Journal of Periodontal and Implant Science

  • 제53권5호
  • /
  • Pages.388-401
  • /
  • 2023
  • /
  • 2093-2278(pISSN)
  • /
  • 2093-2286(eISSN)
대한치주과학회 (Korean Academy of Periodontology)
권호 표지
DOI QR코드

DOI QR Code

Comparison of accuracy between free-hand and surgical guide implant placement among experienced and non-experienced dental implant practitioners: an in vitro study

  • Dler Raouf Hama (Department of Oral and Maxillofacial Surgery, University of Sulaimani College of Dentistry) ;
  • Bayad Jaza Mahmood (Department of Oral and Maxillofacial Surgery, University of Sulaimani College of Dentistry)
  • 투고 : 2022.12.03
  • 심사 : 2023.03.04
  • 발행 : 2023.10.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Purpose: This study investigated the accuracy of free-hand implant surgery performed by an experienced operator compared to static guided implant surgery performed by an inexperienced operator on an anterior maxillary dental model arch. Methods: A maxillary dental model with missing teeth (No. 11, 22, and 23) was used for this in vitro study. An intraoral scan was performed on the model, with the resulting digital impression exported as a stereolithography file. Next, a cone-beam computed tomography (CBCT) scan was performed, with the resulting image exported as a Digital Imaging and Communications in Medicine file. Both files were imported into the RealGUIDE 5.0 dental implant planning software. Active Bio implants were selected to place into the model. A single stereolithographic 3-dimensional surgical guide was printed for all cases. Ten clinicians, divided into 2 groups, placed a total of 60 implants in 20 acrylic resin maxillary models. Due to the small sample size, the Mann-Whitney test was used to analyze mean values in the 2 groups. Statistical analyses were performed using SAS version 9.4. Results: The accuracy of implant placement using a surgical guide was significantly higher than that of free-hand implantation. The mean difference between the planned and actual implant positions at the apex was 0.68 mm for the experienced group using the free-hand technique and 0.14 mm for the non-experienced group using the surgical guide technique (P=0.019). At the top of the implant, the mean difference was 1.04 mm for the experienced group using the free-hand technique and 0.52 mm for the non-experienced group using the surgical guide technique (P=0.044). Conclusions: The data from this study will provide valuable insights for future studies, since in vitro studies should be conducted extensively in advance of retrospective or prospective studies to avoid burdening patients unnecessarily.

키워드

과제정보

We, the authors, would like to extend our thanks and appreciation to the University of Sulaimani, College of Dentistry. We would also like to thank Dr. Aras Jalal for constructing a surgical template and implant planning and for providing jaw models, Dr. Asos Mahmood for statistical analysis, Dr. Ranj Adl for radiographic measures, and Alpha Dent Implant Company for drills and implants.

