Comparison of Implant Placement Accuracy in Healed and Fresh Extraction Sockets between Static and Dynamic Computer-Assisted Implant Surgery Navigation Systems: A Model-Based Evaluation.

Abstract

The aim of this model-base study was to compare the accuracy of implant placement between static and dynamic computer-assisted implant surgery (CAIS) systems in a fresh extraction socket and healed ridge. A randomized in vitro study was conducted. Twenty 3D-printed maxillary models and 80 implants were used. One experienced researcher placed the implants using either the static navigation or dynamic navigation system. Accuracy was measured by overlaying the real position in the postoperative CBCT on the virtual presurgical placement of the implant in a CBCT image. Descriptive and bivariate analyses of the data were performed. In the fresh sockets, the mean deviation was 1.24 ± 0.26 mm (entry point), 1.69 ± 0.34 mm (apical point), and 3.44 ± 1.06° (angle discrepancy) in the static CAIS group, and 0.60 ± 0.29 mm, 0.78 ± 0.33 mm, and 2.47 ± 1.09° in the dynamic CIAS group, respectively. In the healed ridge, the mean deviation was 1.09 ± 0.17 mm and 1.40 ± 0.30 mm, and 2.12 ± 1.11° in the static CAIS group, and 0.80 ± 0.29 mm, 0.98 ± 0.37 mm, and 1.69 ± 0.76° in the dynamic CIAS group, respectively. Compared with the static CAIS system, the dynamic CAIS system resulted in significantly lower entry and apical errors in both fresh sockets and healed ridges. Differences in bone morphology therefore seem to have little effect on accuracy in the dynamic CAIS group.