Open-sleeve templates for computer-assisted implant surgery at healed or extraction sockets: An in vitro comparison to closed-sleeve guided system and free-hand approach

Objective A buccal opening guide provides better view and better irrigation. The aim of this study was to investigate the accuracy of this open-sleeve system. Material and Methods Thirty duplicated maxillary models, each with six extraction sockets and four healed sites, were used. Based on the same digital plan, three modalities, sCAIS with open-sleeves, closed-sleeves, and free-hand approach, were used to place implants. The global, horizontal, depth, and angular deviations between the virtual and actual implant positions were measured. Results Both sCAIS groups exhibited better accuracy than the free-hand group in two clinical scenarios. At healed sites, the closed-sleeve group showed a significantly fewer error than the open-sleeve group in global apical (0.68 +/- 0.33 vs. 0.96 +/- 0.49 mm), horizontal coronal (0.28 +/- 0.15 vs. 0.44 +/- 0.25 mm), horizontal apical (0.64 +/- 0.32 vs. 0.94 +/- 0.48 mm), and angular deviations (1.83 +/- 0.95 vs. 2.86 +/- 1.46 degrees). For extraction sockets, the open-sleeve group exhibited fewer deviations than the closed-sleeve group in terms of global (coronal: 0.77 +/- 0.29 vs. 0.91 +/- 0.22 mm; apical: 1.08 +/- 0.49 vs. 1.37 +/- 0.52 mm) and horizontal (coronal: 0.60 +/- 0.24 vs. 0.86 +/- 0.20 mm; apical: 0.95 +/- 0.50 vs. 1.32 +/- 0.51 mm) deviations. However, the closed-sleeve group was more accurate in the depth control (0.26 +/- 0.20 vs. 0.40 +/- 0.31 mm). Conclusion In this in vitro investigation, open-sleeve sCAIS proved better accuracy than free-hand surgery for both delayed and immediate implant placement. Compared with a closed-sleeve sCAIS system, open sleeve have the potential of providing better outcomes in extraction sockets but not in healed sites.

Automated summary

This study investigated the accuracy of a buccal opening guide system. The results showed that open-sleeve sCAIS proved to be more accurate than free-hand surgery for both delayed and immediate implant placement. However, the closed-sleeve group showed fewer errors at healed sites, while the open-sleeve group exhibited fewer deviations in extraction sockets.