Accuracy of implant placement with a computer-aided fabricated surgical template with guided parallel pins: A pilot study

Background: A precise positioning for dental implant placement is important for further prosthesis fabrication and maintenance. Computer-aided surgery has been developed to transfer digitally planned implant positioning to the patient over the past decades. This study aimed to evaluate the accuracy of a computer-aided laboratory-fabricated surgical template. A further objective was to compare the accuracy between in vivo and in vitro groups. Methods: A total of 20 implants were placed in the posterior tooth region through the aid of surgical templates on 17 partially edentulous patients in the in vivo group. The surgical template was fabricated in laboratory after virtual implant planning was completed using computer software. In the in vitro group, the same procedures were performed on the models without placing fixture with the same templates used in surgery. Deviations of the implant access at the implant platform level and apical region, as well as the angle deviations between the virtual planning data and the surgical results, were measured using a follow-up Cone Beam Computerized Tomography (CBCT) investigation, and image fusion with planning data. Result: The median deviation at platform level, apex and angulation was 0.95 mm (0.3-1.3 mm), 1.35 mm (0.1-3.6 mm) and 3.92 degrees (0.44-11.66 degrees) respectively in the in vivo group; and 0.4 mm (0-1.0 mm), 0.65 mm (0.1-1.9 mm), 2.16 degrees (0.17-6.91) respectively in the in vitro group. The in vitro group displayed significantly less deviation (p < 0.05). Conclusion: The data from this study shows that computer-aided laboratory-fabricated template may be a reliable tool for implant placement. However, the clinical conditions seem to affect the accuracy of the template. Copyright (C) 2018, the Chinese Medical Association. Published by Elsevier Taiwan LLC.