Influence of Bone Conditions on the Accuracy of Implant Placement

This study aimed to assess the influence of cortical bone thickness, bone density, and residual ridge morphology in the posterior mandibular area on the accuracy of implant placement using tooth-supported digital guides. The research included 75 implants from 55 patients. Each patient underwent a cone-beam computed tomography (CBCT) scan for image analysis. Simplant^® Pro 17 software (SIMPLANT Pro 17.01) was utilized to measure cortical bone thickness, bone density, and residual ridge morphology at the implant sites. Subsequently, 3Shape Trios software (3Shape TRIOS Design Studio 1.7.19.0) was applied to delineate optimal implant positions and design tooth-supported surgical guides. After implant treatment, the linear and angular deviations from the planned placement were quantified. Multiple linear regression, Kruskal-Wallis test, Conover-Iman test, and Bonferroni adjustment were conducted to investigate the impact of bone characteristics on implant placement precision. The tooth-supported digital guides used in this study were sufficient to fulfill the precision criteria for implant treatment. Bone density was found to significantly influence the buccal-lingual angular deviation, mesio-distal linear deviation, and mesio-distal angular deviation (p < 0.05). Additionally, significant variances were noted in the coronal deviation, apical deviation and depth deviation in buccal-lingual orientation, coronal deviation, and apical deviation in mesio-distal orientation across various residual ridge morphologies (p < 0.05). Low bone density and S-shape morphology may affect the accuracy of implant placement using tooth-supported surgical guides.