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Effect of Metal Artifacts in CBCT on the Accuracy of Implant Placement by Static and Dynamic Computer-Assisted
Purpose:
To evaluate the impact of metal artifacts in CBCT on the accuracy of static and dynamic computer-assisted implant surgery (CAIS) techniques.
Materials And Methods:
An implant was placed in 30 3D-printed models embedded with cobalt-chromium strips to simulate metal artifacts left by porcelain-fused-to-metal crowns utilizing three CAIS techniques: radiographic template (RT) (n = 10), radiographic markers (RM) (n = 10), and dynamic navigation (DN) (n = 10). Trueness and precision were analyzed by comparing 3D global deviation and the difference in implant positions at the neck, apex, depth, and angle in initial planned and final placed scans.
Results:
DN exhibited a significantly lower 3D global trueness deviation than RT (P = .022) and lower angular deviation compared to both RT (P = .003) and RM (P = .002). RM showed greater trueness at the implant neck compared to DN (P = .005) and better depth trueness than RT (P = .001) and DN (P = .027). DN demonstrated higher precision in implant angulation than RM (P = .011) and RT (P = .041).
Conclusions:
In the presence of metal artifacts, both DN and RM techniques offered greater trueness in specific implant positions compared to RT. However, DN proved to be the most precise method for implant placement.
