The use of computer-guided surgery via a partially guided protocol does not completely compensate for the level of operator experience in implant placement

Abstract

Purpose: There is always a tension between allowing novice trainees to place implantsindependently and the need to achieve accurate functional and esthetic outcomes. We aimed tomeasure the influence of surgeon experience on the accuracy of implants placed using a teethsupportedsurgical guide via a partially guided surgical protocol in a clinical setting.Materials and Methods: Twenty partially edentulous patients were randomly allocatedto expert and novice surgeon groups. Implant drilling and placement for the two groups wereperformed through a flapless surgical technique using surgical guides following a partially guidedsurgical protocol. The study primary independent variable was the surgeon experience, whilethe outcome variable was the accuracy, which was measured based on the differences in implantangulations pre- and postoperatively. Two-way analysis of variance (ANOVA) was applied to findthe influence of surgeon experience, implant size, and the interactive effect of surgeon experienceand implant size on the angular deviation.Results: A total of 40 implants were inserted in 7 males and 13 females. There was no significantdifference (p = 0.453) in the mesio-distal deviation between the expert and novice groups. In abucco-lingual direction, the expert group performed more accurate implant placement (3.7 ± 3.35)compared with the novice surgeons (8.5 ± 6.3). There was no effect for implant size and/or theinteraction effect on the degree of angular deviations.Conclusion: The level of surgeon experience affects the accuracy of implants placed using ateeth-supported surgical guide in a bucco-lingual direction; therefore, the use of computer-guidedsurgery via a partially guided protocol does not completely compensate for the level of operatorexperience. However, such surgical guide might be used in a whole task training of novice surgeons,as it can bridge a gap between simulation training in vitro and free-hand surgery in a clinical setting.