Accuracy of different types of surgical guides for dental implant placement

Abstract

BACKGROUND: The advancement of three-dimensional (3D) imaging techniques and implant planning software has contributed to a wide adoption of prosthetically guided implant placement. AIM: This study aims to examine the virtual planning accuracy of dental implant placement using various surgical templates. MATERIALS AND METHODS: The study included 24 partially and fully edentulous patients. Patients were divided into four groups using a parallel group design: templates for pilot osteotomy made by 3D printing (group I), full-guided templates made by 3D printing (group II), surgical templates for pilot osteotomy made by milling (group III), and full-guided templates made by milling (group IV). The accuracy of dental implant position was assessed by comparing the planned and actual position of the implants using preoperative and postoperative computed tomography. Three mean deviation parameters (angular, at the neck position, and at the apex position) were defined to evaluate the discrepancy between the planned and placed implant positions. RESULTS: The best results were obtained in group III, where dental implant placement was performed using milled surgical templates for pilot osteotomy. The mean angular deviation, deviation at the neck, and deviation at the apex of the implant were 4.013.21, 0.380.23 mm, and 0.560.51 mm, respectively (p 0.001 for all). The mean angular deviation in the group that used milled surgical templates for the full-guided osteotomy was 5.665.38, with deviations at the implant neck and apex of 0.730.71 and 0.680.67 mm, respectively (p 0.001 for all), demonstrating high accuracy of implant placement within the safety zone. Lower accuracy scores were found in groups I and II, when 3D printed templates were used. The mean angular deviation in the pilot osteotomy group was 7.715.94, the mean deviation at the neck was 1.021.07 mm, and the mean deviation at the apex of the implant was 1.401.69 mm (p 0.001 for all). In the group for full-guided osteotomy, the mean angular deviation, deviation at the neck, and deviation at the apex of the implant were 6.46.21, 0.580.45 mm, and 0.830.80 mm, respectively (p 0.001 for all). CONCLUSION: The use of surgical templates in dental implant placement allows for a high accuracy in implant position. Milled surgical templates for dental implants are more accurate than 3D-printed templates, allowing us to introduce surgical templates into clinical practice to improve dental care quality.