Exploring training dental implant placement using computer-guided implant navigation system

Abstract

Purpose This prospective randomized study was designed to evaluate the learning progression, defined as accuracy in placement of dental implants on a simulation model, when a computer-guided dynamic navigation was used to train senior dental students with no previous implant training. The study was designed to define the learning curve and the minimal number of attempts necessary in utilizing computer-guided implant navigation system to improve implant placement skill in a novice implant trainee. Methods A total of 5 implant placement attempts were assigned to each student. The first 4 attempts were randomly assigned for placing either 3 maxillary or 4 mandibular implants. A randomization schedule was generated in SAS EG v6.1 software (Opsware Inc.) to assign all students to a random sequence of the first 4 jaws (2 for maxilla and 2 for mandible), as well as the implant sites within each jaw for all attempts. The spatial relationship between the JagTag on the stent installed on a plastic model and the DrillTag on handpiece was tracked by the stereoscopic camera. Repeated measures analysis of variance was used to evaluate discrepancies in the 2-dimensional (2D) lateral deviation, overall 3-dimensional (3D) apex deviation, 2D vertical apex deviation, and overall 3D angle deviation. Results Fourteen students participated, with a mean age of 26.1 years and equal males and females. Mean time for implant placement was associated with attempt number (P Conclusions Novice operators learn the skill of placing implants with dynamic navigation within 3 attempts. The speed and angulation deviation improve significantly within the first 3 attempts and are sustained. Performance for males, on average, was marginally better in time and accuracy than females.