Accuracy of digital light processing versus selective LASER sintering surgical-templates for All-On-Four technique of computer guided dental implant placement in the mandible: a prospective double blind randomized clinical trial

Abstract

Purpose: Success and safety of dental implants requires accurate treatment planning andprecise implant placement. There should be no deviation between the virtually planned implantposition and the actual implant position after the implant installation regardless the technique ofconstruction of the surgical-guide. So this study was to evaluate and compare the accuracy of twodifferent CAD/CAM surgical guides in placement of all-on-4 implants. Materials and methods:A prospective randomized controlled double blind clinical study was carried out, in which twentyfour implants were placed in 6 edentulous patients. Patients were randomly allocated into one of thetwo groups: control group where surgeries were done using digital light processing (DLP) surgicalguidesand study group where implants were placed using selective laser sintering (SLS) surgicalguides.Each patient received 4 implants in the anterior part of the mandible, 2 axial implants in thecenter and 2 tilted implants at the distal ends. CBCT were taken to the implants after the surgery andthe actual implant positions were compared to the planned implant position. The deviation betweenthe planned and actual implant positions were compared between the 2 techniques of surgical guideconstructions. Results: The results of comparison between the two groups showed a statisticallysignificant difference for all comparisons, with the SLS fabricated guides showing higher deviationfrom control than those fabricated by the DLP printer.Conclusion: Although the computer manufactured surgical guides simplifies surgery and helpin optimal implant placement, there is still evidence of degree of deviation from the planned implantspositions in both of the surgical guides, particularly the SLS fabricated guides so a safety zone so asafety zone is recommended during planning to avoid to avoid critical anatomical structures.