Accuracy Of Computer-guided Implant Surgery In Fully Edentulous Arches Using A Partial Navigation Surgical Guide

Purpose:In this study,the accuracy of computer-guided implant placement in fully edentulous arches were measured.Factors affecting the accuracy of implant placement were analyzed.It provides a theoretical basis for further improvement on the accuracy of computer-guided implant surgery in fully edentulous arches and realizing prefabrication of implant-support fixed restoration.Experiment methods:Totally,20 fully edentulous patients received computer-guided implant surgery were included according to the inclusion and exclusion criteria.Implant plan and basic information of patients were collected.Digital data of the implant plan and postoperative cone beam computer tomography(CBCT)were superimposed using implant surgical guide design software and Materialise Magics software.Based on the ideal implant position,the 3D deviations in terms of cervical and apical distance,angulation were measured.According to the deviation of the implant position obtained,the potential factors affecting the accuracy of computer-guided implant surgery in fully edentulous arches were analyzed including type of surgical guides,upper/lower jaw,implant length,implant direction and bone mineral density in the implant area.SPSS 21.0 was used for statistical analysis.The analysis methods including spearman correlation analysis,independent T test,one-way ANOVA and multiple linear regression analysis.Results:1.Overall accuracy of computer-guided implant placementTotally,20 patients(96 implants)were included in the study.The average deviations in terms of cervical and apical distance,angulation were1.45±0.92 mm,1.81±1.04 mm and 4.60±3.80°,respectively.2.Accuracy of computer-guided implant placement--analysis by single factor2.1 There was no significant difference in linear deviation and angulation deviation between groups of different surgical guide(p>0.05).2.2 The cervical linear deviation was significantly higher in the maxilla than that in the mandible(p<0.05).There was no significant difference in apical linear deviation and angulation deviation between the implants in upper and lower arches(p>0.05).2.3 The apical linear deviation was significantly higher in 13-14 mm group than that in the other groups(p<0.05).There was no significant difference in cervical linear deviation and angulation deviation among groups(p>0.05).There was significant correlation between apical linear deviation,angulation deviation and implant length(p<0.05).2.4 There was no significant difference in linear deviation and angulation deviation between vertical and tilted implants(p>0.05).2.5 The cervical linear deviation in type II bone group was significantly lower than that in type I bone group and type III bone group(p<0.05).There was no significant difference in apical linear deviation and angulation deviation among groups(p>0.05).3.Analysis of factors influencing the accuracy of computer-guided implant placement through multiple linear regression3.1 There was a significant correlation between implant area(upper or lower arch)and cervical linear deviation of the implants(p<0.05),and the correlation coefficient was-0.308.3.2 There was a significant correlation between implant length and apical linear deviation of the implants(p<0.005),and the correlation coefficient was 0.291.Conclusions:1.The accuracy of computer-guided implant placement is high.The overall accuracy of implant placement in this study is generally consistent with the results of literature review.2.The accuracy of computer-guided implant placement in fully edentulous mandible is higher than that in maxilla.3.The accuracy of computer-guided implant placement is higher in short implants than that in long implants.Clinically,the accuracy of implant placement can be improved by innovation in design of the surgical guide and avoiding the design of overlong implant in the posterior region of dental arch.4.Factors such as type of surgical guides,implant direction and bone mineral density were not significantly related to the accuracy of computer guided implant surgery in fully edentulous arches.5.Exploration of the influencing factors on the accuracy of computer-guided implant surgery in edentulous arches command large sample size and multi-factor comprehensive analysis.