Does guided level (fully or partially) influence implant placement accuracy at post-extraction sockets and healed sites? An in vitro study.

Abstract

The aim of this study is to evaluate the effect of guide level on the accuracy of static computer-aided implant surgery (sCAIS) at post-extraction sockets and healed sites. A total of 30 duplicate dental models, with 300 potential implant sites, were used. All the models were equally randomized into three groups: fully guided (FG, n = 100), partially guided (PG, n = 100), and free handed (FH, n = 100) surgeries. After implant placement, the mean global, horizontal, depth, and angular deviations between the virtually planned and actual implant positions were measured automatically by a Python script within software Blender. Both FG and PG surgeries showed significantly higher accuracy than FH surgery at post-extraction sockets and healed sites. In both sCAIS groups, there were nearly 50% more deviations from implants placed at sockets than those from delayed placement. For the immediate implant placement, the accuracy of sCAIS was significantly affected by the level of guidance. The FG group exhibited lower deviations than the PG group, with a significant difference in coronal global and horizontal deviations (p < .05). For the healed sites, two guided groups exhibited similar outcomes (p > .05). sCAISs provide more accuracy than the free-handed approach in position transferring from planning to a model simulation. Full guidance can significantly increase the accuracy, especially at post-extraction sites. Guided protocols showed significantly higher accuracy than free-handed surgery regardless of implantation timing, but both had nearly 50% more deviations in immediate implant placement.