A randomized clinical trial comparing guided implant surgery (bone- or mucosa-supported) with mental navigation or the use of a pilot-drill template

J Clin Periodontol. 2014 Jul;41(7):717-23. doi: 10.1111/jcpe.12231. Epub 2014 Apr 10.

Abstract

Aim: To assess the accuracy of guided surgery (mucosa and bone-supported) compared to mental navigation or the use of a surgical template, in fully edentulous jaws, in a randomized controlled study.

Material and methods: Fifty-nine patients (72 jaws), requiring four to six implants (maxilla or mandible), were consecutively recruited and randomly assigned to one of the following treatment groups; guidance via Materialise Universal(®)/mucosa, Materialise Universal(®)/bone, Facilitate™/mucosa, Facilitate™/bone, or mental navigation or a pilot-drill template. The precision was assessed by matching the planning computed tomography (CT) with a post-operative cone beam CT.

Results: A significant lower mean deviation at the entry point (1.4 mm, range: 0.3-3.7), at the apex (1.6 mm, range: 0.2-3.7) and angular deviation (3.0°, range: 0.2-16°) was observed for the guiding systems when compared to mental navigation (2.7 mm, range: 0.3-8.3; 2.9 mm, range: 0.5-7.4 and 9.9°, range: 1.5-27.8) and to the surgical template group (3.0 mm, range: 0.6-6.6; 3.4 mm, range: 0.3-7.5 and 8.4°, range: 0.6-21.3°). Differences between bone and mucosa support or type of guidance were negligible. Jaw and implant location (posterior-anterior, left-right), however, had a significant influence on the accuracy when guided.

Conclusion: Based on these findings, guided implant placement appears to offer clear accuracy benefits.

Keywords: accuracy; dental implant; stereolitography; surgical template; three-dimensional imaging.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Bone Density / physiology
  • Computer-Aided Design
  • Cone-Beam Computed Tomography / methods
  • Dental Implantation, Endosseous / instrumentation
  • Dental Implantation, Endosseous / methods*
  • Dental Implants
  • Dental Prosthesis Design
  • Female
  • Fiducial Markers
  • Humans
  • Image Processing, Computer-Assisted / methods
  • Imaging, Three-Dimensional / methods
  • Jaw, Edentulous / surgery*
  • Male
  • Mandible / diagnostic imaging
  • Mandible / surgery
  • Maxilla / diagnostic imaging
  • Maxilla / surgery
  • Middle Aged
  • Multidetector Computed Tomography / methods
  • Osteotomy / instrumentation
  • Osteotomy / methods
  • Patient Care Planning
  • Single-Blind Method
  • Smoking
  • Surgery, Computer-Assisted / instrumentation
  • Surgery, Computer-Assisted / methods*
  • Surgical Flaps / surgery

Substances

  • Dental Implants