J Periodontal Implant Sci.  2014 Aug;44(4):184-193. 10.5051/jpis.2014.44.4.184.

Accuracy of computer-aided template-guided oral implant placement: a prospective clinical study

• Beretta M
• Poli PP
• Maiorana C

• KMID: 2212012
• DOI: http://doi.org/10.5051/jpis.2014.44.4.184

Abstract

PURPOSE
The aim of the present study was to evaluate the in vivo accuracy of flapless, computer-aided implant placement by comparing the three-dimensional (3D) position of planned and placed implants through an analysis of linear and angular deviations.
METHODS
Implant position was virtually planned using 3D planning software based on the functional and aesthetic requirements of the final restorations. Computer-aided design/computer-assisted manufacture technology was used to transfer the virtual plan to the surgical environment. The 3D position of the planned and placed implants, in terms of the linear deviations of the implant head and apex and the angular deviations of the implant axis, was compared by overlapping the pre- and postoperative computed tomography scans using dedicated software.
RESULTS
The comparison of 14 implants showed a mean linear deviation of the implant head of 0.56 mm (standard deviation [SD], 0.23), a mean linear deviation of the implant apex of 0.64 mm (SD, 0.29), and a mean angular deviation of the long axis of 2.42degrees (SD, 1.02).
CONCLUSIONS
In the present study, computer-aided flapless implant surgery seemed to provide several advantages to the clinicians as compared to the standard procedure; however, linear and angular deviations are to be expected. Therefore, accurate presurgical planning taking into account anatomical limitations and prosthetic demands is mandatory to ensure a predictable treatment, without incurring possible intra- and postoperative complications.

Keyword

Computer-aided design; Dental implants; X-ray computed tomography

MeSH Terms

Axis, Cervical Vertebra
Computer-Aided Design
Dental Implants
Head
Postoperative Complications
Prospective Studies*
Tomography, X-Ray Computed
Dental Implants

Figure

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  Figure 1 Preoperative frontal view of the edentulous jaws.

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  Figure 2 Computer-aided planning in the upper jaw.

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  Figure 3 Computer-aided planning in the lower jaw.

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  Figure 4 Stabilization of the two surgical stent by means of a silicone index.

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  Figure 5 Upper surgical stent fixed in the proper position by means of cortical pins and implants insertion.

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  Figure 6 Lower surgical stent fixed in the proper position by means of cortical pins and implants insertion.

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  Figure 7 Overlapping of the pre- and postoperative scans for the comparison between planned (red) and real (green) implant positions in order to analyse the accuracy of the system in the upper jaw.

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  Figure 8 Accuracy assessments in the upper jaw between planned (red) and real (green) implant positions.

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  Figure 9 Overlapping of the pre and postoperative scans for the comparison between planned (red) and real (green) implant positions in order to analyse the accuracy of the system in the lower jaw.

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  Figure 10 Accuracy assessments in the lower jaw between planned (red) and real (green) implant positions.

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  Figure 11 Frontal view of the final upper and lower restorations.

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  Figure 12 Follow-up X-rays control.

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