Accuracy And Safety Research In The Mandibular Posterior Area By Using Digital-Guided And Freehand Implant Surgery With Computer-Assisted Technology

Objective: To compare the accuracy and safety,postoperative pain,and satisfaction of restorations between digital-guided implants surgery and freehand implants surgery in the mandibular posterior area with computer-assisted technology,to investigate the advantages and disadvantages of the two procedures in the mandibular posterior area,to verify the clinical application,and to provide support for clinical treatment.Methods: 60 patients with missing mandibular posterior teeth requiring implant restorative treatment who visited the Department of Oral Implant Restoration of the People’s Hospital of Guangxi Zhuang Autonomous region from March 2021 to April 2022 were retrospectively collected,60 patients were divided into two groups according to the implant operation method decided by the operator and the patient,there are 30 patients in each group.The age of the patients were 27 to 69 years old,with a mean age of(47.25±12.32)years.68 implants were placed in 60 patients.There were 35 implants in the digital-guided plate group and 33 implants in the freehand group.All patients completed the preoperative design by using computer-assisted technology before surgery,and completed the implant surgery under digital-guided plate and freehand surgery respectively.Preoperative and postoperative images input to software to measure implant placement accuracy and distance to surrounding anatomical structures,and postoperative pain and restoration satisfaction scores were obtained from patients in postoperative follow-up.SPSS 26.0 statistical software was used to analyze data.Results: The shoulder straight deviation,shoulder height deviation,apex straight deviation,mesiodistal deviation,buccolingual deviation,angular deviation in the guide-plate group were lower than those in the free-hand group,and the difference was statistically significant(P < 0.05).The difference of distance between implant and the buccal bone plate,the lingual bone plate,the mandibular nerve canal,the mental foramen,the proximal tooth root and distal tooth root were all lower in the guide plate group before and after surgery than in the freehand group,and the difference was statistically significant(P < 0.05).The postoperative pain on the first to third postoperative days in the digital-guided plate group was less than that in the freehand group,and the difference was statistically significant(P < 0.05).The mastication,comfort,cleanliness,aesthetics,and total scores of the restorations in the digital-guided plate group were higher than those in the freehand group,and the difference was statistically significant(P < 0.05).Conclusion: The application of digital-guided plate implant in the posterior mandibular area can effectively improve the implant accuracy of shoulder,apex straight,mesiodistal,buccolingual,angular.The use of digital-guided plate implant in the posterior mandibular area is less likely to damage the surrounding tissues and safer than freehand implant.The digital guide is less invasive,and less painful than freehand in 1～3 days after the surgery,which effectively reduces the patient’s fear and accelerates the postoperative recovery speed.There is no significant difference in speech between digital-guided implant surgery and freehand implant surgery after crown restoration in mandibular posterior teeth area,but the mastication,comfort,cleanliness and aesthetics of the restoration are more satisfactory.