Master of Oral Surgery and Implantology, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona Spain.
Director of the Dental and Maxillofacial Institute at the Hospital Universitari Sagrat Cor, Grupo Quirosalud. Barcelona (Spain). Head of the department of oral and maxillofacial surgery, University Hospital of Mutua Terrassa, University of Barcelona, Terrassa Spain.
J Dent. 2024 Jul;146:105072. doi: 10.1016/j.jdent.2024.105072. Epub 2024 May 18.
This study aimed to compare the effect the radiographic marker registration (RMR) and markerless tracing registration (MTR) on implant placement accuracy using a dynamic computer-assisted implant surgery system (dCAIS). Additionally, this study aimed to assess the surgical time and whether the implant location influences the accuracy of the two registration methods.
136 dental implants were randomly allocated to the RMR or MTR group and were placed with a dCAIS in resin models. Preoperative and postoperative Cone Beam Computer Tomograms (CBCT) were overlaid and implant placement accuracy was assessed. Descriptive and multivariate analysis of the data was performed.
Significant differences (P < 0.001) were found for all accuracy variables except angular deviation (RMR:4.30° (SD:4.37°); MTR:3.89° (SD:3.32°)). The RMR had a mean 3D platform deviation of 1.53 mm (SD:0.98 mm) and mean apex 3D deviation of 1.63 mm (SD:1.05 mm) while the MTR had lower values (0.83 mm (SD:0.67 mm) and 1.07 mm (SD:0.86 mm), respectively). In the MTR group, implant placement in the anterior mandible was more accurate (p < 0.05). Additionally, MTR did not significantly increase the surgical time compared with RMR (P = 0.489).
MTR seems to increase the accuracy of implant placement using dCAIS in comparison with the RMR method, without increasing the surgical time. The operated area seems to be relevant and might influence the implant deviations.
Considering the limitations of this in-vitro study, MTR seems to provide a higher accuracy in implant placement using dCAIS without increasing the surgical time. Furthermore, this method does not require radiographic markers and allows re-registration during surgery.
本研究旨在比较使用动态计算机辅助种植手术系统（dCAIS）时，放射标记物注册（RMR）和无标记物追踪注册（MTR）对种植体放置精度的影响。此外，本研究旨在评估手术时间以及种植体位置是否会影响两种注册方法的准确性。
136 颗牙种植体被随机分配到 RMR 或 MTR 组，并在树脂模型中使用 dCAIS 进行放置。对术前和术后的锥形束计算机断层扫描（CBCT）进行叠加，并评估种植体放置精度。对数据进行描述性和多变量分析。
除了角度偏差（RMR：4.30°（SD：4.37°）；MTR：3.89°（SD：3.32°））外，所有准确性变量均存在显著差异（P < 0.001）。RMR 的平均三维平台偏差为 1.53mm（SD：0.98mm），平均根尖三维偏差为 1.63mm（SD：1.05mm），而 MTR 的值较低（分别为 0.83mm（SD：0.67mm）和 1.07mm（SD：0.86mm））。在 MTR 组中，前下颌骨的种植体放置更准确（p < 0.05）。此外，与 RMR 相比，MTR 并未显著增加手术时间（P = 0.489）。
与 RMR 方法相比，MTR 似乎可以提高使用 dCAIS 的种植体放置精度，而不会增加手术时间。手术区域似乎很重要，可能会影响种植体偏差。
考虑到本体外研究的局限性，MTR 似乎可以在不增加手术时间的情况下，提高使用 dCAIS 的种植体放置精度。此外，该方法不需要放射标记物，并允许在手术过程中重新注册。
