Surgical Stent Guided Versus Conventional Method of Implant Placement.

Abstract

The aim of this study is to compare the surgical accuracy and efficiency of endo-osseous implant placement using a conventional method and when placed using a custom surgical guide. The study was carried out in a case control design on 20 patients aged between 15years and 60years. In the study group (n = 10) the implants were placed with the help of a surgical stent, while in the control group (n = 10) implants were placed in a conventional manner (without surgical stent) planned only with CBCT scan. The same surgeon placed the implants in both the groups. Each patient was considered in terms of the number of implants received. Each planned and actual implant was compared in terms of the 8 quantitative variables, which were used to observe and compare the accuracy of the surgical guides and conventionally placed implants. Data were analysed by a single blinded statistician using statistical software (Graphpad Prism (Version 5)). The Microsoft excel and Student T test for parametric data and Chi-square test for categorical data were used to observe significant differences between the 2 study groups. The nonparametric Chi-Square test revealed a statistically significant difference between surgical stent guided and conventional surgery in terms of buccal and lingual/palatal cortical plate to implant deviation, adjacent tooth to implant deviation, and mesiodistal angular deviation, whereas the differences between the marginal bone loss deviation, stability deviation, pain and swelling deviation, treatment time and number of sessions deviation, satisfaction deviation were not statistically significant. From our study, we can conclude that guided surgery is essential for insertion of the implants regardless of the surgical technique. The success of the guided surgery depends on accuracy of the clinical and/or laboratorial steps of the virtual planning. Despite all the limitations and probability of errors encountered in our study, the guided surgery is superior in better positioning of implants.