Evaluation of the accuracy of three different computer-aided surgery systems in dental implantology:: optical tracking vs. stereolithographic splint systems

Objectives: In dental implant surgery, computer-aided surgery (CAS) techniques can provide a high medical benefit. Two different techniques are established for transferring a CAS treatment planning to the patient: the use of surgical templates (splints) or intraoperative navigation using optical tracking. The aim of this study was to evaluate the total application accuracy of three different CAS systems (Artma virtual patient (TM), RoboDent LapAccedo (R), Materialise SurgiGuide (TM)): two featuring optical tracking, one featuring stereolithographically manufactured splints. Materials and Methods: A total of 120 implants were placed into 20 human cadaver mandibles. Preoperative computed tomography (CT) scans imported to the corresponding software were used to plan the implant positions on the computer. Implant placement was performed using either optical tracking or stereolithographic splints. Postoperative CT scans were used to obtain the achieved implant positions. A semi-automatic approach was developed to compare planned and achieved implant positions. Deviations between planned and achieved positions were measured for each implant in position (Delta xy), depth (Delta z) and axis (Delta phi). Conclusion: Despite the different techniques of transfer, no statistically significant differences were found between all groups. The accuracy achieved corresponded well with the spatial resolution of the CT Scans used.