Accuracy and interindividual outcome of navigation guided dental implant socket drilling in an experimental setting

Abstract

The three-dimensional accuracy of navigation-guided (NG) socket drilling before implant installation was compared to the conventional free-hand (CF) method in a synthetic edentulous lower jaw model. The drillings were performed by two surgeons with different years of working experience. The inter-individual outcome was assessed. NG drillings were performed using an optical computerized tomography (CT) based navigation system. CF drillings were performed using a surgical template. The coordinates of the drilled sockets were determined on the basis of CT scans. A total of n = 224 drillings was evaluated. Inter-individual differences in terms of the surgeons' years of work experience were without statistical significance. The mean deviation of the CF drilled sockets ( n = 112) on vestibulo-oral and mesio-distal direction was 11.2 ± 5.6 (range: 4.1–25.3). Concerning the NG drilled sockets ( n = 112), the mean deviation was 4.2 ± 1.8 (range: 2.3–11.5). The mean distance to the mandibular canal was 1.1 mm ± 0.6 mm (range: 0.1–2.3 mm) for CF drilled sockets and 0.7 mm ± 0.5 mm (range: 0.1–1.8 mm) for NG drilled sockets. The differences between the two methods were highly significant ( p < 0.01). A potential benefit from image-data-based navigation in implant surgery is discussed against the background of cost-effectiveness.