Implant Placement Accuracy When Using Stereolithographic Template as a Surgical Guide: Preliminary Results

Purpose: The aim of this study is to evaluate implant placement accuracy using the coordinate measure machine (CMM) and to assess how accurate implant angulations and point of entrance can be transferred when using a stereolithographic surgical template as a guide during implant placement. Material and Methods: Angulations, entrance points of 40 implants placed in 6 edentulous jaws using stereolithographic surgical template were evaluated. The angulations were noted in both mesio-distal and bucco-lingual planes. The central axis of each treatment-planned implant was determined using the CMM by locating 3 points along the hollow channel of the drill guide stainless steel sleeve of the stereolithographic surgical template and the central axis of the actual implant, evaluated postsurgically, were determined Three points along the guide pins were noted after mounted to the implant fixture analogs on the working cast. The differences between the proposed and actual implant point of entrance and angulations were calculated and the data were analyzed using the paired t test. Results: The mean mesio-distal angle deviation of the actual implant from the planned position. was 0.7 +/- 5.02 degrees, and the mean bucco-lingual angle deviation was 0.46 +/- 4.43 degrees. Thirty implants (88%) and 31 implants (91%) recorded a <7 degrees angle deviation for the mesio-distal and bucco-lingual plane angle, respectively. No statistical significant difference was found for the angle deviation. The mean difference of the entrance point was within 0.2 +/- 0.72 min, 29 implants (85%) were within <1 mm from the intended position. Statistically significant difference was shown for the entrance point deviation. Conclusion: When measured using the CMM, the stereolithographic surgical template was sufficiently accurate in transferring the planned implant position to the surgical field relative to the implant angulations and point of entrance. Further clinical studies using a greater number of patients are needed to confirm the results of this study. (Implant Dent 2009;18:46-56)