Accuracy of static computer-assisted implant placement in long span edentulous area by novice implant clinicians: A cross-sectional in vitro study comparing fully-guided, pilot-guided, and freehand implant placement protocols

Background To ensure accurate implant placement, surgical guides are used to control the steps of implant placement surgery. Purpose Evaluation of the accuracy of implant placement in long span edentulous area by novice implant clinicians according to fully-guided (FG), pilot-guided (PG), and freehand (FH) placement protocols. Materials and methods Maxillary surgical models with four missing teeth from the right first canine to the first molar were produced by 3-dimensional printing. Fourteen clinicians new to implant dentistry participated in the study, and each one of them inserted one canine and one molar implant for every implant placement protocol. All implant placement steps were completed in phantom heads to simulate the clinical situation. To evaluate the accuracy, the implant vertical, horizontal platform, horizontal apex, angle, and interimplant distance deviations from the planned positions were calculated. Results With the exception of vertical deviation, the FG placement was clearly more accurate than the PG and FH placements for all the variables for canine and molar implants. The PG placement was significantly more accurate than the FH placement for the horizontal platform and apex deviations, and interimplant distance deviation. The FG placement did not show a significant impact of the location of the implant, or the horizontal deviations of the platform or the apex. The PG and FH placements showed increased deviation at the canine implant than the molar implant, and at the apex of the implants than the platform of the implants. Conclusions Within the limitations of this in vitro study, novice clinicians achieved a significantly more accurate implant position with FG placement, followed by PG and FH placements respectively. Therefore, a form of guided surgery is beneficial for novice clinicians.

Automated summary

In this study, it was found that fully-guided placement was significantly more accurate than pilot-guided and freehand placements for novice clinicians. Pilot-guided placement was more accurate than freehand placement for horizontal platform and apex deviations, as well as interimplant distance deviation. Fully-guided placement showed consistent accuracy regardless of implant location or horizontal deviations of the platform and apex.