Implant Placement Accuracy Using Dynamic Navigation

Abstract

The aim of this prospective study was to determine platform and angle accuracy for dental implants using dynamic navigation, a form of computer-assisted surgery. Three hypotheses were considered: (1) the overall accuracy for implant placement relative to the virtual plan is similar to that of static tooth-borne computerized tomography (CT)-generated guides; (2) the dynamic system is more accurate than freehand methods; and (3) there is a learning curve associated with this method. Materials and Methods: This study involved three surgeons placing implants in the mandible and maxilla of patients using a dynamic navigation system (X-Guide, X-Nav Technologies). Virtual implants were placed into planned sites using the navigation system computer. Post-implant placement cone beam CT scans were taken on all patients. For each patient, this scan was mesh overlayed with the virtual plan and used to determine platform and angular deviations to the virtual plan. The primary outcome variables were platform and angular deviations comparing the actual placement to the virtual plan. Secondary analyses included determination of accuracy related to case experience and freehand placement of implants. Comparisons to published accuracy studies were made for implant placement using static guides. Results: Accuracy deviations from the virtual plan were similar to those reported for static tooth-based guides using literature references as the comparison. The accuracy of dynamic navigation was superior compared to freehand implant placement. The three surgeons had similar accuracies after their learning curve was achieved. Proficiency based on case series was achieved by the 20th surgical procedure. Conclusion: Dynamic navigation can achieve accuracy of implant placement similar to static guides and is an improvement over freehand implant placement. In addition, there was a learning curve to achieve proficiency. Int J Oral MaxIllOfac IMplants 2016 (8 pages).

Accuracy of dental implant placement via dynamic navigation or the freehand method: A split‐mouth randomized controlled clinical trial

“…Many of the previous reports are based on arbitrary collection of cases without any priori sample size calculation; therefore, a direct comparison of the present results may not be feasible. In 100 consecutive cases, Block and co‐workers (Block, Emery, Lank, & Ryan, ) employed a navigation device based on infra‐red beam light triangulation technology and reported a mean 0.87 ( SD : 0.42) and 1.56 ( SD : 0.69) mm linear deviation at the implant shoulder and tip, respectively. Freehand insertion of implants yielded with a significant increase of discrepancies with a mean 1.15 ( SD : 0.59) and 2.51 ( SD : 0.69) mm linear deviation at the implant shoulder and tip, respectively.…”

“…tentially provided this result.The graphical representation of the rate of learning how to place implants with better accuracy over time or repeated experiences can be defined as the learning curve(Kassite, Bejan-Angoulvant, Lardy, & Binet, 2019). Such a curve was implied by the aforementioned two previous studies(Block et al, 2017;Stefanelli et al, 2019), revealing a trend towards a lower deviation rate after 15 to 25 cases. In contrast, no statistically significant learning curve was found in this study when incorporating all variables in a single analysis model.…”

The accuracy of static vs. dynamic computer‐assisted implant surgery in single tooth space: A randomized controlled trial

“…Based on the implant platform, apex, and angle deviation values of static and dynamic CAIS systems reported in previous studies (0.21 ± 0.16 mm vs. 1.37 ± 0.55 mm, 0.32 ± 0.34 mm vs. 1.56 ± 0.69 mm, and 1.35 ± 1.11 degrees vs. 3.62 ± 2.73 degrees, respectively) (Behneke, Burwinkel, & Behneke, ; Block et al, ), the minimum required sample size of 10, 14, and 48 implants according to platform, apex, and angle deviation, respectively, was separately calculated using a statistical software (G*Power software version 3.1, Erdfelder, Faul, & Buchner, 1996) for Mann–Whitney U test with 95% of study power and significant level ( α ) of 0.05.…”

“…The accuracy of transferring the virtual implant position to the patient using static and dynamic CAIS systems has been shown to be superior compared to conventional implant placement methods (Block, Emery, Lank, & Ryan, ; Brief, Edinger, Hassfeld, & Eggers, ; Farley, Kennedy, McGlumphy, & Clelland, ; Ruppin et al, ; Somogyi‐Ganss et al, ). However, there are limited clinical studies which systematically compare transferring accuracy between static and dynamic CAIS systems, particularly in single tooth space implant placement.…”

Exploring training dental implant placement using computer‐guided implant navigation system for predoctoral students: A pilot study

“…6 Dynamically guided implant placement has been shown to be more accurate than freehand implant placement in terms of angular deviation, platform positioning and apical positioning. 1,[7][8][9] Most dynamic guided implant surgery studies however have been performed by experienced surgeons with prior training on the respective navigation system. 1,6 The question was raised whether dynamic navigation technology could be used to train the novice operator, such as a dental student with no previous implant surgical experience, to perform implant placement competently and accurately.…”