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<p>To evaluate the accuracy of tooth-supported fully-guided surgery compared to free-handed, countersink surgery in the posterior maxilla and mandibule of partially edentulous patients by using a CBCT image after placing the implant and superimposing it with pre-operative CBCT. A total of 30 implants of the same brand and type (M4 MIS Dentsply, Germany) were placed in 15 partially edentulous volunteers in need of implantation in the mandible or maxilla or both. All cases were digitally planned using data from cone beam computed tomography, and the comparison of the planned and actual implant positions was performed using medical image analysis software (Blue Sky Plan 4). Post-operative CBCT was used for nine measurements representing the deviations in angles, implant shoulders, and apexes. The outcome parameters were angular deviation (AD, degrees), crestal global deviation (CGD, mm), vertical linear deviation (VLD, mm), lateral linear deviation (LLD, mm), apical global deviation (AGD, mm), apical vertical deviation (AVD, mm), apical lateral deviation (ALD, mm), distance from the maxillary sinus, and distance from the inferior alveolar nerve. Statistical analysis was performed using Fisher’s exact test to compare the proportion between groups and the chi-square test to test the relationship between the two categorical variables. The angular deviation showed a stepwise improvement in significant steps as the amount of guidance decreased. The median angular deviations for freehand surgery, countersink guide, and fully guided surgery were 2.92° and 5°, respectively. As for the secondary outcome variables, most guided protocols turned out to be slightly superior to freehand surgery, but they were not always significantly different from each other. The study found no significant difference between the accuracy of dental implant surgery using the fully guided method versus freehand surgery, countersink-guided in terms of all outcome variables. This suggests that the use of the fully guided approach did not have a significant impact on the outcomes of the procedure in partially edentulous patients. The number of clinical registrations is NCT07061418, which gets through the American Clinical Trial.gov Identifier.</p>

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3D accuracy comparison of tooth-supported fully guided and countersink-guided freehand implant surgery in partially edentulous patients

  • 期刊论文

  • 发表日期：

    2025年12月18日

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  • Thiab Alsalibi,
  • Hazem Melad,
  • Yasser S. Alajerami,
  • Tayseer J. Afifi

摘要

To evaluate the accuracy of tooth-supported fully-guided surgery compared to free-handed, countersink surgery in the posterior maxilla and mandibule of partially edentulous patients by using a CBCT image after placing the implant and superimposing it with pre-operative CBCT. A total of 30 implants of the same brand and type (M4 MIS Dentsply, Germany) were placed in 15 partially edentulous volunteers in need of implantation in the mandible or maxilla or both. All cases were digitally planned using data from cone beam computed tomography, and the comparison of the planned and actual implant positions was performed using medical image analysis software (Blue Sky Plan 4). Post-operative CBCT was used for nine measurements representing the deviations in angles, implant shoulders, and apexes. The outcome parameters were angular deviation (AD, degrees), crestal global deviation (CGD, mm), vertical linear deviation (VLD, mm), lateral linear deviation (LLD, mm), apical global deviation (AGD, mm), apical vertical deviation (AVD, mm), apical lateral deviation (ALD, mm), distance from the maxillary sinus, and distance from the inferior alveolar nerve. Statistical analysis was performed using Fisher’s exact test to compare the proportion between groups and the chi-square test to test the relationship between the two categorical variables. The angular deviation showed a stepwise improvement in significant steps as the amount of guidance decreased. The median angular deviations for freehand surgery, countersink guide, and fully guided surgery were 2.92° and 5°, respectively. As for the secondary outcome variables, most guided protocols turned out to be slightly superior to freehand surgery, but they were not always significantly different from each other. The study found no significant difference between the accuracy of dental implant surgery using the fully guided method versus freehand surgery, countersink-guided in terms of all outcome variables. This suggests that the use of the fully guided approach did not have a significant impact on the outcomes of the procedure in partially edentulous patients. The number of clinical registrations is NCT07061418, which gets through the American Clinical Trial.gov Identifier.