The accuracy of single‐tooth implants placed using fully digital‐guided surgery and freehand implant surgery

Abstract

The optimal three-dimensional (3D) implant position is a critically important factor for the long-term success of implant therapy, as it can ensure the proper design of the prosthesis. Optimal positioning of the implant can allow for favourable prosthetic outcomes, such as function, aesthetics, occlusion and implant loading patterns. Moreover, correct implant position is essential for ensuring a prosthesis design compatible with long-term maintenance and access for adequate oral hygiene (Assche et al., 2012; Cooper, 2015; Tahmaseb, Wismeijer, Coucke, & Derksen, 2014).Key factors for long-term implant success include proper planning of the ideal implant position and precise transfer of the planned position to the surgical site. The outcome of conventional planning has been achieved with the use of a radiographic stent with a radiopaque marker, produced from duplicating the wax-up of the ideal prostheses on study models. The radiographic stent is then worn by the patient during a pre-operative cone beam computed tomography (CBCT) scan, thereby allowing transposition of the ideal prosthesis shape to the alveolar ridge and indicating the ideal prosthetic position for the implant. The radiographic stent can be thereafter Abstract Aim: This randomized controlled clinical trial (RCT) aimed to compare the accuracy of implant positions between static computer-assisted implant surgery (CAIS) and freehand implant surgery in a single edentulous space. Materials and methods:Sites with single edentulous spaces and neighbouring natural teeth were randomized into static CAIS or freehand implant surgery groups. In both groups, digital implant planning was performed using data from cone beam computed tomography (CBCT) and surface scans. In the static CAIS group, a surgical guide was produced and used for fully guided implant surgery, while in the freehand group, the implants were placed in a freehand manner. Postoperative CBCT was used for nine measurements representing the deviations in angles, implant shoulders and apexes between planned and actual implant positions.Results: Fifty-two patients received 60 single implants. The median (IQR) deviations in angles, shoulders and apexes were 2.8 (2.6)°, 0.9 (0.8) mm and 1.2 (0.9) mm, respectively, in the static CAIS group, and 7.0 (7.0)°, 1.3 (0.7) mm and 2.2 (1.2) mm, respectively, in the freehand group. Statistically significant differences were found in 6 out of nine measured parameters using Mann-Whitney U test (p < 0.05). Conclusion:Static CAIS provided more accuracy in implant positions than freehand placement in a single edentulous space. K E Y W O R D Saccuracy of implant position, dental implant, freehand implant surgery, static computerassisted implant surgery

Does a fully digital workflow improve the accuracy of computer‐assisted implant surgery in partially edentulous patients? A systematic review of clinical trials

“…14,26 Data for the fully-digital workflow group were extracted from the two previously mentioned RCTs 14,26 which included information on both partially-and fully-digital workflows, and four additional studies which reported solely on fully-digital workflows. [15][16][17]27 3.3 | Results of the individual studies A total of 13 studies met the selection criteria for review ( Figure 2). This provided 669 implants in 325 patients.…”

“…Angular deviation was reported in 12 out of 13 studies, including six RCTs 14,15,[23][24][25][26] and six prospective clinical studies. 12,16,17,21,22,27 The overall weighted mean angular deviation was 2.68 , with a 95% CI of 2.32 to 3.03 ( Figure 5).…”

Accuracy of computer-guided implantation in the placement of one-piece ceramic dental implants in the anterior region: A prospective clinical study

“…Because there was no control group in this study, we could not conclude that the computer-guided surgery was more accurate than the conventional implant surgery when placing one-piece ceramic implants. Although a few studies [ 23 , 24 ] have reported that the computer-guided surgery provided more accurate implant positioning than the conventional implant surgery, they are based on titanium implants, in which all surgical steps can be completely controlled through surgical templates. To the best of the authors’ knowledge, this study is the first to focus on the accuracy of computer-guided surgery involving a small-diameter one-piece ceramic implant.…”

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 ].…”

“…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 ]. A precise surgical template can be fabricated by merging the intraoral-scan data with the 3D radiographic data [ 5 – 7 ].…”