Abstract
The aim of our randomized clinical study was to analyze the influence of surgical experience and bone density on the accuracy of static computer-assisted implant surgery (CAIS) in edentulous jaws using a mucosa-supported surgical template with a half-guided implant placement protocol. Altogether, 40 dental implants were placed in the edentulous jaws of 13 patients (novice surgeons: 18 implants, 6 patients (4 male), age 71 ± 10.1 years; experienced surgeons: 22 implants, 7 patients (4 male), age 69.2 ± 4.55 years). Angular deviation, coronal and apical global deviation and grey level measurements were calculated for all implants by a blinded investigator using coDiagnostiX software. 3DSlicer software was applied to calculate the bone volume fraction (BV/TV) for each site of implant placement. There were no statistically significant differences between the two study groups in either of the primary outcome variables. There was a statistically significant negative correlation between angular deviation and both grey level measurements (R-value: −0.331, p < 0.05) and BV/TV (R-value: −0.377, p < 0.05). The results of the study suggest that surgical experience did not influence the accuracy of implant placement. The higher the bone density at the sites of implant placement, the higher the accuracy of static CAIS.
Highlights
In contemporary implantology, a multidisciplinary approach to oral rehabilitation requires backwards planning
40 dental implants were placed in the edentulous jaws of 13 patients (test group, novice surgeons: 18 implants placed in 6 patients (4 male), age 71 ± 10.1 years; control group, experienced surgeons: 22 implants placed in 7 patients (4 male), age 69.2 ± 4.55 years)
Another approach more accurate than mucosa-supported templates that may be used in case of an edentulous jaw is an implant-supported template. This requires an additional surgical procedure to insert temporary implants, which increases patient discomfort and costs [1,2,3,8,14]. Both full-guided and half-guided static computer-assisted implant surgery (CAIS) significantly reduce the length of surgery, which decreases postoperative morbidity and ensures that the implant positions achieved are closer to the prosthetically ideal, planned implant positions compared to those achieved by free-hand surgery [1,2,8,14,35]
Summary
A multidisciplinary approach to oral rehabilitation requires backwards planning. The number, dimensions, position and inclination of dental implants placed are determined by prosthetic planning, which facilitates optimal esthetic results, optimal function, ideal biomechanical loading for all components of the prosthesis and long-term stability of soft and hard tissues surrounding the implants [1,2,3]. Surface treatment of dental implants and fixtures during production plays an important role in muco-integration. Materials 2020, 13, 5759 influence the health of soft tissues surrounding the implants [4,5]. Computer-assisted design and computer-assisted manufacturing (CAD/CAM) enable virtual planning of the prosthesis and position of the dental implants, which allows better communication between the prosthodontist, the implant surgeon and the dental technician. Virtual planning promotes the management of patient expectations by way of visualization of the expected treatment outcomes [3,6]
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