Effect of Surgical Guide Design and Surgeon's Experience on the Accuracy of Implant Placement

Hinckfuss, Simon; Conrad, Heather J.; Lin, Lianshan; Lunos, Scott; Seong, Wook-Jin

doi:10.1563/aaid-joi-d-10-00046

Cited by 38 publications

(33 citation statements)

References 21 publications

(31 reference statements)

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“…Multiple in-vitro studies found a statistically significant difference between the experienced and inexperienced surgeons for angular and horizontal error at the implant apex and platform. 13,14 The degree of bucco-lingual deviation in the expert surgeon group in our study was within the normal range of previous studies. The expert surgeon group in Cushen and Turkyilmaz 13 study performed with a horizontal angular deviation of 2.60 ± 1.25.…”

Section: Discussionsupporting

confidence: 82%

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The use of computer-guided surgery via a partially guided protocol does not completely compensate for the level of operator experience in implant placement

Marei

2018

Egyptian Dental Journal

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Purpose: There is always a tension between allowing novice trainees to place implants independently and the need to achieve accurate functional and esthetic outcomes. We aimed to measure the influence of surgeon experience on the accuracy of implants placed using a teethsupported surgical guide via a partially guided surgical protocol in a clinical setting. Materials and Methods:Twenty partially edentulous patients were randomly allocated to expert and novice surgeon groups. Implant drilling and placement for the two groups were performed through a flapless surgical technique using surgical guides following a partially guided surgical protocol. The study primary independent variable was the surgeon experience, while the outcome variable was the accuracy, which was measured based on the differences in implant angulations pre-and postoperatively. Two-way analysis of variance (ANOVA) was applied to find the influence of surgeon experience, implant size, and the interactive effect of surgeon experience and implant size on the angular deviation. Results:A total of 40 implants were inserted in 7 males and 13 females. There was no significant difference (p = 0.453) in the mesio-distal deviation between the expert and novice groups. In a bucco-lingual direction, the expert group performed more accurate implant placement (3.7 ± 3.35) compared with the novice surgeons (8.5 ± 6.3). There was no effect for implant size and/or the interaction effect on the degree of angular deviations. Conclusion:The level of surgeon experience affects the accuracy of implants placed using a teeth-supported surgical guide in a bucco-lingual direction; therefore, the use of computer-guided surgery via a partially guided protocol does not completely compensate for the level of operator experience. However, such surgical guide might be used in a whole task training of novice surgeons, as it can bridge a gap between simulation training in vitro and free-hand surgery in a clinical setting.(3258)

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Section: Discussionsupporting

confidence: 82%

“…The authors anticipated that the magnitude of deviation in accuracy of implant angulation would be higher if novice surgeons operated in a real clinical setting. 14 The real clinical setting is a complex environment that might exert a cognitive load on novice learners, negatively affecting their performance.…”

Section: Introductionmentioning

confidence: 99%

The use of computer-guided surgery via a partially guided protocol does not completely compensate for the level of operator experience in implant placement

Marei

2018

Egyptian Dental Journal

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“…The size and the location of the edentulous site were found to significantly affect the accuracy of implant placement via a tooth-supported SLA guide [18,31]. In this study, each dentist placed three implants at different sites of the model in which two were in a distal free-end situation.…”

Section: Discussionmentioning

confidence: 94%

“…They concluded that more experienced operators place implants more accurately. Hinckfuss et al [18] reported significantly less angulation error in the buccal-lingual direction for experienced operators utilizing tooth-supported surgical guides, yet no significant difference in positional errors was found between experienced and inexperienced operators. A similar result was reported by Fernandez-Gil et al in a model study using a tooth-supported guide [8].…”

Section: Discussionmentioning

confidence: 98%

“…All of the abovementioned studies exploring the relationship between operator experience and accuracy used the CT matching method to measure the errors, except for one study by Hinckfuss et al [18], which used a coordinate measuring machine to record the implant coordinates. However, they found only minimum effect of the operator experience on the accuracy of implant placement, and the magnitude of error was not large enough to be clinically significant.…”

Section: Discussionmentioning

confidence: 99%

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In Vitro Accuracy of Static Guided Implant Surgery Measured by Optical Scan: Examining the Impact of Operator Experience

et al. 2020

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Studies examining the effect of operator experience on the accuracy of static guided implant surgery have used postoperative computed tomography (CT) images to measure the error, with inconsistent results. The purpose of this study was to try to clarify this issue by using a measurement method based on the postoperative optical scan. Thirty dentists were divided into an experienced group and an inexperienced group. On a partially edentulous mandibular model in the manikin head, each dentist placed three implants via the stereolithographic (SLA) surgical guide. The implant positions were identified by a desktop scanner and compared with the planned positions using a metrology software program. No statistically significant differences were observed for any of the measured positional and angular deviations of the three implant sites between experienced and inexperienced operators (p > 0.01). All the mean values of deviations of the inexperienced group, except the depth deviation, were less than the experienced group. Implants inserted by dentists under 40 years old had significantly better accuracy than senior doctors in the global deviation at implant apex (p = 0.006). Within the limits of this study, we concluded that operator experience is not a critical factor in achieving the accuracy of guided implant surgery via the tooth-supported SLA surgical guide. Large deviations could occur even with the aid of the SLA surgical guide, and care must be taken to avoid errors for both experienced and inexperienced operators.

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Digital Implant Surgery

Weber

Cano

Bonino

2015

Clinical Applications of Digital Dental Technology

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Effect of Surgical Guide Design and Surgeon's Experience on the Accuracy of Implant Placement

Cited by 38 publications

References 21 publications

The use of computer-guided surgery via a partially guided protocol does not completely compensate for the level of operator experience in implant placement

The use of computer-guided surgery via a partially guided protocol does not completely compensate for the level of operator experience in implant placement

In Vitro Accuracy of Static Guided Implant Surgery Measured by Optical Scan: Examining the Impact of Operator Experience

Digital Implant Surgery

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