Accuracy of Edentulous Computer-Aided Implant Surgery as Compared to Virtual Planning: A Retrospective Multicenter...

Area of Science:

• Dentistry
• Oral Surgery
• Biomedical Engineering

Background:

• Computer-aided surgery (CAS) enhances precision in dental implantology.
• Mucosal-supported surgical templates offer an alternative for guiding implant placement.

Purpose of the Study:

• To assess the accuracy of computer-aided dental implant positioning using mucosal-supported templates compared to traditional three-dimensional (3D) virtual planning.
• Evaluate discrepancies in implant position and angulation between virtual plans and clinical outcomes.

Main Methods:

• One hundred implants were placed in 14 edentulous patients using the All-on-4/6 protocol with virtual planning.
• Software including RealGUIDE, 3DIEMME, and Geomagic was utilized for surgical planning.
• Three-dimensional spatial coordinates of implant necks (V) and apices (S) were measured after 6 months and compared to virtual plans.

Main Results:

• Significant discrepancies were found between clinical and virtual implant positions in the mandible (S and V coordinates, p<0.05).
• Maxillary implant positions showed no significant difference in V coordinates (p=0.71) but a trend towards discrepancy in S coordinates (p=0.091).
• Mean deviations included 1-mm horizontal error at V, 1.6-mm at S, and a 5° angular deviation, with greater errors in the mandible and posterior jaw sections.

Conclusions:

• Computer-aided surgery with mucosal-supported templates is a predictable method for dental implant placement.
• Detected horizontal and angular deviations suggest that flapless surgery may lead to positioning errors, particularly in cases of severe jaw atrophy.
• Consideration of flap surgery is recommended to mitigate potential inaccuracies in implant positioning.