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Objectives <p>This randomized clinical trial compared the accuracy of palatal paramedian miniscrew placement using static computer-assisted surgery (s-CAS) and dynamic computer-assisted surgery (d-CAS).</p> Materials and methods <p>Forty subjects (11–17 years) requiring palatal paramedian miniscrew insertion were randomized into two groups to receive two miniscrews placed with s-CAS (Group A; <i>n</i> = 20 subjects, 40 miniscrews) and d-CAS (Group B; <i>n</i> = 20 subjects, 40 miniscrews). Preoperative digital intraoral scans and CBCT images were used for virtual planning. Group A procedures employed patient-specific surgical guides, while group B procedures were performed with real-time navigation. Immediate postoperative CBCT scans were superimposed to measure four accuracy parameters: coronal, apical, depth, and angular deviation from the planned position. Statistical analysis included the mixed-effect model analysis.</p> Results <p>Eighty miniscrews were analyzed. Mean coronal (<i>p</i> &lt; 0.001), apical (<i>p</i> &lt; 0.001) and angular deviations (<i>p</i> = 0.001) were significantly lower in the s-CAS group compared to the d-CAS group. No significant difference was observed for depth deviation (<i>p</i> = 0.065). The s-CAS technique also exhibited smaller standard deviations and lower maximum deviations across all parameters.</p> Conclusions <p>Static computer-assisted surgery achieved greater linear and angular accuracy than dynamic navigation for palatal miniscrew insertion, while vertical control was comparable between the two approaches.</p> Clinical relevance <p>In the present study, static computer-assisted surgery offered superior consistency and accuracy in palatal miniscrew placement, supporting its use in anatomical areas where spatial accuracy is critical to avoid adjacent anatomical structures. Dynamic navigation remains a viable alternative when flexibility, visibility, or same-day digital workflows are prioritized.</p> Clinical trial registration <p>The trial was registered in clinicaltrials.gov; reference number. NCT07378618.</p>

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Accuracy of palatal orthodontic miniscrew placement: Static vs dynamic computer-guided techniques in a randomized clinical trial

  • 期刊论文

  • 发表日期：

    2026年6月15日

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  • Davide Brilli,
  • Matteo Giansanti,
  • Federica Altieri,
  • Michele Cassetta

摘要

Objectives

This randomized clinical trial compared the accuracy of palatal paramedian miniscrew placement using static computer-assisted surgery (s-CAS) and dynamic computer-assisted surgery (d-CAS).

Materials and methods

Forty subjects (11–17 years) requiring palatal paramedian miniscrew insertion were randomized into two groups to receive two miniscrews placed with s-CAS (Group A; n = 20 subjects, 40 miniscrews) and d-CAS (Group B; n = 20 subjects, 40 miniscrews). Preoperative digital intraoral scans and CBCT images were used for virtual planning. Group A procedures employed patient-specific surgical guides, while group B procedures were performed with real-time navigation. Immediate postoperative CBCT scans were superimposed to measure four accuracy parameters: coronal, apical, depth, and angular deviation from the planned position. Statistical analysis included the mixed-effect model analysis.

Results

Eighty miniscrews were analyzed. Mean coronal (p < 0.001), apical (p < 0.001) and angular deviations (p = 0.001) were significantly lower in the s-CAS group compared to the d-CAS group. No significant difference was observed for depth deviation (p = 0.065). The s-CAS technique also exhibited smaller standard deviations and lower maximum deviations across all parameters.

Conclusions

Static computer-assisted surgery achieved greater linear and angular accuracy than dynamic navigation for palatal miniscrew insertion, while vertical control was comparable between the two approaches.

Clinical relevance

In the present study, static computer-assisted surgery offered superior consistency and accuracy in palatal miniscrew placement, supporting its use in anatomical areas where spatial accuracy is critical to avoid adjacent anatomical structures. Dynamic navigation remains a viable alternative when flexibility, visibility, or same-day digital workflows are prioritized.

Clinical trial registration

The trial was registered in clinicaltrials.gov; reference number. NCT07378618.