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Accuracy and Precision of Implant Placement on Kennedy Class 1 Maxillary models: An in vitro comparison between static guides and use of a dynamic navigation system.


Authors:

Hung-Chi Liao, DDS – Resident, Loma Linda University School of Dentistry

Abstract:

Purpose of the Study: Computer-aided guide surgery has been widely applied in implant dentistry. Despite the satisfactory result, challenges remain as related to mucosa support. Studies have shown inferior accuracy when using such guides for complete mouth edentulous ridges. Clinically, mucosa-tooth supported guides are used frequently. However, there is a lack of research related to accuracy when using tooth-mucosa supported guides. Therefore, the purpose of this study was to compare the accuracy and precision of mucosa-tooth supported stereolithographic surgical guides with a dynamic navigation system and to determine which method presents more favorable result in Kennedy class I clinical scenario.

Methods: 10 custom made drillable models with a tissue-like coating were designed and fabricated based on a Maxillary Kennedy Class I clinical scenario (with only teeth #6 to #11 present). In this cast, implant #12 has been placed and will be used as a reference. One experienced clinician (>100 implants placed) was randomly assigned to place implants in the positions of teeth #3,5,14 using a stereolithographic surgical guide and also place these implants using a navigator (5 models each). Preoperative CBCT scans were taken on 5 models and used to for guide surgery preparation (NobelClinician). The other 5 models were scanned with fiducial markers and planned in dynamic navigation system. Postoperative CBCT were taken on all of the models. Pre-existing #12 implant was used as a reference for parallelism comparison with #14. Accuracy and precision analysis of #3 and #5 were performed by superimposing the preoperative virtual plan with postoperative CBCT scans. Deviations of placed and planned implant were quantified by using a mathematical algorithm.

Results: TBD.

Conclusion: TBD.

Articles: 1. 2. 3.

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