Does machine-vision-assisted dynamic navigation improve the accuracy of digitally planned prosthetically guided immediate implant placement? A randomized controlled trial.

Abstract

This randomized controlled clinical trial was designed to compare the accuracy of machine-vision (MV)-based dynamic navigation (DN)-assisted immediate implant placement with the conventional freehand technique. A total of 24 subjects requiring immediate implant placement in maxillary anterior teeth were randomly assigned to either the control (freehand by an experienced surgeon, n=12) or the test group (MV-DN, n=12). Implant platform, implant apex, angular, and depth deviations with respect to prosthetically guided digital planning and differences in implant insertion torque (ITV) and implant stability quotient (ISQ) were compared between the groups. MV-DN resulted in more accurate immediate implant position: significantly smaller global platform deviation (1.01 ± 0.41 mm vs. 1.51 ± 0.67 mm, p=.038), platform depth deviation (0.44 ± 0.46 mm vs. 0.95 ± 0.68 mm, p=.045), global apex deviation (0.88 ± 0.43 mm vs. 1.94 ± 0.86 mm, p=.001), and lateral apex deviation (0.68 ± 0.30 mm vs. 1.61 ± 0.88 mm, p=.004) were found in MV-DN compared to controls. No significant intergroup differences were observed for ITV and ISQ. MV-DN achieved more precise immediate implant position and comparable primary stability. Further trials are necessary to assess the benefits in terms of esthetics and tissue health/stability.