How does an error in positioning the template affect the accuracy of implants inserted using a single fixed mucosa-supported stereolithographic surgical guide?

Computer-aided implantology using a single fixed stereolithographic surgical guide involves a sequence of diagnostic and therapeutic events, and errors can creep in at different stages. Taken together, these can be termed the 'total error'. A positioning of the surgical guide on the support surface different to that of the diagnostic template may generate an error that reoccurs with all the implants inserted, and this error can be termed the 'guide positioning error'. The aim of the present study was to measure the deviation between the planned and inserted implants due to this guide positioning error, to evaluate if this error was statistically significant, and concurrently, to assess the influence of the type of arch (upper vs lower jaw) and mucosal thickness on the guide positioning error. Twenty-four subjects were treated and 172 implants inserted. Preoperative and postoperative computed tomography images were compared using Mimics software to determine the total error and guide positioning error. Quantitative data were described; the t-test and Pearson correlation coefficient were used. The guide positioning error was found to affect the accuracy, but was statistically significant only for global coronal deviation (P = 0.038). Arch of support and mucosa thickness did not affect the guide positioning error.

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

[2]  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.

[3]  M. Jeffcoat,et al.  A comparison of the diagnostic advantages of panoramic radiography and computed tomography scanning for placement of root form dental implants. , 1994, Clinical oral implants research.

[4]  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.

[5]  G. Widmann,et al.  Errors and error management in image-guided craniomaxillofacial surgery. , 2009, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[6]  David Schneider,et al.  Computer technology applications in surgical implant dentistry: a systematic review. , 2009, The International journal of oral & maxillofacial implants.

[7]  Lambert J Stumpel,et al.  Deformation of stereolithographically produced surgical guides: an observational case series report. , 2012, Clinical implant dentistry and related research.

[8]  E Barbato,et al.  Is it possible to improve the accuracy of implants inserted with a stereolithographic surgical guide by reducing the tolerance between mechanical components? , 2013, International journal of oral and maxillofacial surgery.

[9]  G. Mandelaris,et al.  Computer-guided implant dentistry for precise implant placement: combining specialized stereolithographically generated drilling guides and surgical implant instrumentation. , 2010, The International journal of periodontics & restorative dentistry.

[10]  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.

[11]  Jacob Rosen,et al.  Accuracy of implant placement using precision surgical guides with varying occlusogingival heights: an in vitro study. , 2009, The Journal of prosthetic dentistry.

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

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

[14]  Philippe B Tardieu,et al.  Computer-assisted implant placement. A case report: treatment of the mandible. , 2003, The International journal of oral & maxillofacial implants.

[15]  Michele Cassetta,et al.  Accuracy of implant placement with a stereolithographic surgical template. , 2012, The International journal of oral & maxillofacial implants.

[16]  Paul Suetens,et al.  A custom template and definitive prosthesis allowing immediate implant loading in the maxilla: a clinical report. , 2002, The International journal of oral & maxillofacial implants.

[17]  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.

[18]  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.