Dynamic navigation for dental implant placement in single-tooth gaps: A preclinical pilot investigation

Abstract

ObjectivesTo compare the planned (PIP) and transferred implant position (TIP) after dental implant placement in single-tooth gaps utilizing dynamic computer-assisted implant surgery (dCAIS). MethodsFive pairs of artificial jaws (n = 5) with four single tooth gaps in FDI (Fédération Dentaire Internationale) regions 16, 25, 36 and 44 were manufactured via injection molding technique. Cone beam computed tomographies (CBCTs) were made and digital implant planning of twenty implants (n = 20) was performed with a dynamic navigation system (DNS, Navident, ClaroNav, Toronto, Canada). After guided drilling and manual implant placement, post-operative CBCTs were made. Global deviations at entry point (two-dimensional, 2D), apex (three-dimensional, 3D), apex (vertical, V) and angulation (in degrees, °) were calculated by DNS software. For statistical analysis, level of significance was set to p < 0.05. ResultsMean deviation at the implants entry point (2D) was 0.78 ± 0.45 mm (range: 0.10–1.63 mm). For the implants apex (3D) and the implants apex (V) deviations were 1.08 ± 0.50 mm (range: 0.33–2.10 mm) and 0.32 ± 0.22 mm (range: 0.02–0.90 mm), respectively. The median angular deviation (°) was 2.81 ± 2.29° (range: 0.56–9.58°). Statistically significant differences (p < 0.05) were found regarding apex (3D), apex (V), and angulation (°) comparing I.–IV. quadrants. ConclusionsUsing the investigated dCAIS seems to provide satisfactory results regarding TIP in single-tooth gaps in vitro. Due to documented deviations, a safety distance of more than 2 mm should be respected while implant planning in DNS software. Clinical significanceThe investigated DNS seems to be reliant in transferring PIP with acceptable deviations in vitro.