Related Experiment Video
Updated: Oct 1, 2026
Dynamic Navigation for Dental Implant Placement
Published on: September 13, 2022
OPTIMISING ACCURACY OF COMPUTER-ASSISTED IMPLANT SURGERY USING NOVEL DRILLING KEY DESIGN: SIMULATION-BASED STUDY
Thaysan Kaing1, Sirida Arunjaroensuk1, Xin Hui Yeo1
1Oral and Maxillofacial surgery and Digital Implant Surgery Research Unit, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand; Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
Background:
Accurate implant positioning remains the goal of guided surgery for improving surgical outcomes and minimizing complications. The aim is to compare the accuracy of standard versus novel drilling key in static-dynamic computer assisted implant surgery across D2 and D3 bone densities relative to a zero-deviation benchmark.
Methods:
Sixty-four bone-level tapered implants were placed in 32 models across four groups (n = 16), stratified by drilling key designs (standard vs novel) and bone density (D2 vs D3). Preoperative cone-beam computed tomography (CBCT) was imported into the navigation system for implant planning. Surgical guide was designed to match the navigation planning. Implant placement followed the manufacturer protocols. Postoperative CBCT was superimposed on pre-operative plan to measure 3D platform, 3D apex, and angular deviations. Two-way ANOVA, Levene, Kruskal-Wallis, and post-hoc Mann-Whitney U tests were used (p < 0.05).
Results:
The novel drilling key significantly reduced angular deviation compared to the standard key (1.84°± 1.58 vs 0.21°± 0.56, p < 0.001); 3D platform (0.78 ± 0.30 vs 0.74 ± 0.17 mm, p = 0.262) and apex (0.82 ± 0.31 vs 0.93 ± 0.41 mm, p = 0.596) were comparable. D3 bone showed higher 3D apex (p = 0.017) and angular deviations (p = 0.044) than D2.
Conclusion:
The findings imply that the novel key design provides a targeted advantage in reducing angular deviation in both bone densities while linear deviations at the platform and apex remain influenced by bone density and other potential sources of error within the guided workflow.
Clinical Significance:
This study addresses accuracy in implant dentistry in technically challenging cases such as long free drilling distance where low sleeve positioning is not feasible.