Abstract
Purpose: To compare virtual planning accuracy of novel computer-assisted, template-based implant placement techniques, which make use of CAD/CAM stereolithographic surgical templates with or without metallic sleeves. Furthermore, to compare open versus closed sleeves for templates without metallic sleeves. Materials and methods: Any partially edentulous patients requiring at least one implant to be placed according to a computer-assisted template-based protocol were enrolled. Patients were randomized according to a parallel group design into two arms: Surgical template with or without metallic sleeves. Three deviation parameters (angular, horizontal, vertical) were defined to evaluate the discrepancy between the planned and placed implant positions. Results: No implants failed, and no complications were experienced. Forty-one implants were placed using surgical templates with metallic sleeves while 49 implants were placed with a surgical template without metallic sleeves. Of these, 16 implants were placed through open sleeves and 33 through closed sleeves. There was a statistically significant difference in angle (p = 0.0212) and in the vertical plan (p = 0.0073) with lower values for implants placed with a surgical template without metallic sleeves. In the test group, close sleeves were more accurate compared with open sleeves in angle (p = 0.0268) and in horizontal plan (p = 0.0477). Conclusion: With the limitations of the present study, surgical templates without metallic sleeves were more accurate in the vertical plan and angle compared to the conventional template with metallic sleeves. Open sleeves should be used with caution in the molar region only in case of reduced interarch space. Further research is needed to confirm these preliminary results.
Highlights
Nowadays, the development of three-dimensional (3D) imaging techniques and implant planning software has contributed to a large diffusion of prosthetically guided implant placement, Dent
Out, and and all all patients were treated to the allocated interventions
To evaluate possible differences in accuracy between open versus closed sleeves in case of sleeve-designed templates. Both templates achieve successful results, the null hypothesis that there. Both templateswere wereable abletoto achieve successful results, the null hypothesis that would be no differences in implant accuracy between templates with or without metallic sleeves was there would be no differences in implant accuracy between templates with or without metallic sleeves partially rejected in favor the hypothesis of differences
Summary
The development of three-dimensional (3D) imaging techniques and implant planning software has contributed to a large diffusion of prosthetically guided implant placement, Dent. J. 2019, 7, 41 the replacement of lost natural teeth is still a challenge for the clinician, mostly due to bone deficiency. Modern digital technology could help to improve patients’ acceptance and clinical success. The use of digital intraoral optical scanner (IOS) has been shown to be a viable option for the rehabilitation of partial edentulous patients, even when associated to computer-guided template-assisted implant placement [1,2]. The clinician and the patient can benefit in terms of shorter treatment time if intraoral digital impression is used [2]
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