Accuracy of dynamic navigation compared to static surgical guides and the freehand approach in implant placement: a prospective clinical study.

Publisher: BioMed Central Country of Publication: England NLM ID: 101245792 Publication Model: Electronic Cited Medium: Internet ISSN: 1746-160X (Electronic) Linking ISSN: 1746160X NLM ISO Abbreviation: Head Face Med Subsets: MEDLINE

Original Publication: [London] : BioMed Central, [2005]-

Cone-Beam Computed Tomography*/methods ; Dental Implantation, Endosseous*/methods ; Surgery, Computer-Assisted*/methods; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies

Background: Computer-guided implant surgery has improved the quality of implant treatment by facilitating the placement of implants in a more accurate manner. This study aimed to assess the accuracy of implant placement in a clinical setting using three techniques: dynamic navigation, static surgical guides, and freehand placement. We also investigated potential factors influencing accuracy to provide a comprehensive evaluation of each technique's advantages and disadvantages.
Materials and Methods: Ninety-four implants in 65 patients were included in this prospective study. Patients were randomly assigned to one of three groups: dynamic navigation, static surgical guides, or freehand placement. Implants were placed using a prosthetically oriented digital implant planning approach, and postoperative CBCT scans were superimposed on preoperative plans to measure accuracy. Seven deviation values were calculated, including angular, platform, and apical deviations. Demographic and consistency analyses were performed, along with one-way ANOVA and post-hoc tests for deviation values.
Results: The mean global platform, global apical, and angular deviations were 0.99 mm (SD 0.52), 1.14 mm (SD 0.56), and 3.66° (SD 1.64°) for the dynamic navigation group; 0.92 mm (SD 0.36), 1.06 mm (SD 0.47), and 2.52° (SD 1.18°) for the surgical guide group; and 1.36 mm (SD 0.62), 1.73 mm (SD 0.66), and 5.82° (SD 2.79°) for the freehand group. Both the dynamic navigation and surgical guide groups exhibited statistically significant differences in all values except depth deviations compared to the freehand group (p < 0.05), whereas only the angular deviation showed a significant difference between the dynamic navigation and surgical guide groups (p = 0.002).
Conclusion: Our findings highlight the superior accuracy and consistency of dynamic navigation and static surgical guides compared to freehand placement in implant surgery. Dynamic navigation offers precision and flexibility. However, it comes with cost and convenience considerations. Future research should focus on improving its practicality.
Trial Registration: This study was retrospectively registered at the Thai Clinical Trials Register-Medical Research Foundation of Thailand (MRF) with the TCTR identification number TCTR20230804001 on 04/08/2023. It was also conducted in accordance with the Declaration of Helsinki and approved by the institutional ethics committee at the Xian Jiaotong University Hospital of Stomatology, Xian, China (xjkqII[2021] No: 043). Written informed consent was obtained from all participants.
(© 2024. The Author(s).)

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22078209 National Natural Science Foundation of China; 2022JH-YBYJ-0354 Xi'an Municipal Bureau of Science and Technology

Keywords: Computer-aided surgery; Computer-assisted surgery; Dental implants; Surgical navigation

Date Created: 20240514 Date Completed: 20240515 Latest Revision: 20240518

20250114

PMC11092008

10.1186/s13005-024-00433-1

38745297