Evaluation of Accuracy of Static Computer-Guided Implant Placement Compared with Partially-Guided or Free-Hand Placement
Date of Award
Master of Science (MS)
Purpose: To evaluate precision and trueness of static computer-assisted implant surgery (sCAIS) in comparison with partially-guided and free-hand implant placement in vitro.Materials & Methods: The study was conducted on one hundred mandible replicas obtained from a cone beam computer tomography of a partially edentulous case for implant placement in mandibular right first molar site. First, the fully guided implant placement with different sleeve to bone distances (2mm = H2, 4mm = H4, 6mm= H6) was determined. Second, fully guided implant placement was compared with partially guided, and free implant placement. The achieved implant position was digitized and compared with the planned position. The study followed the recommendation of the ISO 5725-1, where trueness is defined as the distance to the reference value and precision is defined as degree to which repeated measurements show the same result under unchanged conditions. The three-dimensional (3D) deviation at the crest was the primary outcome parameter. Twenty implants were placed in each group. ANOVA and Scheffe’s post-hoc comparison were used for statistical analysis. Statistical significance was set as p<0.05.Results: The mean 3D deviation at the crest from the reference value (trueness) for the H2-group was 0.220.07mm, for H4 was 0.450.16mm, and for H6 was 0.430.15mm. The values for H4 and H6 were significantly higher (p<0.05) than for H2. The H2 group showed the highest trueness and precision. No statistical difference with respect to precision was detectable between the H4 and H6 groups (p>0.05). The mean 3D-deviation at the crest was 0.690.15mm for partially-guided, and 0.800.35mm for free-hand placement. Fully-guided placed implants showed also the highest precision (distance of implants among each other) with 0.080.07mm for the 3D-deviation, followed by partially-guided (0.180.15mm), and free-hand placement (0.420.28 mm).Conclusion: Static computer-assisted implant surgery (fully guided approach) is more accurate and precise than partially guided and free hand implant placement.Sleeve heights of 2 mm or 4 mm should be preferred. The close to the bone the more accurate and precise. Partially guided implant surgery was significantly better than free hand placement. Free hand was not precise and not accurate.