Date of Award
Spring 2021
Document Type
Thesis
Degree Name
Master of Science (MS)
Department
Dentistry
Program
Prosthodontics
First Advisor
Guentsch, Arndt
Second Advisor
Kassab, Moawia
Third Advisor
Kofina, Vrisiis
Abstract
Purpose: The aim of this study is to evaluate the influence of operator experience in the fully guided placement of implants in dentate patients. Methods: Three different providers with different level of experience in implant surgery (unexperienced, moderate experienced = 2 years of experience, and experienced = more than 5 years of experience in implant surgery) placed each n=20 implants fully guided or free hand in identical replicas, produced from a CBCT of a partially edentulous patient case. The achieved implant position was digitized by using a laboratory scanner and compared with the planned position. Trueness (planned versus actual position) and precision (difference among implants) were determined. The 3D-offset at the crest of the implant (Root mean square between virtual preoperative planning and postoperative standard triangulation file) was defined as primary outcome parameter. The means, standard deviation, and 95%-confidence intervals were analyzed statistically with 1-way ANOVA and the Scheffe procedure. Intraoperator reliability was calculated with Cronbach’s Alpha.Results: In the analysis of the implants placed using the fully guided protocol, 3D-deviation of the crest for the unexperienced provider (0.56±0.09mm) was statistically different (p<0.001) from the moderate experienced provider (0.28±0.08mm) and the experienced provider (0.28±0.17mm). No statistically significant differences between moderate and experienced provider were observed (p=0.94). The use of a fully guided approach did not improve the outcome of the implant placement for an unexperienced provider. Significant improvements of the accuracy were seen in the moderate experienced and the experienced providers with significant differences for the angle deviation (free-hand: 1.67±0.77degree vs. fully guided: 1.29±0.52 degree; p<0.001) and the 3D-deviation at the crest (0.34±0.17mm vs. 0.28±0.08mm; p<0.01) for the moderate experienced provider. Conclusions: Within the limitations of this study, operator experience has an impact on the accuracy and reliability of fully guided implant placement. When using the fully guided system it appears that a certain degree of experience is necessary to achieve high accuracy.