Implant Deviation Assessment in Static and Dynamic Guidance: An In Vitro Study

Area of Science:

• Dental Implantology
• Surgical Navigation Technologies
• Biomedical Engineering

Background:

• Accurate dental implant placement is crucial for successful outcomes.
• Static and dynamic guidance systems offer different approaches to improve surgical precision.
• Evaluating the comparative accuracy of these guidance methods is essential for clinical decision-making.

Purpose of the Study:

• To compare the implant placement positioning accuracy between static and dynamic guidance systems.
• To quantify 3D, 2D, and volumetric deviations of placed implants against a planned reference position.
• To assess the clinical applicability of static versus dynamic guidance in simulated single-tooth edentulism.

Main Methods:

• An in vitro study using 20 resin models with simulated single-tooth edentulism.
• Implant planning performed using cone-beam computed tomography (CBCT) and specialized software.
• Random assignment of models to static guidance (PMMA templates) or dynamic guidance (X-Guide navigation system).
• Post-placement deviation analysis using surface scans and specialized software (Geomagic Control X, Blender).

Main Results:

• Dynamic guidance exhibited statistically significant higher 3D coronal, coronal linear, coronal vertical, and apical vertical deviations compared to static guidance.
• No statistically significant differences were found in 3D apical deviation, apical linear deviation, angular deviation, or overall accuracy percentage.
• Both static and dynamic guidance demonstrated comparable global implant deviation and accuracy percentages.

Conclusions:

• Static guidance demonstrated superior accuracy in coronal and vertical positioning compared to dynamic guidance in this in vitro setting.
• While specific deviations were higher with dynamic guidance, overall accuracy was similar between the two methods.
• Limitations include the absence of bone density and gingival tissue simulation, necessitating further clinical studies for broader applicability.