Duration, deviation and operator's perception of static computer assisted implant placements by inexperienced clinicians

Effect of pilot-guided implant placement concept on the accuracy of osteotomy preparation and implant placement

PURPOSE

To evaluate the accuracy of osteotomy preparation and implant placement for 3 pilot-guided (PG) concepts, namely, a surgical template with a metal sleeve (MS), a surgical template with an in-built nonmetal sleeve (NMS), and a surgical template with an in-built nonmetal sleeve for round bur indentation (RB).

METHODS

Surgical models with missing maxillary molars were studied. The MS templates were designed to accept metal sleeves, while the NMS and RB templates were designed with in-built nonmetal sleeves. Ten templates were tested per group (n = 10). After each step (pilot drilling, 2nd drilling, 3rd drilling, profiling, and implant placement), the surgical model was scanned and compared against the planning model to determine maximum horizontal deviation (MHD) and maximum angle deviation (MAD).

RESULTS

The MS and NMS templates exhibited a similar increase in MHD with successive drilling steps. The MAD for the pilot drilling step was significantly lower for MS than for the other groups. However, the differences among groups for MHD and MAD diminished in later steps. All templates had an MHD of 1.0 mm or less and an MAD less than 8°.

CONCLUSION

The investigated PG implant placement concepts resulted in similar deviations in the placed implants.

Advancing accuracy in guided implant placement: A comprehensive meta-analysis: Meta-Analysis evaluation of the accuracy of available implant placement Methods

OBJECTIVES

This meta-analysis aimed to determine the accuracy of currently available computer-assisted implant surgery (CAIS) modalities under in vitro conditions and investigate whether these novel techniques can achieve clinically acceptable accuracy.

DATA

In vitro studies comparing the postoperative implant position with the preoperative plan were included. Risk of bias was assessed using the Quality Assessment Tool For In Vitro Studies (QUIN Tool) and a sensitivity analysis was conducted using funnel plots.

SOURCES

A systematic search was performed on April 18, 2023, using the following three databases: MEDLINE (via PubMed), EMBASE, and Cochrane Central Register of Controlled Trials. No filters or restrictions were applied during the search.

RESULTS

A total of 5,894 studies were included following study selection. Robotic- and static CAIS (sCAIS) had the most accurate and clinically acceptable outcomes. sCAIS was further divided according to the guidance level. Among the sCAIS groups, fully guided implant placement had the greatest accuracy. Augmented reality-based CAIS (AR-based CAIS) had clinically acceptable results for all the outcomes except for apical global deviation. Dynamic CAIS (dCAIS) demonstrated clinically safe results, except for horizontal apical deviation. Freehand implant placement was associated with the greatest number of errors.

CONCLUSIONS

Fully guided sCAIS demonstrated the most predictable outcomes, whereas freehand sCAIS demonstrated the lowest accuracy. AR-based and robotic CAIS may be promising alternatives.

CLINICAL SIGNIFICANCE

To our knowledge, this is the first meta-analysis to evaluate the accuracy of robotic CAIS and investigate the accuracy of various CAIS modalities.

Influence of different education approaches on the implantation performance of dental practitioners in aesthetic zone

PURPOSE

To investigate the influence of different education approaches on the implantation performance (operation time, three-dimensional deviation) of inexperienced operators.

METHODS

Eighteen students who met the inclusion criteria were randomly assigned to traditional training group or digital training group. After training, the average operation time and implant deviation (platform deviation, apex deviation, and angle deviation) of the two groups were calculated by Student's t-test. A self-developed questionnaire was used to evaluate the students' grasp of clinical knowledge and skill.

RESULT

Compared with the traditional training group, the duration of implant installation and temporary prosthesis placement of the digital training group decreased significantly (p < 0.05). The implant deviation of the digital training group was lower than that of the traditional training group. The apex deviation (p = 0.015) and angle deviation (p = 0.015) significantly improved with digital training, but differences in platform deviation (p = 0.065) were not statistically significant. The questionnaire survey showed that the overall perception of the inexperienced operators in the digital training group was better than that in the traditional training group.

CONCLUSION

In the hands of inexperienced operators, digital training reduced the operation time and improved the implant accuracy in comparison with traditional training.