Accuracy of partially and fully guided surgical techniques for immediate implant placement: An in vitro assessment |
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| Institution: | 1. PhD student, Department of Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry at Araraquara, Araraquara, São Paulo, Brazil;2. PhD student, Department of Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry at Araraquara, Araraquara, São Paulo, Brazil;3. Professor, Department of Biologic and Materials Sciences and Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, Mich;4. Professor, Department of Periodontology, Unitri School of Dentistry (UFTM), Uberlândia, Minas Gerais, Brazil;5. Professor, Department of Periodontology and Implantology, FAESA University Center (FAESA), Espírito Santo, Brazil;6. Professor, Department of Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry at Araraquara, Araraquara, São Paulo, Brazil;1. Associate Professor, Department of Prosthodontics, Dental Faculty, University of Lyon, Lyon, France;2. Medical Imaging Manager, GRPD, Nobel Biocare AB, Sweden;3. Associate Professor, Department of Public Health, Dental Faculty, University of Lyon, Lyon, France;1. Assistant Professor, Oral and Maxillofacial Rehabilitation Department, College of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia;2. Postdoctoral fellow, Center for Craniofacial Molecular Biology (CCMB), Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, Calif;3. Director, Implant Dentistry, Ralph and Jean Bleak Professor of Restorative Dentistry; and Codirector, Advanced Prosthodontics, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, Calif;4. Professor, Division of Restorative and Prosthetic Dentistry, College of Dentistry, The Ohio State University, Columbus, Ohio;1. Graduate student, Department of Dentistry, Federal University of Juiz de Fora/Campus GV (UFJF/GV), Governador Valadares, MG, Brazil;2. Postgraduate student, Program in Applied Health Sciences (PPGCAS), Federal University of Juiz de Fora/Campus GV (UFJF/GV), Governador Valadares, MG, Brazil;3. Postgraduate student, Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State Univeristy (UNESP), Araçatuba, SP, Brazil;4. Postgraduate student, Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State Univeristy (UNESP), Araçatuba, SP, Brazil;5. Professor, Department Prosthodontics, Presidente Prudente Dental School, University of Western São Paulo (UNOESTE), Presidente Prudente, SP, Brazil;6. Professor, Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State Univeristy (UNESP), Araçatuba, SP, Brazil;7. Professor, Department of Dentistry, Federal University of Juiz de Fora/Campus GV (UFJF/GV), Governador Valadares, MG, Brazil |
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| Abstract: | Statement of problemOptimal implant positioning is essential to achieving predictable results. Computer-guided surgery has been reported to be an accurate technique for implant placement in healed sites, but the accuracy of guided techniques for immediate implant placement into fresh sockets is still unclear.PurposeThe purpose of this experimental randomized split-mouth study in pig jaws was to determine the accuracy of partially and fully guided surgical techniques for immediate implant placement into fresh sockets and to compare 2 different methods of implant position deviations analysis.Material and methodsTwenty implants were installed in 10 pig jaws using 2 different techniques: partially guided (n=10) and fully guided (n=10). Cone beam computed tomography and digital scanning were performed before and after the surgical procedure to plan the virtual implant position and fabricate the surgical guide, as well as to determine implant position deviations. Two methods were used to evaluate implant deviations: tomographic and digital scanning. The Shapiro-Wilk test of normality was used. Deviation comparisons were carried out by using paired t tests (α=.05), and intraclass correlation coefficient (ICC) was computed to assess the agreement between the 2 methods of implant deviation analysis.ResultsIn the tomographic analysis, the partially guided technique resulted in significantly higher global apical and lateral coronal deviations (2.25 ±0.59 mm; 0.96 ±0.55 mm) than fully guided (1.52 ±0.89 mm; 0.75 ±0.52 mm) (P<.01 and P<.05, respectively). The analysis performed using digital scanning showed significantly higher angular, global apical, and lateral apical deviations in the partially guided (6 ±3.28 degrees; 2.49 ±1.03 mm; 2.16 ±1.07 mm) technique than in the fully guided (3.32 ±1.84 degrees; 1.5 ±0.58 mm; 0.98 ±0.67 mm) (P<.05). An ICC of 0.522 between the 2 methods of implant deviation analysis was obtained.ConclusionsThe partially guided technique was less accurate than the fully guided technique for immediate implant placement into fresh sockets. A moderate concordance was observed between cone beam computed tomography and digital scanning analyses, suggesting that more studies are required to validate and to define the most reliable method of measuring implant deviation. |
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