Comparison of Different Types of Static Computer-Guided Implant Surgery in Varying Bone Inclinations

An in vitro analysis of the accuracy of static and robot-assisted implant surgery

OBJECTIVES

Robot-assisted implant surgery (RAIS) is purported to improve the accuracy of implant placement. The objective of this study was to compare RAIS with static computer-assisted implant surgery (sCAIS) in a controlled environment.

MATERIALS AND METHODS

A total of n = 102 implants were placed in the same modified typodont (n = 17 repeated simulated implant surgeries with each n = 3 implants per group) using robot-assisted or static computer-assisted implant surgery. The final implant positions were digitized utilizing cone-beam tomography and compared with the planned position. The angular deviation was the primary outcome parameter. 3D deviations at the implant platform level and the apex were secondary outcome parameters. Accuracy in terms of trueness and precision were assessed. Means, standard deviation, and 95%-confidence intervals were analyzed statistically.

RESULTS

The overall angular deviation was 2.66 ± 1.83° for the robotic system and 0.68 ± 0.38° for guided surgery using static guides (p < .001), the 3D-deviation of the implant platform at crest level was for sCAIS 0.79 ± 0.28 mm and RAIS 1.51 ± 0.53 mm (p < .001) and at the apex for sCAIS 0.82 ± 0.26 mm and for RAIS 1.97 ± 0.79 mm (p < .001), respectively.

CONCLUSIONS

Robotically guided implant surgery was less accurate in terms of trueness (planned vs. actual position) and precision (deviations among implants) than traditional static computer-assisted implant surgery in this in vitro study.

Advancing accuracy in guided implant placement: A comprehensive meta-analysis: Meta-Analysis evaluation of the accuracy of available implant placement Methods

OBJECTIVES

This meta-analysis aimed to determine the accuracy of currently available computer-assisted implant surgery (CAIS) modalities under in vitro conditions and investigate whether these novel techniques can achieve clinically acceptable accuracy.

DATA

In vitro studies comparing the postoperative implant position with the preoperative plan were included. Risk of bias was assessed using the Quality Assessment Tool For In Vitro Studies (QUIN Tool) and a sensitivity analysis was conducted using funnel plots.

SOURCES

A systematic search was performed on April 18, 2023, using the following three databases: MEDLINE (via PubMed), EMBASE, and Cochrane Central Register of Controlled Trials. No filters or restrictions were applied during the search.

RESULTS

A total of 5,894 studies were included following study selection. Robotic- and static CAIS (sCAIS) had the most accurate and clinically acceptable outcomes. sCAIS was further divided according to the guidance level. Among the sCAIS groups, fully guided implant placement had the greatest accuracy. Augmented reality-based CAIS (AR-based CAIS) had clinically acceptable results for all the outcomes except for apical global deviation. Dynamic CAIS (dCAIS) demonstrated clinically safe results, except for horizontal apical deviation. Freehand implant placement was associated with the greatest number of errors.

CONCLUSIONS

Fully guided sCAIS demonstrated the most predictable outcomes, whereas freehand sCAIS demonstrated the lowest accuracy. AR-based and robotic CAIS may be promising alternatives.

CLINICAL SIGNIFICANCE

To our knowledge, this is the first meta-analysis to evaluate the accuracy of robotic CAIS and investigate the accuracy of various CAIS modalities.

Accuracy of Guided Implant Surgery in the Partially Edentulous Jaw Using Digital impression versus Desktop Scanner and CBCT cast scan: Randomized Clinical Trial

AIM: The aim of the study is to compare the accuracy of surgical guided implant produced by intraoral scanner, desktop scanner, and CBCT cast scan. SUBJECTS AND METHODS: A total of 63 dental implants were placed using 14 surgical guides. A total of 15 subjects, eight males and seven females (eight bilateral cases and seven unliteral cases), with mean age of 45 years (38–55 years) were included in the study. Patients were randomly divided into three groups (n = 21 each): Group 1: Surgical guide manufactured using intraoral digital impression. Group 2: Surgical guide manufactured using model cast scanning by CBCT while Group 3: Surgical guide manufactured using model cast scanning by desktop scanner the linear and angular deviations of inserted planned implants were measured. RESULTS: In the intraoral scan group, the mean angular deviation, platform 3D deviation, apical 3D deviation, and vertical deviation were 2.5°, 0.7 mm, 1.1 mm, and 0.6 mm, respectively. While in desktop scanner group, the mean angular deviation, platform 3D deviation, apical 3D deviation, and vertical deviation were 2.6°, 0.1 mm, 1.1 mm, and 1.1 mm, respectively. In the CBCT scan group, the mean angular deviation, 3D platform deviation, 3D apical deviation, and vertical deviation were 3.5°, 1.3 mm, 1.6 mm, and 1.7 mm, respectively. There is no statistically significance difference between intraoral scanner, CBCT cast scan, and desktop scanning on implant deviation that was observed. CONCLUSION: There was no statistically significance difference between intraoral scanner, CBCT cast scan, and desktop scanning on implant deviation that was observed although IOS shows better accuracy and least mean angular deviation.

Evaluating the accuracy of CAD/CAM optimized stones compared to conventional type IV stones

This study compared the accuracy (trueness and precision) of stone models fabricated using two brands of CAD/CAM optimized stones Cerec Stone (BC) and Elite Master (EM), and a conventional type IV stone Elite Rock Fast (ERF). 30 conventional Type IV and scannable stone complete-arch models were scanned with a blue LED extraoral scanner, and root mean square values were obtained. 6 abutments were used in complete-arch models. The digital models were compared with the master model to evaluate their trueness using model superimposition with Geomagic software. Precision was determined for each case by superimposing combinations of the 10 datasets in each group. The point cloud density of each model was calculated with MeshLab software. Kruskal-Wallis and Mann-Whitney non-parametric tests were used for the statistical analysis. The trueness of the stone models was 96 μm for the BC, 88.2 μm for the EM, and 87.6 μm for the ERF. There were no significant differences between the tested dental stones (p = .768). However, the EM models (35.6 μm) were more precise than the BC (46.9 μm) and ERF (56.4 μm) models (p = .001, p < .001). EM models also showed the highest point cloud density. There were significant differences in point cloud density (p = .003). The EM models showed significant differences in precision but no significant differences in terms of trueness. Although EM was more precise and had the highest point cloud density, all models were within the clinically acceptable limit.