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Un método alternativo libre de radiación para evaluar la precisión de la cirugía de implantes asistida por
Rongrong Zhu1, Longlong He2, Qin Zhou2
1Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China; Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Disease, College of Stomatology, Xi'an Jiaotong University, Xi'an, China; Department of Implant Dentistry, College of Stomatology, Xi'an Jiaotong University, Xi'an, China; Department of Dentistry, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
Objectives:
This study aimed to assess the accuracy of implant placement performed using robotic computer-assisted implant surgery (r-CAIS) by comparing postoperative measurements obtained via intraoral scanning (IOS) with those derived from cone-beam computed tomography (CBCT).
Methods:
The study employed a cross-sectional design. All patients received a preoperative CBCT and IOS for surgical planning and registration. All the surgeries were performed using r-CAIS. Postoperative CBCT and IOS datasets were acquired for each patient and superimposed on the preoperative datasets to assess deviations between planned and actual implant positions. Paired t-tests were used to analyze differences between the two assessment modalities, with statistical significance defined as P < 0.05. Agreement between the two methods was evaluated using intra-class correlation coefficients (ICCs) and Bland-Altman analyses.
Results:
Thirty-four implants in twenty-seven patients were included. Global coronal, global apical, and angular deviations measured using the IOS method were 0.59 ± 0.23 mm, 0.66 ± 0.24 mm, and 1.28 ± 0.69°, respectively, compared with 0.59 ± 0.24 mm, 0.63 ± 0.25 mm, and 1.19 ± 0.70° measured by the CBCT method. No statistically significant differences were observed between the two modalities (P > 0.05, respectively). ICCs for global coronal, global apical, and angular deviations were 0.911, 0.886, and 0.856, respectively. Bland-Altman analyses further confirmed excellent agreement between the two methods.
Conclusions:
Both IOS and CBCT methods demonstrated comparable accuracy and good agreement in r-CAIS.
Clinical Significance:
Postoperative IOS method may serve as a reliable and radiation-free alternative to CBCT for assessing implant placement accuracy in r-CAIS in patients with a single missing tooth or two consecutive missing teeth. In future, multicenter randomized controlled trials with larger sample sizes are warranted to further validate these findings.
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