Accuracy of computer-aided implant placement.

AIM To assess the accuracy of static computer-guided implant placement. MATERIAL AND METHODS Electronic and manual literature searches were conducted to collect information on the accuracy of static computer-guided implant placement and meta-regression analyses were performed to summarize and analyse the overall accuracy. The latter included a search for correlations between factors such as: support (teeth/mucosa/bone), number of templates, use of fixation pins, jaw, template production, guiding system, guided implant placement. RESULTS Nineteen accuracy studies met the inclusion criteria. Meta analysis revealed a mean error of 0.99 mm (ranging from 0 to 6.5 mm) at the entry point and of 1.24 mm (ranging from 0 to 6.9 mm) at the apex. The mean angular deviation was 3.81° (ranging from 0 to 24.9°). Significant differences for all deviation parameters was found for implant-guided placement compared to placement without guidance. Number of templates used was significant, influencing the apical and angular deviation in favour for the single template. Study design and jaw location had no significant effect. Less deviation was found when more fixation pins were used (significant for entry). CONCLUSION Computer-guided implant placement can be accurate, but significant deviations have to be taken into account. Randomized studies are needed to analyse the impact of individual parameters in order to allow optimization of this technique. Moreover, a clear overview on indications and benefits would help the clinicians to find the right candidates.

[1]  R Jacobs,et al.  The use of CT scan based planning for oral rehabilitation by means of implants and its transfer to the surgical field: a critical review on accuracy. , 2008, Journal of oral rehabilitation.

[2]  Nikolaus Behneke,et al.  Accuracy assessment of cone beam computed tomography-derived laboratory-based surgical templates on partially edentulous patients. , 2012, Clinical oral implants research.

[3]  Filip Schutyser,et al.  A computed tomographic scan-derived customized surgical template and fixed prosthesis for flapless surgery and immediate loading of implants in fully edentulous maxillae: a prospective multicenter study. , 2005, Clinical implant dentistry and related research.

[4]  H. Bosmans,et al.  Effective dose range for dental cone beam computed tomography scanners. , 2012, European journal of radiology.

[5]  N. Van Assche,et al.  Accuracy assessment of computer-assisted flapless implant placement in partial edentulism. , 2010, Journal of clinical periodontology.

[6]  Ai Komiyama,et al.  Accuracy of virtually planned and template guided implant surgery on edentate patients. , 2012, Clinical implant dentistry and related research.

[7]  Eduardo Passos Rocha,et al.  Computer-Guided Surgery in Implantology: Review of Basic Concepts , 2010, The Journal of craniofacial surgery.

[8]  R Jacobs,et al.  Comparison between effective radiation dose of CBCT and MSCT scanners for dentomaxillofacial applications. , 2009, European journal of radiology.

[9]  Georg Eggers,et al.  Accuracy of image-guided implantology. , 2005, Clinical oral implants research.

[10]  I. Turkyilmaz,et al.  A preliminary report of patients treated with early loaded implants using computerized tomography-guided surgical stents: flapless versus conventional flapped surgery. , 2007, Journal of oral rehabilitation.

[11]  Ai Komiyama,et al.  Virtually planned and template-guided implant surgery: an experimental model matching approach. , 2011, Clinical oral implants research.

[12]  Nikolaus Behneke,et al.  Factors influencing transfer accuracy of cone beam CT-derived template-based implant placement. , 2012, Clinical oral implants research.

[13]  Chengtao Wang,et al.  Modular preoperative planning software for computer-aided oral implantology and the application of a novel stereolithographic template: a pilot study. , 2009, Clinical implant dentistry and related research.

[14]  Joachim Mühling,et al.  Accuracy of template-based dental implant placement. , 2009, The International journal of oral & maxillofacial implants.

[15]  Predrag Sukovic,et al.  Accuracy of implant placement with a stereolithographic surgical guide. , 2003, The International journal of oral & maxillofacial implants.

[16]  Jörg Neugebauer,et al.  Accuracy of a newly developed integrated system for dental implant planning. , 2009, Clinical oral implants research.

[17]  Hugo De Bruyn,et al.  Effect of smoking habits on accuracy of implant placement using mucosally supported stereolithographic surgical guides. , 2013, Clinical implant dentistry and related research.

[18]  Reinhilde Jacobs,et al.  Accuracy of drilling guides for transfer from three-dimensional CT-based planning to placement of zygoma implants in human cadavers. , 2003, Clinical oral implants research.

