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Updated: Jan 9, 2026
Real-Time Dynamic Navigation System for the Precise Quad-Zygomatic Implant Placement in a Patient with a Severely Atrophic Maxilla
Published on: October 18, 2021
Accuracy of pin-supported surgical guides for complete arch implant placement: A comparison with conventional
Yu Jen Chen1, Yuqing Lu2, Jiayi Lu3
1Graduate Prosthodontic Resident, Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, Mich.
Statement Of Problem:
While static computer-assisted implant surgery (sCAIS) has improved implant placement accuracy in edentulous arches, mucosa-supported sCAIS guides present limitations, including a lack of direct visualization and irrigation. A novel design for pin-supported sCAIS guides has been developed to address these issues, but its accuracy compared with that of mucosa-supported sCAIS guides remains unclear.
Purpose:
The purpose of this in vitro study was to compare the accuracy of implant placement achieved with pin-supported and mucosa-supported sCAIS guides using standardized edentulous maxillary models.
Material And Methods:
Twenty-four identical edentulous maxillary models were divided into 2 groups (n=12). The mucosa-supported group underwent fully guided implant placement using mucosa-supported sCAIS guides with a flapless protocol. The pin-supported group used a 2-guide pin-supported sCAIS protocol with flap elevation, with 6 implants being planned and placed per model. After implant placement, scan bodies were attached, and the models were scanned. Deviations between planned and actual implant positions were measured using the Blender software program and custom Python scripts. A linear mixed model was used to compare mean deviations between groups (α=.05, with Bonferroni correction for multiple comparisons).
Results:
The pin-supported group demonstrated statistically higher deviations across most parameters, including coronal global (0.89 ±0.36 mm versus 0.72 ±0.305 mm), apical global (1.22 ±0.47 mm versus 0.97 ±0.43 mm), coronal horizontal (0.63 ±0.36 mm versus 0.48 ±0.23 mm), apical horizontal (1.01 ±0.51 mm versus 0.77 ±0.44 mm), and angular deviations (2.84 ±1.33 degrees versus 2.03 ±1.03 degrees), compared with the mucosa-supported group (P<.05). Depth deviation showed no significant difference (P>.05). All mean deviations remained within clinically acceptable limits (<2 mm and <5 degrees).
Conclusions:
In this in vitro study, pin-supported sCAIS guides showed statistically greater deviations than mucosa-supported sCAIS guides across most parameters. However, the mean differences were small, approximately 0.15 to 0.25 mm in linear deviation and 0.8 degree in angular deviation. These differences remained within generally accepted sCAIS accuracy thresholds. Further studies are warranted to validate these findings in clinical settings, assess applicability across patient variations, and evaluate long-term treatment outcomes.