참고문헌

  1. Ahmed MF, AbdelHamid AM, AlAbbasy FH. Accuracy of implant placement using two different types of CAD/CAM surgical guides (an invitro study). Alexandria Dent J 2019;44:28-33.
  2. Ramasamy M, Giri , Raja R, Subramonian , Karthik , Narendrakumar R. Implant surgical guides: From the past to the present. J Pharm Bioallied Sci 2013;5:S98-102.
  3. Beshtawi KR, Peck MT, Chetty M. Review of the radiographic modalities used during dental implant therapy-a narrative. South Afr Dent J 2021;76:84-90.
  4. Hinckfuss S, Conrad HJ, Lin L, Lunos S, Seong WJ. Effect of surgical guide design and surgeon's experience on the accuracy of implant placement. J Oral Implantol 2012;38:311-23.
  5. Rosenfeld AL, Mandelaris GA, Tardieu PB. Prosthetically directed implant placement using computer software to ensure precise placement and predictable prosthetic outcomes. Part 2: rapid-prototype medical modeling and stereolithographic drilling guides requiring bone exposure. Int J Periodontics Restorative Dent 2006;26:347-53.
  6. Choi W, Nguyen BC, Doan A, Girod S, Gaudilliere B, Gaudilliere D. Freehand versus guided surgery: factors influencing accuracy of dental implant placement. Implant Dent 2017;26:500-9.
  7. Buser D, Martin W, Belser UC. Optimizing esthetics for implant restorations in the anterior maxilla: anatomic and surgical considerations. Int J Oral Maxillofac Implants 2004;19 Suppl:43-61.
  8. Belser UC, Schmid B, Higginbottom F, Buser D. Outcome analysis of implant restorations located in the anterior maxilla: a review of the recent literature. Int J Oral Maxillofac Implants 2004;19 Suppl:30-42.
  9. Mangano F, Shibli JA, Fortin T. Digital dentistry: new materials and techniques. Int J Dent 2016;2016:5261247.
  10. Gulati M, Anand V, Salaria SK, Jain N, Gupta S. Computerized implant-dentistry: advances toward automation. J Indian Soc Periodontol 2015;19:5-10.
  11. Hanazawa T, Sano T, Seki K, Okano T. Radiologic measurements of the mandible: a comparison between CT-reformatted and conventional tomographic images. Clin Oral Implants Res 2004;15:226-32.
  12. Ersoy AE, Turkyilmaz I, Ozan O, McGlumphy EA. Reliability of implant placement with stereolithographic surgical guides generated from computed tomography: clinical data from 94 implants. J Periodontol 2008;79:1339-45. 
  13. Worthington P, Rubenstein J, Hatcher DC. The role of cone-beam computed tomography in the planning and placement of implants. J Am Dent Assoc 2010;141 Suppl 3:19S-24S.
  14. Hultin M, Svensson KG, Trulsson M. Clinical advantages of computer-guided implant placement: a systematic review. Clin Oral Implants Res 2012;23 Suppl 6:124-35.
  15. Lin CC, Ishikawa M, Huang BH, Huang MS, Cheng HC, Maida T, et al. In vitro accuracy of static guided implant surgery measured by optical scan: examining the impact of operator experience. Appl Sci 2020;10:2718.
  16. Nagata K, Fuchigami K, Hoshi N, Atsumi M, Kimoto K, Kawana H. Accuracy of guided surgery using the silicon impression and digital impression method for the mandibular free end: a comparative study. Int J Implant Dent 2021;7:2.
  17. Zoghbi SA, de Lima LA, Saraiva L, Romito GA. Surgical experience influences 2-stage implant osseointegration. J Oral Maxillofac Surg 2011;69:2771-6.
  18. Rungcharassaeng K, Caruso JM, Kan JY, Schutyser F, Boumans T. Accuracy of computer-guided surgery: a comparison of operator experience. J Prosthet Dent 2015;114:407-13.
  19. Prasad DK, Shetty M, Mehra DR. Anatomical considerations in implant selection and positioning. Int J Oral Implantol Clin Res 2013;4:24-9. 
  20. Ozan O, Turkyilmaz I, Ersoy AE, McGlumphy EA, Rosenstiel SF. Clinical accuracy of 3 different types of computed tomography-derived stereolithographic surgical guides in implant placement. J Oral Maxillofac Surg 2009;67:394-401.
  21. Geng W, Liu C, Su Y, Li J, Zhou Y. Accuracy of different types of computer-aided design/computer-aided manufacturing surgical guides for dental implant placement. Int J Clin Exp Med 2015;8:8442-9.
  22. Bencharit S, Staffen A, Yeung M, Whitley D 3rd, Laskin DM, Deeb GR. In vivo tooth-supported implant surgical guides fabricated with desktop stereolithographic printers: fully guided surgery is more accurate than partially guided surgery. J Oral Maxillofac Surg 2018;76:1431-9.
  23. Vermeulen J. The accuracy of implant placement by experienced surgeons: guided vs freehand approach in a simulated plastic model. Int J Oral Maxillofac Implants 2017;32:617-24.
  24. Nickenig HJ, Wichmann M, Hamel J, Schlegel KA, Eitner S. Evaluation of the difference in accuracy between implant placement by virtual planning data and surgical guide templates versus the conventional free-hand method - a combined in vivo - in vitro technique using cone-beam CT (part II). J Craniomaxillofac Surg 2010;38:488-93.
  25. Kivovics M, Penzes D, Nemeth O, Mijiritsky E. The influence of surgical experience and bone density on the accuracy of static computer-assisted implant surgery in edentulous jaws using a mucosa-supported surgical template with a half-guided implant placement protocol-a randomized clinical study. Materials (Basel) 2020;13:5759.
  26. Van de Wiele G, Teughels W, Vercruyssen M, Coucke W, Temmerman A, Quirynen M. The accuracy of guided surgery via mucosa-supported stereolithographic surgical templates in the hands of surgeons with little experience. Clin Oral Implants Res 2015;26:1489-94.
  27. Koop R, Vercruyssen M, Vermeulen K, Quirynen M. Tolerance within the sleeve inserts of different surgical guides for guided implant surgery. Clin Oral Implants Res 2013;24:630-4.
  28. Arisan V, Karabuda CZ, Mumcu E, Ozdemir T. Implant positioning errors in freehand and computer-aided placement methods: a single-blind clinical comparative study. Int J Oral Maxillofac Implants 2013;28:190-204.
  29. Huh YJ, Choi BR, Huh KH, Yi WJ, Heo MS, Lee SS, et al. In-vitro study on the accuracy of a simple-design CT-guided stent for dental implants. Imaging Sci Dent 2012;42:139-46.
  30. Chen YW, Hanak BW, Yang TC, Wilson TA, Hsia JM, Walsh HE, et al. Computer-assisted surgery in medical and dental applications. Expert Rev Med Devices 2021;18:669-96.
  31. Chong BS, Dhesi M, Makdissi J. Computer-aided dynamic navigation: a novel method for guided endodontics. Quintessence Int 2019;50:196-202.