Abstract
Purpose. Computer-assisted stereolithographically guided surgery allows an ideal implant placement for prosthetic restoration. Two types of stereolithographic templates are currently available: a fully guided template and a pilot-drill guided template. The purpose of this study was (i) to evaluate the accuracy of implant insertion using these types of surgical templates and (ii) to define parameters influencing accuracy. Materials and Methods. 20 patients were enrolled and divided into 2 study groups: in group A, implants were placed using CAD-CAM templates with fully guided sleeves; in group B, implants were placed with a template with only pilot-drill guided sleeves. Pre- and postoperative computed tomographies were used to measure differences between final positions of implants and virtually planned positions. Three linear discrepancies (coronal, apical, and depth) and two angular ones (buccolingual and mesiodistal) were measured. Correlations between accuracy and jaws of interest, implant length and diameters, and type of edentulism were also analysed. Results. A total of 50 implants were inserted in 15 patients using CAD-CAM templates: 23 implants in group A and 27 in group B. The mean coronal deviations were 1.16 and 1.11 mm (P = 0.35), respectively; the mean apical deviations were 1.65 and 1.71 mm (P = 0.22); the mean depth deviations were 0.95 and −0.68 mm (P = 0.032); the mean buccolingual angular deviations were 4.16° and 6.72° (P = 0.042); and the mean mesiodistal ones were 2.81° and 5.61° (P = 0.029). In addition, the accuracy was statistically influenced only by implant diameter for coronal discrepancy (P = 0.035) and by jaw of interest for mesiodistal angulation (P = 0.045). Conclusion. Fully guided implant surgery was more accurate than pilot-drill guided surgery for different parameters. For both types of surgery, a safety margin of at least 2mm should be preserved during implant planning to prevent damage to nearby anatomical structures.
Highlights
Over the past decades, implant dentistry has become widely used to rehabilitate edentulism [1]
In the era of prosthetically guided surgery, the templates were made by dental technicians and the ideal implant position was chosen with reference to mechanical and aesthetic factors
Since the results found that several variables influence the accuracy of implant placement, the fully guided implant surgery technique should be preferred when influencing factors are not favourable
Summary
Implant dentistry has become widely used to rehabilitate edentulism [1]. Different techniques have been developed to transfer the ideal implant position (established during planning) to the surgical field, using templates [5]. In the era of prosthetically guided surgery, the templates were made by dental technicians and the ideal implant position was chosen with reference to (principally) mechanical and aesthetic factors. Bone volume analysis was the province of the clinician and was performed with the aid of two-dimensional radiographs at the planning stage or evaluated intraoperatively when a mucoperiosteal flap was raised. These limitations were removed by the introduction of three-dimensional (3D) radiographic techniques, 3D implant planning software, and 3D stereolithographic (SLA) printing
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
