Computer-assisted surgery in the edentulous jaw based on 3 fixed intraoral reference points

Area of Science:

• Oral and Maxillofacial Surgery
• Biomedical Engineering
• Dental Implantology

Background:

• Computer-assisted implantation surgery relies on accurate transfer of prosthodontic plans via registration templates.
• Edentulous jaws present challenges for precise registration template repositioning, impacting surgical accuracy.

Purpose of the Study:

• To evaluate the in vitro registration and targeting accuracy of surgical navigation in edentulous jaws.
• To assess the efficacy of using three fixed intraoral reference points for this purpose.

Main Methods:

• Utilized edentulous cadaver maxilla and mandible specimens with three fixed reference-point screws.
• Employed a resin template, registration mouthpiece, and optical navigation system for implant planning and drilling.
• Assessed accuracy through fiducial registration error and post-surgical scan fusion with pre-surgical planning.

Main Results:

• Performed 14 registrations and 104 stone cast drillings across 9 maxillas and 5 mandibles.
• Achieved a mean fiducial registration error of 0.49 ± 0.14 mm.
• Reported mean total error at the borehole tip of 0.88 ± 0.65 mm, with mean lateral errors of 0.51 mm at the base and 0.46 mm at the tip, and a mean angular error of 0.83 ± 0.60 degrees.

Conclusions:

• Three fixed intraoral reference points effectively support a registration mouthpiece for computer-assisted surgery.
• This method demonstrates in vitro registration and targeting accuracy comparable to tooth-supported templates or bone markers.
• Offers a viable solution for improving surgical navigation accuracy in edentulous jaws.