Accuracy of the match between cone beam computed tomography and model scan data in template-guided implant planning: A prospective controlled clinical study.

Abstract

Template-guided implant placement is a method for optimal implant positioning from a prosthetic and surgical viewpoint. The treatment planning is based on three-dimensional X-ray data and model scan data, as well as on prosthetic planning (set-up). These data are matched (superimposed) with the aid of an X-ray template or by manual matching without special referencing. The objective of this prospective controlled clinical study was to determine and compare the accuracy of the match with and without an additional X-ray template. The DICOM data of the cone beam computed tomography (CBCT) were converted into surface data sets and then superimposed on model scan data using three different methods (manually, based on an X-ray template, or semi-automatically with computer assistance). The mean deviations between these results of these matching methods were investigated. The procedures achieved a matching accuracy of 0.2 mm on average. This corresponds to the resolution of the CBCT (0.2 voxels). Further studies are necessary to verify the procedure even for patients with few (0-4) residual teeth. In the presence of a sufficient number of residual teeth, the manual matching of model scan data with CBCT data is sufficiently accurate for implant planning and template-guided implementation. The results of the present study suggest that X-ray templates can be dispensed with saving the patient a substantial amount of time and money.