angle deviation than the cylindrical ones. In another clinical study, the implant macro design was shown to only affect the vertical deviation at platform implant 26 . All the implants used in this study were of taper design, but there was a variation in the extent of tapering and some macro design elements such as the design of threads.…”
Background
Different designs of surgical drilling systems have been developed for the purpose of static Computer‐Assisted Implant Surgery (sCAIS), but there is at present little understanding of how design principles affect the accuracy of implant placement.
Purpose
The aim of this in vitro study was to compare the accuracy of implant placement among five drilling systems of sCAIS in a controlled experimental setting.
Materials and Methods
Twenty‐five 3D printed models with two edentulous bilateral premolar spaces were allocated to five different drilling systems: group A: sleeve‐in‐sleeve, group B: sleeve‐in‐sleeve with self‐locking, group C: mounted sleeve‐on‐drill, group D: integrated sleeve‐on‐drill with metal sleeve in the guide, group E: integrated sleeve‐on‐drill without metal sleeve. Models were scanned with CBCT and optical scanner. All implants were digitally planned and 10 implants placed with sCAIS in each group. Postoperative 3D deviation of placed vs planned position was measured by means of platform, apex and angular deviation. Data was analyzed using Kruskal‐Wallis test (P ≤ .05). Pairwise comparisons were tested with Dunn's test with adjusted P values.
Results
The overall platform deviation ranged from 0.42 ± 0.12 mm (group B) to 1.18 ± 0.19 mm (group C). The overall apex deviation ranged from 0.76 ± 0.22 mm (group B) to 1.95 ± 0.48 mm (group D). The overall angular deviation ranged from 2.50 ± 0.89 degree (group B) to 5.30 ± 1.04 degree (group E). Group A and B showed significantly less angular deviation than groups D and E (P < .05). There was no statistically significant differences in all parameters between group A and B, as well as between group D and E (P > .05).
Conclusions
Significant differences were found with regards to accuracy among the five sCAIS systems tested, suggesting that the drilling protocol, the devices used and the design principles of the guides could influence the accuracy of implant placement.
“…An in vitro study from El Kholy, Lazarin, et al (2019) found that in sCAIS, tapered implants (BTL) presented higher accuracy compared to parallel wall implants (TL and BL). However, in a recent prospective clinical study, it was found that implant macrodesign (tapered vs. parallel wall) had no influence on the accuracy of fully guided implant placement in any three‐dimensional direction (Schnutenhaus et al, 2021). Even though there is limited evidence in regard to the effect of implant macrodesign in sCAIS, it is worthwhile noting that the majority of the implants analyzed in the present study's control group were BLT placed with relatively shorter distances to the osteotomy bed, which could lead to a possible over‐interpretation of the results.…”
Section: Discussionmentioning
confidence: 99%
“…Recent studies have been investigating the effect of different implant macrodesigns and systems in the accuracy of guided implant surgery (El Kholy, Ebenezer, et al, 2019; Schnutenhaus et al, 2021; Yeung et al, 2020). In this study, the overall implant macrodesigns used were BLT (46.3%), TL (37.0%), and BL (16.7%), selected based on the patients’ local soft and hard tissue anatomy.…”
Aim
The aim of this retrospective clinical study was to compare the accuracy of static Computer‐assisted implant surgery (sCAIS) in posterior single edentulous patients using different surgical guide designs.
Materials and Methods
Thirty‐seven partially edentulous patients with a total of 54 implants were included in the study. Seventeen implants were included in Group 1—Unbounded Tooth‐Mucosa Supported; 18 implants in Group 2—Unbounded Tooth Supported; and 19 implants in Group 3 (Control)—Bounded Tooth Supported. All partially edentulous patients were treated with fully guided implant surgery using the corresponding surgical guide. Discrepancies between the pre‐planned and post‐operative implant position were evaluated.
Results
The mean angular deviation ± standard deviation (SD) was 2.91 ± 1.56°, 3.33 ± 1.72° and 2.25 ± 1.13° for Groups 1, 2, and 3, respectively. The mean ± SD 3D offset at base was 0.66 ± 0.29 mm, 0.77 ± 0.24 mm, and 0.49 ± 0.22 mm; and 3D offset at tip was 0.84 ± 0.45 mm, 1.07 ± 0.38 mm, and 0.75 ± 0.25 mm for Groups 1, 2, and 3, respectively. No statistically significant differences between groups were found for angular deviation. There were statistically significant differences between Groups 2 and 3 for 3D offset at base (p = .002) and 3D offset at tip (p = .010).
Conclusions
Different surgical guide designs for posterior single edentulous areas appear to be associated with the accuracy level of sCAIS. In unbounded sites, having additional posterior attached soft tissue support is preferable.
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