3D accuracy of implant positions in template-guided implant placement as a function of the remaining teeth and the surgical procedure: a retrospective study
- 410 Downloads
The aim of this study was to investigate differences between the virtually planned and clinically achieved implant positions in completely template-guided implantations as a function of the type of edentulous space, the residual natural dentition, and the surgical implementation.
Materials and methods
Fifty-six patient cases with a total of 122 implants were evaluated retrospectively. The implantations were completely template-based. The data of the planned implant positions were overlaid with the actual clinical implant positions, followed by measurements of the 3D deviations in terms of coronal (xc) and apical distance, height (xh), and angulation (ang) and statistical analysis.
The mean xc was 1.2 mm (SD 0.7 mm); the mean xa was 1.8 mm (SD 0.9 mm), the mean xh was 0.8 mm (SD 0.7 mm); and the mean ang was 4.8° (SD 3.1). The type of edentulous space and the jaw (maxilla/mandible) had no significant effect on the results in terms of implant positions. The presence of an adjacent natural tooth at the time of implantation had a significant influence on xh (p = 0.04) and ang (p = 0.05). No significant differences were found regarding the surgical approach for any of the parameters examined.
The results of our study are in the same range as those of other studies. Template-guided implantation offers a high degree of accuracy even in the presence of different configurations of the residual dentition or different surgical approaches. A clinical benefit is therefore present, especially from a prosthetic point of view.
The clinically achievable accuracy can be described as sufficient for further prosthetic treatment, given the intrinsic and methodological tolerances, making prosthetic rehabilitation safe and predictable.
KeywordsDental implant Surgical template CBCT Computer-guided surgery Accuracy Partially edentulous jaw
The authors declare that no conflict of interest exists as per the guidelines of the International Committee of Medical Journal Editors. There was no funding for this study. Within the framework of another prospective study, Camlog and Swissmeda provided materials. The first-named author has held presentations for Camlog and Swissmeda.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
The study was approved by the Ethics Committee of the University of Ulm (decision no. 339/14 dated April 12, 2014).
For this type of study, formal consent is not required.
- 3.Nickenig HJ, Wichmann M, Hamel J, Schlegel KA, Eitner S (2010) Evaluation of the difference in accuracy between implant placement by virtual planning data and surgical guide templates versus the conventional free-hand method - a combined in vivo - in vitro technique using cone-beam CT (part II). J Craniomaxillofac Surg 38(7):488–493. https://doi.org/10.1016/j.jcms.2009.10.023 CrossRefPubMedGoogle Scholar
- 5.Vercruyssen M, Cox C, Coucke W, Naert I, Jacobs R, Quirynen M (2014) A randomized clinical trial comparing guided implant surgery (bone- or mucosa-supported) with mental navigation or the use of a pilot-drill template. J Clin Periodontol 41(7):717–723. https://doi.org/10.1111/jcpe.12231 CrossRefPubMedGoogle Scholar
- 9.Kernen F et al (2015) Accuracy of three-dimensional printed templates for guided implant placement based on matching a surface scan with CBCT. Clin Implant Dent Relat ResGoogle Scholar
- 13.Raico Gallardo YN et al (2016) Accuracy comparison of guided surgery for dental implants according to the tissue of support: a systematic review and meta-analysis. Clin Oral Implants ResGoogle Scholar
- 16.Naziri E, Schramm A, Wilde F (2016) Accuracy of computer-assisted implant placement with insertion templates. GMS Interdiscip Plast Reconstr Surg DGPW. 5: p. Doc15Google Scholar
- 18.Alzoubi F, Massoomi N, Nattestad A (2016) Accuracy assessment of immediate and delayed implant placements using CAD/CAM surgical guides. J Oral ImplantolGoogle Scholar
- 20.Schnutenhaus S, Edelmann C, Rudolph H, Luthardt RG (2016) Retrospective study to determine the accuracy of template-guided implant placement using a novel nonradiologic evaluation method. Oral Surg Oral Med Oral Pathol Oral Radiol 121(4):e72–e79. https://doi.org/10.1016/j.oooo.2015.12.012 CrossRefPubMedGoogle Scholar
- 21.Cohen J (1988) Statistical power analysis for the behavioral sciences. 2nd ed, vol xxi. L. Erlbaum Associates, Hillsdale 567 pGoogle Scholar
- 23.Schneider D, Schober F, Grohmann P, Hammerle CHF, Jung RE (2015) In-vitro evaluation of the tolerance of surgical instruments in templates for computer-assisted guided implantology produced by 3-D printing. Clin Oral Implants Res 26(3):320–325. https://doi.org/10.1111/clr.12327 CrossRefPubMedGoogle Scholar