4.5 Article

Depth and lateral deviations in guided implant surgery: an RCT comparing guided surgery with mental navigation or the use of a pilot-drill template

Journal

CLINICAL ORAL IMPLANTS RESEARCH
Volume 26, Issue 11, Pages 1315-1320

Publisher

WILEY
DOI: 10.1111/clr.12460

Keywords

accuracy; clinical research; CT imaging; guided implant surgery; surgical techniques

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AimTo assess the accuracy of guided surgery compared with mental navigation or the use of a pilot-drill template in fully edentulous patients. Material and methodsSixty consecutive patients (72 jaws), requiring four to six implants (maxilla or mandible), were randomly assigned to one of the following treatment modalities: Materialise Universal((R)) mucosa, Materialise Universal((R)) bone, Facilitate mucosa, Facilitate bone, mental navigation, or a pilot-drill template. Accuracy was assessed by matching the planning CT with a postoperative CBCT. Deviations were registered in a vertical (depth) and horizontal (lateral) plane. The latter further subdivided into BL (bucco-lingual) and MD (mesio-distal) deviations. ResultsThe overall mean vertical deviation for the guided surgery groups was 0.9mm0.8 (range: 0.0-3.7) and 0.9mm +/- 0.6 (range: 0.0-2.9) in a horizontal direction. For the non-guided groups, this was 1.7mm +/- 1.3 (range: 0.0-6.4) and 2.1mm +/- 1.4 (range 0.0-8.5), respectively (P<0.05). The overall mean deviation for the guided surgery groups in MD direction was 0.6mm +/- 0.5 (range: 0.0-2.5) and 0.5mm +/- 0.5 (range: 0.0-2.9) in BL direction. For the non-guided groups, this was 1.8mm +/- 1.4 (range: 0.0-8.3) and 0.7mm +/- 0.6 (range 0.0-2.9), respectively. The deviation in MD direction was significantly higher in the non-guided groups (P=0.0002). ConclusionThe most important inaccuracy with guided surgery is in vertical direction (depth). The inaccuracy in MD or BL direction is clearly less. For non-guided surgery, the inaccuracy is significantly higher.

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