Intraoral Scanning as an Alternative to Evaluate the Accuracy of Dental Implant Placements in Partially Edentate Situations: A Prospective Clinical Case Series

Abstract

(1) Background: For years, Cone-Beam Computed Tomography’s (CBCT) have been the golden standard to evaluate implant placement accuracy. By validating Intraoral Scans (IOS) as an alternative to determine implant placement accuracy, a second CBCT could be avoided. (2) Methods: Using dynamic guided implant surgery, 23 implants were placed in 16 partially edentate patients. Preoperatively, both CBCT and IOS (Trios® 3) were obtained and subsequently imported into DTX Studio™ planning software to determine the ideal implant location. A CBCT scan and an IOS including scan abutments were acquired immediately after placement. Both postoperative CBCT and postoperative IOS were used to compare the achieved implant position with the planned implant position and were projected and analyzed using the Implant Position Orthogonal Projection (IPOP) method. (3) Results: Mean differences between the CBCT and IOS methods on the mesio–distal plane were 0.09 mm (p = 0.419) at the tip, 0.01 mm (p = 0.910) at the shoulder, −0.55° (p = 0.273) in angulation, and 0.2 mm (p = 0.280) in implant depth. Mean differences between both methods on the bucco-lingual/bucco-palatal plane were 0.25 mm (p = 0.000) at the tip, 0.12 mm (p = 0.011) at the shoulder, −0.81° (p = 0.002) in angulation, and 0.17 mm (p = 0.372) in implant depth. A statistical analysis was performed using a paired t-test. All mesiodistal deviations between the two methods showed no significant differences (p > 0.05). Buccolingual/buccopalatal deviations showed no significant difference in implant depth deviation. However, significant differences were found at the tip, shoulder, and angulation (p < 0.05). These values are of minimal clinical significance. (4) Conclusions: This study supports the hypothesis that a postoperative IOS is a valid alternative for determining implant placement accuracy.

In vitro and in vivo accuracy of autonomous robotic vs. fully guided static computer‐assisted implant surgery

“…Third, CBCT exerted additional radiation damage to patients and it could be influenced by 3D reconstruction, voxel size, exposure dose, imaging time, field of view size, image artifacts, and the movement of patients during the shooting process 38 . Prospective clinical case series confirmed that IOS was better than CBCT to evaluate accuracy and IOS was a valid alternative for determining implant placement accuracy 48 . However, due to the attribute of retrospective study, the postoperative IOS data could not be achieved because it has not yet been popularized in our hospital.…”

“…38 Prospective clinical case series confirmed that IOS was better than CBCT to evaluate accuracy and IOS was a valid alternative for determining implant placement accuracy. 48 However, due to the attribute of retrospective study, the postoperative IOS data could not be achieved because it has not yet been popularized in our hospital. Therefore, IOS can be used as a better method to assess the accuracy of implantation if conditions permit in future research.…”

Accuracy of implant placement with computer-aided static, dynamic, and robot-assisted surgery: a systematic review and meta-analysis of clinical trials

“…Comparisons between pre- and post- dental implant placements can be found among the three navigation types, namely, 43 studies on static systems [ 8 , 18 , 19 , 21 , 22 , 30 – 67 ], 7 studies on dynamic systems [ 7 , 16 , 25 , 68 – 71 ], and only 2 on robot-assisted surgery [ 11 , 13 ]. Nevertheless, 15 studies [ 12 , 15 , 26 , 72 – 83 ] showed comparative data between systems.…”

“…According to Fig. 4 , three case series [ 43 , 44 , 71 ] and one case report [ 13 ] were assessed using JBI Critical Appraisal Checklist. Conclusively, all case series were classified as having an “unclear” assessment, while only one case report seemed to be a high-quality assessment.…”

Accuracy of Dental Implant Placement with Dynamic Navigation—Investigation of the Influence of Two Different Optical Reference Systems: A Randomized Clinical Trial

“…The deviations are only of minimal clinical significance. The reduction in radiation when using a postoperative scan is extremely relevant for the patient [50]. Further studies have shown that evaluation using an intraoral scan does not lead to significantly less accurate results [51,52].…”