Statement of problem

Malpositioning of implants is one of the main factors leading to hard- and soft-tissue deficiencies. Whether static computer-guided implant placement increases accuracy and prevents malpositioning is unclear.

Purpose

The purpose of this in vitro study was to determine accuracy defined by trueness and precision (according to International Organization for Standardization 5725) of computer-assisted implant surgery (fully guided and partially guided) in comparison with freehand single implant placement.

Material and methods

Implants (n=20) were placed fully guided (sleeve-bone distance of 2, 4, or 6 mm), partially guided (guide used for pilot drill), or free hand in identical replicas produced from a cone beam computed tomography (CBCT) scan of a partially edentulous patient. The achieved implant position was digitized by using a laboratory scanner and compared with the planned position. Trueness (planned versus actual position) and precision (difference among implants) were determined. The 3D-offset at the crest of the implant (root mean square between virtual preoperative planning and postoperative standard tessellation language file) was defined as the primary outcome parameter. The means, standard deviation, and 95% confidence intervals were analyzed statistically with 1-way ANOVA and the Scheffé procedure.

Results

Fully guided implant surgery achieved significantly lower 3D deviations between the planned and actual implant position with 0.22 ±0.07 mm (2-mm sleeve-bone distance) than partially guided 0.69 ±0.15 mm and freehand placement 0.80 ±0.35 mm at the crest (P<.001). The distance among the implants in each group was again lowest in the fully guided group and highest in the freehand group.

Conclusions

The static computer-assisted implant surgery showed high trueness and precision. The closer the sleeve to the bone, the more accurate and precise the method. Freehand implant placement was less accurate and precise than computer-assisted implant surgery (partially or fully).

中文翻译：

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使用和不使用静态手术导板的种植体植入的精度和真实性：一项体外研究

问题陈述

种植体的错位是导致硬组织和软组织缺陷的主要因素之一。静态计算机引导的种植体植入是否能提高准确性并防止错位尚不清楚。

目的

这项体外研究的目的是确定由计算机辅助种植体手术（完全引导和部分引导）与徒手单种植体植入的真实性和精确度（根据国际标准化组织 5725）定义的准确性。

材料与方法

种植体 (n = 20) 被完全引导（袖骨距离为 2、4 或 6 毫米）、部分引导（用于导向钻的引导）或自由放置在由锥形束计算机断层扫描 (CBCT) 生成的相同复制品中) 部分缺牙患者的扫描。使用实验室扫描仪将获得的种植体位置数字化，并与计划位置进行比较。确定了真实度（计划位置与实际位置）和精度（植入物之间的差异）。种植体顶部的 3D 偏移（虚拟术前计划和术后标准镶嵌语言文件之间的均方根）被定义为主要结果参数。使用单向方差分析和 Scheffé 程序对平均值、标准偏差和 95% 置信区间进行统计分析。

结果

与部分引导的 0.69 ±0.15 毫米和徒手放置 0.80 ±0.35 毫米（P < .001）。每组种植体之间的距离在完全引导组中再次最低，在徒手组中最高。

结论

静态计算机辅助种植手术显示出较高的真实性和精确度。袖子离骨头越近，方法就越准确和精确。徒手种植体植入的准确度和精确度低于计算机辅助种植体手术（部分或全部）。