Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland.
Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
Int J Implant Dent. 2023 Feb 7;9(1):4. doi: 10.1186/s40729-023-00470-6.
This in vitro study aimed at comparing the accuracy of freehand implant placement with static computer-assisted implant surgery (sCAIS), utilizing a keyless and a drill-key implant system and two guide-hole designs.
A total of 108 implants were placed in 18 partially edentulous maxillary models simulating two different alveolar ridge morphologies. 3D digital deviations between pre-planned and post-operative implant positions were obtained. Guide material reduction was assessed in the keyless implant system for the manufacturer's sleeve and sleeveless guide-hole designs.
sCAIS using a sleeveless guide-hole design demonstrated smaller mean angular, crestal and apical deviations compared to sCAIS utilizing a manufacturer's sleeve and the freehand group (2.6 ± 1.6°, vs 3.3 ± 1.9°, vs 4.0 ± 1.9°; 0.5 ± 0.3 mm, vs 0.6 ± 0.3 mm, vs 0.8 ± 0.3 mm; and 1.0 ± 0.5 mm, vs 1.2 ± 0.7 mm, vs 1.5 ± 0.6 mm). Smaller angular and apical mean deviations were observed in the keyless implant system as compared with the drill-key implant system (3.1 ± 1.7°, vs 3.5 ± 1.9°, p = 0.03; and 1.2 ± 0.6 mm, vs 1.4 ± 0.7 mm, p = 0.045). Overall, smaller angular, crestal, and apical deviations (p < 0.0001) were observed in healed alveolar ridges (2.4 ± 1.7°, 0.5 ± 0.3 mm, and 0.9 ± 0.5 mm) than in extraction sockets (4.2 ± 1.6°, 0.8 ± 0.3 mm, and 1.6 ± 0.5 mm). Higher mean volumetric material reduction was observed in sleeveless than in manufacturer's sleeve guide-holes (- 0.10 ± 0.15 mm, vs - 0.03 ± 0.03 mm, p = 0.006).
Higher final implant positional accuracy was observed in sCAIS for the keyless implant system, with a sleeveless guide-hole design, and in healed ridges. Sleeveless guide holes resulted in higher volumetric material reduction compared with the manufacturer's sleeve.
本体外研究旨在比较无导向种植体植入和静态计算机辅助种植手术（sCAIS）的准确性，分别使用无导向和有导向种植系统以及两种不同的导孔设计。
在模拟两种不同牙槽嵴形态的 18 个部分无牙颌上颌模型中，共植入 108 颗种植体。获得术前计划和术后种植体位置之间的三维数字偏差。评估无导向种植系统中制造商套管和无套管导孔设计的导孔材料减少量。
与使用制造商套管和徒手组相比，使用无套管导孔设计的 sCAIS 显示出较小的平均角度、冠方和根尖偏差（2.6±1.6°，3.3±1.9°，4.0±1.9°；0.5±0.3mm，0.6±0.3mm，0.8±0.3mm；1.0±0.5mm，1.2±0.7mm，1.5±0.6mm）。与有导向种植系统相比，无导向种植系统的平均角度和根尖偏差较小（3.1±1.7°，3.5±1.9°，p=0.03；1.2±0.6mm，1.4±0.7mm，p=0.045）。总体而言，在愈合牙槽嵴（2.4±1.7°，0.5±0.3mm，0.9±0.5mm）中观察到的角度、冠方和根尖偏差较小（p<0.0001），而在拔牙窝（4.2±1.6°，0.8±0.3mm，1.6±0.5mm）中观察到的角度、冠方和根尖偏差较大。无套管导孔的平均体积材料减少量大于制造商套管导孔（-0.10±0.15mm，-0.03±0.03mm，p=0.006）。
无导向种植系统、无套管导孔设计和愈合牙槽嵴中 sCAIS 的最终种植体位置准确性更高。与制造商套管相比，无套管导孔导致更高的体积材料减少量。
