Evaluation of Three Different Validation Procedures regarding the Accuracy of Template-Guided Implant Placement: An In Vitro Study

PurposeThe study aims to evaluate the accuracy of the NobelGuide(TM) (Medicim/Nobel Biocare, Goteborg, Sweden) concept maximally reducing the influence of clinical and surgical parameters. Moreover, the study was to compare and validate two validation procedures versus a reference method. Material and MethodsOverall, 60 implants were placed in 10 artificial edentulous mandibles according to the NobelGuide(TM) protocol. For merging the pre- and postoperative DICOM data sets, three different fusion methods (Triple Scan Technique, NobelGuide(TM) Validation software, and AMIRA (R) software [VSG - Visualization Sciences Group, Burlington, MA, USA] as reference) were applied. Discrepancies between the virtual and the actual implant positions were measured. ResultsThe mean deviations measured with AMIRA (R) were 0.49mm (implant shoulder), 0.69mm (implant apex), and 1.98 degrees mm (implant axis). The Triple Scan Technique as well as the NobelGuide(TM) Validation software revealed similar deviations compared with the reference method. A significant correlation between angular and apical deviations was seen (r=0.53; p<.001). A greater implant diameter was associated with greater deviations (p=.03). ConclusionThe Triple Scan Technique as a system-independent validation procedure as well as the NobelGuide(TM) Validation software are in accordance with the AMIRA (R) software. The NobelGuide(TM) system showed similar or less spatial and angular deviations compared with others.