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Published on: October 18, 2021
Dynamic navigation-guided palatal offset for anterior maxillary implants: a randomized controlled trial
Jia Chen1, Honghong Liu1, Yingying Zhang1
1Department of Stomatology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China.
Objective:
To evaluate the clinical efficacy of palatal offset drilling strategy in compensating for implant labial deviation caused by uneven bone density in the maxillary anterior region.
Study Design:
Thirty-one patients (39 sites) were randomized into control (18 sites, standard preparation) and experimental (21 sites, palatally shifted entry) groups. Deviations and implant stability quotient (ISQ) were evaluated using linear mixed-effects models (LMMs) to account for intra-patient clustering.
Results:
LMMs revealed no significant intergroup differences in overall implant placement accuracy, including entry-point and apex deviations, as well as total angular errors (all P > 0.05). However, the experimental group demonstrated a significantly higher initial implant stability quotient (ISQ) compared to the control (Estimated Marginal Mean: 67.05 vs 57.39; P < .001).
Conclusions:
While not yielding statistically significant reductions in absolute deviation metrics, the palatal offset strategy maintains surgical precision with a tendency toward reduced labial skidding. Importantly, it significantly enhances initial implant stability, validating its clinical utility for navigation-guided osteotomy in the restricted anterior maxilla.
