Trephination-based, guided surgical implant placement: A clinical study.

Area of Science:

• Dental implantology
• Surgical guide fabrication
• Computer-aided implant surgery

Background:

• Conventional guided implant surgery relies on multiple drills and components, leading to complex procedures and limitations for patients with restricted mouth opening.
• Existing protocols can restrict the choice of implant systems and drills.
• A simplified guided surgery protocol using trephination drills is proposed to overcome these limitations.

Purpose of the Study:

• To evaluate the accuracy of dental implant placement using a novel guided trephine drill protocol.
• To compare the accuracy of the protocol with and without the use of a surgical sleeve.

Main Methods:

• Implant treatment planning involved intraoral scanning and cone-beam computed tomography (CBCT).
• Stereolithography was used for surgical guide fabrication.
• Implant placement accuracy was assessed using postoperative CBCT scans, measuring deviations from the planned position. Surgical time and patient satisfaction were also recorded.

Main Results:

• Implant positional deviations were minimal in both groups (with and without surgical sleeve), with no statistically significant difference in overall accuracy.
• The surgical sleeve group demonstrated significantly greater vertical control precision.
• The use of a surgical sleeve also reduced surgical placement time and time variation.

Conclusions:

• The trephination-based guided implant surgery protocol provides accurate surgical guides suitable for limited vertical access and compatible with multiple implant systems.
• Guided sleeves enhance depth control and decrease surgical time but are not universally required for accurate implant placement.
• This protocol offers a simplified and adaptable approach to guided dental implant surgery.