Accuracy and the role of experience in dynamic computer guided dental implant surgery: An in-vitro study

A Jorba-García, R Figueiredo, A González-Barnadas, O Camps-Font, E Valmaseda-Castellón, A Jorba-García, R Figueiredo, A González-Barnadas, O Camps-Font, E Valmaseda-Castellón

Abstract

Background: To compare the accuracy of implant placement using the conventional freehand method and a dynamic navigation system; to assess the role of the surgeon's experience in implant placement using these two methods.

Material and methods: A randomized in-vitro study was conducted. Six resin mandible models and 36 implants were used. Two researchers with differing clinical experience (novice and experienced) placed implants using either the Navident dynamic navigation system (navigation group) or the conventional freehand method (freehand group). Accuracy was measured by overlaying the real position in the postoperative CBCT on the virtual presurgical placement of the implant in a CBCT image. Descriptive and bivariate analyses of the data were performed.

Results: The navigation group showed significantly higher accuracy for all the variables studied except 3D entry and depth deviation. This system significantly enhanced the accuracy of the novice professional in several outcome variables in comparison with the freehand implant placement method. However, when the implants were placed by the experienced clinician the dynamic navigation system only improved angulation deviation. Significant differences were found between the 2 professionals when the freehand method was employed. Similar deviations were observed for the implants placed with the navigation system.

Conclusions: Dynamic computer assisted surgery systems allow more accurate implant placement in comparison with the conventional freehand method, regardless of the surgeon's experience. However, this system seems to offer more advantages to novice professionals, since it allows them to reduce their deviations significantly and achieve similar results to those of experienced clinicians.

Conflict of interest statement

Conflict of interest statement:This study was conducted with the support (non-financial aid) of Bonemodels (Castellón de la Plana, Spain) and TiCare (MozoGrau, Vallodolid, Spain). Dr. Figueiredo reports grants, personal fees and non-financial support from Mozo-Grau (Valladolid, Spain), grants from Mundipharma Research (Cambridge, United Kingdom), personal fees from BioHorizons Ibérica (Madrid, Spain), Inibsa Dental (Lliça de Vall, Spain), Dentsply implants Iberia (Barcelona, Spain) and ADIN Implants (Afula, Israel) outside the submitted work. Dr. Valmaseda-Castellón reports grants, personal fees and non-financial support from MozoGrau, personal fees from BioHorizons Ibérica, personal fees from Inibsa Dental, and personal fees from Dentsply implants Iberia outside the submitted work. The authors declare no other conflicts of interest regarding this study. The present research was conducted by the Dental and Maxillofacial Pathology and Therapeutics research group at the IDIBELL Institute.

Figures

Figure 1
Figure 1
Navident: A: Navident© work diagram; B: Navident© software interface during surgical procedures; C: Artificial resin models employed in the study.
Figure 2
Figure 2
Consort flow diagram showing allocation to the participants in the study.
Figure 3
Figure 3
Differences between experienced and novice clinicians with the two implant placement systems.

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Source: PubMed

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