Accuracy of navigation-guided socket drilling before implant installation compared to the conventional free-hand method in a synthetic edentulous lower jaw model.

In this study, the three-dimensional (3D) accuracy of navigation-guided (NG) socket drilling before implant installation was compared to the conventional free-hand (CF) method in a synthetic edentulous lower jaw model. The drillings were performed by two surgeons with different years of working experience. The inter-individual outcome was assessed. NG drillings were performed using an optical computerized tomography (CT)-based navigation system. CF drillings were performed using a surgical template. The coordinates of the drilled sockets were determined on the basis of CT scans. A total of n=224 drillings was evaluated. Inter-individual differences in terms of the surgeons' years of work experience were without statistical significance. The mean deviation of the CF drilled sockets (n=112) on the vestibulo-oral and mesio-distal direction was 11.2+/-5.6 degrees (range: 4.1-25.3 degrees ). With respect to the NG drilled sockets (n=112), the mean deviation was 4.2+/-1.8 degrees (range: 2.3-11.5). The mean distance to the mandibular canal was 1.1+/-0.6 mm (range: 0.1-2.3 mm) for CF-drilled sockets and 0.7+/-0.5 mm (range: 0.1-1.8 mm) for NG drilled sockets. The differences between the two methods were highly significant (P<0.01). A potential benefit from image-data-based navigation in implant surgery is discussed against the background of cost-effectiveness.