The accuracy of computer‐guided implant surgery with tooth‐supported, digitally designed drill guides based on CBCT and intraoral scanning. A prospective cohort study

Abstract

Objectives:The purpose of this prospective cohort study was to evaluate computerguided implant surgery with tooth-supported drill guides based on CBCT scans and intraoral scanning. Materials and methods:For partially edentulous patients, a prosthetic and surgical planning was completed in the guided surgery software (coDiagnostiX) and drill guides were 3D-printed accordingly. Three months after implant placement, an intraoral scan of the implant's position was used to evaluate the accuracy of placement using the coDiagnostiX treatment evaluation tool. Deviations were reported in degrees and in distance at implant's entry point and apex. Several risk factors, which might influence the accuracy, were evaluated separately: treated jaw, flap design, prior augmentations, amount of unrestored teeth, crowding, location of implants, cortical interference, and implant's length and diameter.

Influence of bone condition on implant placement accuracy with computer-guided surgery

“…The implant placement accuracy with CGS is generally affected by cumulative factors from the clinical and technical errors, which arise during the examination, planning, laboratory process, and/or surgical procedures [8,36,37]. Various patterns of edentulous area in the posterior mandible, number of placed implants, and implant dimension, which can influence the accuracy outcome [10,31,38], were found in our study. However, the influences of those factors were not analyzed due to the limited number of subjects as well as the uneven distribution of those factors.…”

How Accurate Is Oral Implant Installation Using Surgical Guides Printed from a Degradable and Steam-Sterilized Biopolymer?

“…The final implant position was assessed by digitization of the scan body and superimposing the planed and final implant position. This approach has already been described in vitro [28] and in vivo [29,30]. In a recent RCT, a postoperative CBCT, with the same field of view of the diagnostic one, was conducted to evaluate the accuracy of guided implant positioning as an alternative method [31] showing comparable results to digitization of scan bodies [32].…”

The Digital Abutment Check: An Improvement of the Fully Digital Workflow

“…Before implant surgery, the final position of the implants can be determined virtually using planning software and 3D radiograph images. The position of the inserted implants is of crucial importance for the final design of the anchored prosthesis and the long-term survival of the dentures [ 2 – 4 ]. In this context, template-guided implant surgery allows for the accurate placement of dental implants [ 2 , 3 ].…”

“…Four implants are used to immediately rehabilitate the edentulous jaw with a fixed interim restoration. The advantages of the system lie in the maximum expansion of the support polygon through a precisely planned implant position, but especially implant angulation; the distal implants are usually inserted at an angle between 15 and 30 degrees [ 3 , 4 , 12 – 14 ]. This allows the prosthetic support field to be expanded posteriorly without compromising relevant anatomical structures and without having to perform extensive bone augmentation measures.…”