Statement of problem

The accuracy of partially guided implant placement protocols in comparison with fully guided protocols is still unclear. C-shaped guide holes have become popular; however, their effect on drilling and implant position accuracy has not been thoroughly investigated.

Purpose

The purpose of this split-mouth clinical study was to evaluate the accuracy of implant placement by using fully guided versus partially guided surgical guides with cylindrical versus C-shaped guiding holes.

Material and methods

Adopting 80% power of the study in calculating sample size, a total of 48 implants were placed in the mandibular interforaminal area of 12 edentulous participants, who were randomly divided into 2 groups: a fully guided group, comprising 24 implants placed on 1 side by using a fully guided protocol and a partially guided group, comprising 24 implants placed on the other side in a partially guided protocol. Each group was further subdivided into 2 subgroups: cylindrical, including 12 implants placed through cylindrical guide holes, and C-shaped (12 implants) placed through C-shaped guiding holes. Postoperative cone beam computed tomography scans were made, and based on image fusion, the total deviations between the virtually preplanned and actual implant positions were determined and compared between both groups and subgroups. The linear horizontal deviation of the implant hexagon and apex, together with apical depth deviation and angular deviations between the position of the actually placed and virtually planned implants, were analyzed in 3 dimensions. The Kolmogorov-Smirnov test of normality was used. Comparisons were carried out by using the Kruskal-Wallis test. Post hoc pair-wise comparisons when the Kruskal-Wallis test was significant were carried out by using the Dunn-Sidak test (α=.05).

Results

No statistically significant differences were found in coronal linear deviation (P>.05), apical linear deviation (P>.05), apical depth deviation (P=.086), or angular deviation (P=.247), between the fully guided protocol and the partially guided protocol.

Conclusions

The accuracy of partially guided implant placement was clinically comparable with that of fully guided placement whether the guiding holes were cylindrical or C-shaped.

中文翻译：

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通过使用完全引导与部分引导的组织支持的带有圆柱孔和C形导向孔的组织支撑外科手术导向器评估植入物放置的准确性：裂口临床研究

问题陈述

与完全引导的方案相比，部分引导的植入物放置方案的准确性仍不清楚。C形导向孔已普及。但是，它们对钻孔和种植体位置精度的影响尚未得到彻底研究。

目的

这项裂口临床研究的目的是通过使用带有圆柱孔和C形导向孔的完全导向或部分导向的手术导向器来评估植入物的准确性。

材料与方法

利用研究的80％功效计算样本量，将总共48个植入物放置在12位无牙参与者的下颌孔间区域中，将其随机分为2组：完全引导组，包括24个植入物，并排放置在一侧使用完全引导的方案和部分引导的组，包括以部分引导的方案放置在另一侧的24个植入物。每组进一步细分为2个子组：圆柱形，包括通过圆柱形导向孔放置的12个植入物，以及通过C形导向孔放置的C形（12个植入物）。进行术后锥束计算机断层扫描，并基于图像融合，确定虚拟预定位与实际植入物位置之间的总偏差，并在两组和亚组之间进行比较。在3个维度上分析了种植体六角形和顶点的线性水平偏差，以及实际放置的种植体和实际上计划种植的种植体位置之间的根尖深度偏差和角度偏差。使用了Kolmogorov-Smirnov正常性检验。通过使用Kruskal-Wallis检验进行比较。通过使用Dunn-Sidak检验（α= .05）进行Kruskal-Wallis检验显着时的事后成对比较。

结果

没有统计学上在冠状线性偏差（发现显著差异P > 0.05），顶端线性偏差（P > 0.05），顶端深度偏差（P = 0.086），或角度偏差（P = 0.247），完全之间引导协议和部分引导协议。

结论

无论引导孔是圆柱形还是C形，部分引导的植入物放置的准确性在临床上都可以与完全引导的植入物媲美。