Abduo Jaafar, Lau Douglas
Associate Professor in Prosthodontics, Convenor of Postgraduate Diploma in Clinical Dentistry (Implants), Melbourne Dental School, Melbourne University, 720 Swanston Street, Melbourne, VIC, 3010, Australia.
Periodontist, Private Practice, Melbourne University, Melbourne, VIC, Australia.
Int J Implant Dent. 2020 Mar 11;6(1):10. doi: 10.1186/s40729-020-0205-3.
One of the challenges encountered by clinicians new to implant dentistry is the determination and controlling of implant location. This study compared the accuracy of fully guided (FG) and pilot-guided (PG) static computer-assisted implant placement (sCAIP) protocols against the conventional freehand (FH) protocol for placing single anterior and posterior implants by recently introduced clinicians to implant dentistry.
Ten clinicians new to implant dentistry inserted one anterior (central incisor) and one posterior (first molar) implants per protocol in training maxillary models. The FG protocol involved drilling and implant placement through the guide, while the PG protocol controlled the pilot drilling only. The FH implant placement was completed without the aid of any guide. A total of 30 models were used, and 60 implants were inserted. The implant vertical, horizontal neck, horizontal apex, and angle deviations from planned positions were calculated.
The FG protocol provided the most accurate implant placement in relation to horizontal neck (0.47 mm-0.52 mm), horizontal apex (0.71 mm-0.74 mm), and angle deviations (2.42-2.61). The vertical deviation was not significantly different among the different protocols. The PG protocol was generally similar to the FH protocol with a horizontal neck deviation of 1.01 mm-1.14 mm, horizontal apex deviation of 1.02 mm-1.35 mm, and angle deviation of 4.65-7.79. The FG protocol showed similarity in the accuracy of the anterior and posterior implants. There was a tendency for inferior accuracy for posterior implants compared with anterior implants for the PG and FH protocols.
In the hands of recently introduced clinicians to implant dentistry, it appears that the accuracy of the FG protocol was superior to the other protocols and was not influenced by the position of the implants. The PG and FH protocols showed inferior accuracy for posterior implants compared with anterior implants.
种植牙科新手临床医生面临的挑战之一是确定和控制种植体位置。本研究比较了完全引导（FG）和导钻引导（PG）静态计算机辅助种植体植入（sCAIP）方案与传统徒手（FH）方案在近期接触种植牙科的临床医生植入单个前牙和后牙种植体时的准确性。
10位种植牙科新手临床医生在训练用的上颌模型中，按照每种方案植入一枚前牙（中切牙）和一枚后牙（第一磨牙）种植体。FG方案包括通过导板钻孔和植入种植体，而PG方案仅控制导钻。FH种植体植入在没有任何导板辅助的情况下完成。共使用了30个模型，植入了60枚种植体。计算种植体垂直、颈部水平、根尖水平以及与计划位置的角度偏差。
就颈部水平（0.47毫米 - 0.52毫米）、根尖水平（0.71毫米 - 0.74毫米）和角度偏差（2.42 - 2.61）而言，FG方案提供了最准确的种植体植入。不同方案之间垂直偏差无显著差异。PG方案通常与FH方案相似，颈部水平偏差为1.01毫米 - 1.14毫米，根尖水平偏差为1.02毫米 - 1.35毫米，角度偏差为4.65 - 7.79。FG方案在前牙和后牙种植体植入准确性上表现相似。与FG和FH方案中的前牙种植体相比，后牙种植体准确性有降低的趋势。
在近期接触种植牙科的临床医生手中，FG方案的准确性似乎优于其他方案，且不受种植体位置影响。与前牙种植体相比，PG和FH方案在后牙种植体植入时准确性较低。
