Gianmaria D'addazio^*; Imena Rexhepi; Manlio Santilli; Sergio Caputi; Bruna Sinjari

Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” of Chieti-Pescara, Chieti, Italy

Background: Guided implant surgery can enhance implant placement positioning increasing predictability and decreasing post-operative complication and invasiveness. Precision of guided implant surgery has been extensively studied. Different protocols for the production and use of surgical templates have been described. Data collection methods, production techniques, and materials used may vary. For this reason, further evidence should be collected to understand the best protocol of template realization.

Aim/Hypothesis: Thus, the aim of this in vivo study was to investigate the clinical accuracy of two different protocols for data matching and realization of surgical templates. The null hypothesis was that there were no differences between the two groups in terms of precision and accuracy.

Material and Methods: Ten totally edentulous patients were enrolled in this prospective pilot study for a total of 48 implant insertion. In Group A (24 implant) a stereolithographic with radiopaque markers template (SMT) was realized from intraoral impression. Cone-beam computed tomography (CBCT) was taken to patient with SMT and a second CBCT was realize to SMT alone (Group A). In Group B (24 implants) a standard intraoral stent with extraoral known support was used for intraoral impression and for patient CBCT (Group B). The obtained data in each group were matched and used for implant planning and surgical template fabrication. After surgery pre-implant virtual planning and post CBCT images were superimposed, and global and lateral deviation at the implant platform/apex, depth deviation, and angular deviation between placed and planned implants were measured. Two-sample T-test and ANOVA were used to examine differences between groups.

Results: There were no intraoperative complications or implant failures. The average deviations at the implant platform were 0.803 ± 0.433 mm. While at the apex of the implant were 1.20 ± 0.484 mm. The mean depth change was 1.22 ± 0.65 mm. The mean angular deviation was 4,186 ± 1,486 °. No statistically significant differences emerged between the two groups (p = 0.76). On the contrary, evaluating the differences between individual patients statistically significant differences (p < 0.05) were found between maxillary and mandible, where the latter showed greater accuracy.

Conclusion and Clinical implications: Within the limits of this study, we concluded that the clinical accuracy of the surgical templates allows for the confident approach of guided surgery, regardless of the protocol used. Further studies are needed to better understand how to reduce the margin of error and the discrepancy between the planning and the surgical procedure.

Disclosure of Interest: None Declared.

Keywords: accuracy, clinical studies/trials, guided implant surgery

詹玛丽亚·达达齐奥^* ; 伊梅娜·雷克斯皮；曼利奥·桑蒂利；塞尔吉奥·卡普蒂；布鲁娜·辛贾里

大学医学和牙科创新技术系“G. 意大利基耶蒂-佩斯卡拉的 d'Annunzio

背景：引导种植体手术可以增强种植体放置位置，增加可预测性并减少术后并发症和侵入性。引导种植体手术的精度已得到广泛研究。已经描述了用于生产和使用手术模板的不同协议。数据收集方法、生产技术和使用的材料可能会有所不同。因此，应收集更多证据以了解模板实现的最佳协议。

目的/假设：因此，这项体内研究的目的是调查两种不同方案的临床准确性，用于数据匹配和手术模板的实现。零假设是两组在精密度和准确度方面没有差异。

材料与方法：10 名完全缺牙的患者参加了这项前瞻性试点研究，总共植入了 48 颗种植体。在 A 组（24 颗种植体）中，通过口内印模实现了带有不透射线标记模板 (SMT) 的立体光刻。对 SMT 患者进行锥形束计算机断层扫描 (CBCT)，对 SMT 患者进行第二次 CBCT（A 组）。在 B 组（24 颗种植体）中，标准口内支架和已知的口外支架用于口内印模和患者 CBCT（B 组）。将获得的每组数据进行匹配，用于种植体规划和手术模板制作。手术后，将种植前虚拟规划和 CBCT 图像叠加，测量种植体平台/根尖处的整体和横向偏差、深度偏差以及植入和计划种植体之间的角度偏差。T检验和方差分析用于检查组之间的差异。

结果：没有出现术中并发症或种植失败。种植体平台的平均偏差为 0.803 ± 0.433 mm。而在植入物的顶点为 1.20 ± 0.484 毫米。平均深度变化为 1.22 ± 0.65 毫米。平均角度偏差为 4,186 ± 1,486 °。两组之间没有出现统计学上的显着差异（p = 0.76）。相反，评估个体患者之间的差异在上颌骨和下颌骨之间发现有统计学显着差异（p < 0.05），后者显示出更高的准确性。

结论和临床意义：在本研究的范围内，我们得出的结论是，无论使用何种方案，手术模板的临床准确性都允许进行自信的引导手术方法。需要进一步研究以更好地了解如何减少误差幅度以及计划与手术程序之间的差异。

利益披露：无声明。

关键词：准确性，临床研究/试验，引导种植手术