J Adv Prosthodont.  2013 Nov;5(4):440-447. 10.4047/jap.2013.5.4.440.

An assessment of template-guided implant surgery in terms of accuracy and related factors

• Lee JH
• Park JM
• Kim SM
• Kim MJ
• Lee JH
• Kim MJ

• KMID: 2176536
• DOI: http://doi.org/10.4047/jap.2013.5.4.440

Abstract

PURPOSE
Template-guided implant therapy has developed hand-in-hand with computed tomography (CT) to improve the accuracy of implant surgery and future prosthodontic treatment. In our present study, the accuracy and causative factors for computer-assisted implant surgery were assessed to further validate the stable clinical application of this technique.
MATERIALS AND METHODS
A total of 102 implants in 48 patients were included in this study. Implant surgery was performed with a stereolithographic template. Pre- and post-operative CTs were used to compare the planned and placed implants. Accuracy and related factors were statistically analyzed with the Spearman correlation method and the linear mixed model. Differences were considered to be statistically significant at P< or =.05.
RESULTS
The mean errors of computer-assisted implant surgery were 1.09 mm at the coronal center, 1.56 mm at the apical center, and the axis deviation was 3.80degrees. The coronal and apical errors of the implants were found to be strongly correlated. The errors developed at the coronal center were magnified at the apical center by the fixture length. The case of anterior edentulous area and longer fixtures affected the accuracy of the implant template.
CONCLUSION
The control of errors at the coronal center and stabilization of the anterior part of the template are needed for safe implant surgery and future prosthodontic treatment.

Keyword

Computer-assisted surgery; Dental implant; Accuracy

MeSH Terms

Axis, Cervical Vertebra
Dental Implants
Humans
Methods
Prosthodontics
Surgery, Computer-Assisted
Dental Implants

Figure

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  Fig. 1 The location and angulation of the implant were determined through the use of planning software and virtual surgery by considering the critical anatomical structures and the future dental prostheses.

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  Fig. 2 The information from the planned fixture was used to create the stereolithographic implant template. (A) Completion of planning of implant surgery on 3D software, (B) Stereolithographic template for computer-assisted implant surgery.

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  Fig. 3 Surgical procedure for template-guided implant surgery. (A) Preparation of operation field, (B) Setting of surgical template in the oral cavity, (C) Flap elevation for sequential drilling, (D) Implantation of fixture guided by the template.

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  Fig. 4 (A) Comparison of the planned and placed implants by superimposition of the pre- and postoperative images, (B) Disassembly of the total errors into horizontal and vertical directions at the coronal center, (C) Disassembly of the total errors into horizontal and vertical directions at the apical center.a: coronal distance, b: apical distance, c: axis deviation, h: horizontal deviation, v: vertical deviation.

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