[19]  Daniel Wismeijer,et al.  Reference-based digital concept to restore partially edentulous patients following an immediate loading protocol: a pilot study. , 2011, The International journal of oral & maxillofacial implants.

[20]  N. Van Assche,et al.  Tolerance within a surgical guide. , 2010, Clinical oral implants research.

[21]  André Gahleitner,et al.  Computed tomography-based evaluation of template (NobelGuide™)-guided implant positions: a prospective radiological study. , 2011, Clinical oral implants research.

[22]  Daniel Wismeijer,et al.  Computer technology applications in surgical implant dentistry: a systematic review. , 2014, The International journal of oral & maxillofacial implants.

[23]  M. Cassetta,et al.  Depth deviation and occurrence of early surgical complications or unexpected events using a single stereolithographic surgi-guide. , 2011, International journal of oral and maxillofacial surgery.

[24]  E. Machtei,et al.  Accuracy of a computerized tomography-guided template-assisted implant placement system: an in vitro study. , 2009, Clinical oral implants research.

[25]  J. D'haese,et al.  A prospective study on the accuracy of mucosally supported stereolithographic surgical guides in fully edentulous maxillae. , 2012, Clinical implant dentistry and related research.

[26]  Jean Loup Coudert,et al.  Reliability of preoperative planning of an image-guided system for oral implant placement based on 3-dimensional images: an in vivo study. , 2003, The International journal of oral & maxillofacial implants.

[27]  Gerlig Widmann,et al.  Flapless implant surgery in the edentulous jaw based on three fixed intraoral reference points and image-guided surgical templates: accuracy in human cadavers. , 2010, Clinical oral implants research.

[28]  Stephan Eitner,et al.  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). , 2010, Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery.

[29]  Volkan Arısan,et al.  Accuracy of two stereolithographic guide systems for computer-aided implant placement: a computed tomography-based clinical comparative study. , 2010, Journal of periodontology.

[30]  Ilser Turkyilmaz,et al.  Reliability of implant placement with stereolithographic surgical guides generated from computed tomography: clinical data from 94 implants. , 2008, Journal of periodontology.

[31]  M. Strauss,et al.  Evaluation of the accuracy of three different computer-aided surgery systems in dental implantology: optical tracking vs. stereolithographic splint systems. , 2008, Clinical oral implants research.

[32]  Patricia R Cury,et al.  Clinical application of stereolithographic surgical guides for implant placement: preliminary results. , 2005, Journal of periodontology.

[33]  Gerlig Widmann,et al.  Accuracy in computer-aided implant surgery--a review. , 2006, The International journal of oral & maxillofacial implants.

[34]  G. Schiroli,et al.  Accuracy of computer-aided oral implant surgery: a clinical and radiographic study. , 2009, The International journal of oral & maxillofacial implants.

[35]  J. D'haese,et al.  Accuracy and complications using computer-designed stereolithographic surgical guides for oral rehabilitation by means of dental implants: a review of the literature. , 2012, Clinical implant dentistry and related research.

[36]  R Jacobs,et al.  Accuracy of implant placement based on pre-surgical planning of three-dimensional cone-beam images: a pilot study. , 2007, Journal of clinical periodontology.

[37]  J. D. da Silva,et al.  Accuracy and complications of computer-designed selective laser sintering surgical guides for flapless dental implant placement and immediate definitive prosthesis installation. , 2012, Journal of periodontology.

[38]  M. Zwahlen,et al.  A systematic review on the accuracy and the clinical outcome of computer-guided template-based implant dentistry. , 2009, Clinical oral implants research.

[39]  Marc Quirynen,et al.  Tolerance within the sleeve inserts of different surgical guides for guided implant surgery. , 2013, Clinical oral implants research.

[40]  Rikard Söderberg,et al.  Accuracy of CAD/CAM-guided surgical template implant surgery on human cadavers: Part I. , 2010, The Journal of prosthetic dentistry.

[41]  Saad A Al-Harbi,et al.  Implant Placement Accuracy When Using Stereolithographic Template as a Surgical Guide: Preliminary Results , 2009, Implant dentistry.

[42]  Ersilia Barbato,et al.  Accuracy of two stereolithographic surgical templates: a retrospective study. , 2013, Clinical implant dentistry and related research.