Accuracy analysis of free-handed implant placement compared to a dynamic navigation system

Robert William Emery, Rossano Vinícius Dala Rosa Silva, Breno Monteiro Tavares, Ali Sheikh, Andre Alberto Camara Puppin

Objective: The purpose of this study was to determine the platform, apical and angular accuracy of implant placement using dynamic navigation surgery, and to compare it to freehanded implant placement technique in clinically simulated model surgery. The study focused on overall accuracy measurements of implant placement by dental students relative to virtual plans on dentate models. Methods: Two dental students without surgical experience in Implantology placed 44 implants in sawbones models of the mandible and maxilla. Planning of all implants was performed virtually. Cone beam computed tomographic images were imported into the software and superimposed for virtual planning. The first 22 implants were placed using a free-handed technique, followed by 22 implants placed using a visible wavelength dynamic navigation system. After implant placement, CBCTs were taken. The preoperative plan and the pre and post-surgical CBCTs were comparatively analyzed after the CBCTs and the scans were mesh overlayed. The primary outcome variables were three-dimensional platform, apical and angular deviations from the virtual plan. Both techniques were compared to one another and to the published literature for implants placed using static image guided systems in model-based implant surgery. Results: Implants placed using dynamic image navigation are significantly (p < 0.001) more accurate when compared with the freehanded technique disproving the null hypothesis. Conclusion: Dynamic navigation is accurate and holds promise for the training of novice dental surgeons.

Keywords: Dental implants. Surgery, computer- assisted. Data accuracy.

How to cite: Emery RW, Silva RVDR, Tavares BM, Sheikh A, Puppin AAC. Accuracy analysis of free-handed implant placement compared to a dynamic navigation system. Clin Dent Res. 2019 May-Aug;16(2):24-39. DOI: https://doi.org/10.14436/2447-911x.16.2.024-039.oar

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