A Prospective Study on Accuracy of Computer-Based Fully Guided Versus Pilot-Guided Implant Surgery

Abstract

The aim of this study is to compare the implant placement deviations and evaluate the 1-year post-implant placement bone loss of pilot and fully guided implant placement protocols. In the first method, the pilot drill is used for guide surgery, and the following procedure is a method for performing implant surgery in a non-guided protocol. The second method is to perform fully guided surgery. A total of 74 implants in 20 patients were included. Postoperative CT scans were used to compare the implant placement deviations with the preoperative plan. In addition, bone loss was compared one year after surgery. In shoulder area, the implant deviations from the planned positions for dx(mesio-distal), dy(bucco-lingual), dz(vertical) dimensions, mean deviations with pilot-guided protocol (n = 31) were 0.50 ± 0.42 mm, 0.61 ± 0.55 mm, 0.87 ± 0.71 mm, and 1.33 ± 0.75 mm, respectively. The corresponding deviations for fully guided protocol (n = 41) were 0.50 ± 0.52 mm, 0.29 ± 0.27 mm, 0.56 ± 0.51 mm, and 0.96 ± 0.57 mm. In apical area, the corresponding deviations for pilot-guided protocol were 0.75 ± 0.72 mm, 0.61 ± 0.46 mm, 0.98 ± 0.76 mm, and 1.54 ± 0.87 mm. Deviations for fully guided protocol were 0.91 ± 0.90 mm, 0.44 ± 0.39 mm, 0.54 ± 0.51 mm, and 1.38 ± 0.76 mm, respectively. Angular deviations were 3.33 ± 3.23° with pilot-guided protocol and 3.90 ± 1.85° with fully guided protocol. The average bone loss after 1 year was 0.50 + 0.29 mm and 0.50 ± 0.24 mm, respectively. In the shoulder area, dy(bucco-lingual) of horizontal deviations, vertical deviations, and mean value of the deviations showed a statistically significant difference between fully guided and pilot-guided (p = 0.005, p = 0.033, and p = 0.023, respectively). In the apical area, vertical deviations showed a statistically significant difference. However, the mean value of the deviations did not show a statistically significant difference (p = 0.347). There was no statistically significant difference in angular deviations (p = 0.59).