Comparison between planned prosthetic trajectory and residual bone trajectory using surgical guides and tomography--a...

Area of Science:

• Dental Implantology
• Oral and Maxillofacial Surgery
• Radiographic Imaging in Dentistry

Background:

• Dental implant treatment is complex, requiring meticulous planning considering patient health, anatomy, and bone characteristics.
• Traditional implant placement relied on available bone, sometimes compromising optimal prosthetic outcomes.
• Accurate trajectory planning is crucial for successful dental implant integration and function.

Purpose of the Study:

• To quantify the angular discrepancies between the planned prosthetic trajectory (PPT) and the residual bone trajectory (RBT).
• To evaluate these deviations across different regions of the maxillary and mandibular arches.
• To enhance the predictability of dental implant success through improved diagnostic procedures.

Main Methods:

• Utilized cross-sectional tomography and custom surgical guides with radiopaque indicators for 25 patients (66 implant sites).
• Determined the planned prosthetic trajectory (PPT) perpendicular to the occlusal plane.
• Measured and compared the angulation difference between PPT and the residual bone trajectory (RBT) at each site.

Main Results:

• Identified notable discrepancies between the planned prosthetic trajectory and residual bone trajectory.
• Observed the greatest angular deviations in the mandibular molar regions.
• Highlighted the need for further investigation into pre-implant diagnostics correlating PPT and RBT.

Conclusions:

• Significant angular differences exist between planned prosthetic and residual bone trajectories in dental implant planning.
• Mandibular molar areas exhibit greater deviations, suggesting potential challenges for ideal implant placement.
• Further research on pre-implant diagnostics is essential to improve the accuracy and success rates of dental implant procedures.