Gianmaria D'addazio*; Imena Rexhepi; Manlio Santilli; Sergio Caputi; Bruna Sinjari

Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” of Chieti-Pescara, Chieti, Italy

Background: Guided implant surgery can enhance implant placement positioning increasing predictability and decreasing post-operative complication and invasiveness. Precision of guided implant surgery has been extensively studied. Different protocols for the production and use of surgical templates have been described. Data collection methods, production techniques, and materials used may vary. For this reason, further evidence should be collected to understand the best protocol of template realization.

Aim/Hypothesis: Thus, the aim of this in vivo study was to investigate the clinical accuracy of two different protocols for data matching and realization of surgical templates. The null hypothesis was that there were no differences between the two groups in terms of precision and accuracy.

Material and Methods: Ten totally edentulous patients were enrolled in this prospective pilot study for a total of 48 implant insertion. In Group A (24 implant) a stereolithographic with radiopaque markers template (SMT) was realized from intraoral impression. Cone-beam computed tomography (CBCT) was taken to patient with SMT and a second CBCT was realize to SMT alone (Group A). In Group B (24 implants) a standard intraoral stent with extraoral known support was used for intraoral impression and for patient CBCT (Group B). The obtained data in each group were matched and used for implant planning and surgical template fabrication. After surgery pre-implant virtual planning and post CBCT images were superimposed, and global and lateral deviation at the implant platform/apex, depth deviation, and angular deviation between placed and planned implants were measured. Two-sample T-test and ANOVA were used to examine differences between groups.

Results: There were no intraoperative complications or implant failures. The average deviations at the implant platform were 0.803 ± 0.433 mm. While at the apex of the implant were 1.20 ± 0.484 mm. The mean depth change was 1.22 ± 0.65 mm. The mean angular deviation was 4,186 ± 1,486 °. No statistically significant differences emerged between the two groups (p = 0.76). On the contrary, evaluating the differences between individual patients statistically significant differences (p < 0.05) were found between maxillary and mandible, where the latter showed greater accuracy.

Conclusion and Clinical implications: Within the limits of this study, we concluded that the clinical accuracy of the surgical templates allows for the confident approach of guided surgery, regardless of the protocol used. Further studies are needed to better understand how to reduce the margin of error and the discrepancy between the planning and the surgical procedure.

Disclosure of Interest: None Declared.

Keywords: accuracy, clinical studies/trials, guided implant surgery