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Accuracy of navigation guided implant surgery for immediate loading complete arch restorations: Prospective clinical trial.

Authors :
Pozzi A
Carosi P
Laureti A
Mattheos N
Pimkhaokham A
Chow J
Arcuri L
Source :
Clinical implant dentistry and related research [Clin Implant Dent Relat Res] 2024 Oct; Vol. 26 (5), pp. 954-971. Date of Electronic Publication: 2024 Jul 05.
Publication Year :
2024

Abstract

Objectives: To assess navigation accuracy for complete-arch implant placement with immediate loading of digitally prefabricated provisional.<br />Materials and Methods: Consecutive edentulous and terminal dentition patients requiring at least one complete-arch FDP were treated between December 2020 and January 2022. Accuracy was evaluated by superimposing pre-operative and post-operative cone beam computed tomography (CBCT), recording linear (mm) and angular (degrees) deviations. T-tests were performed to investigate the potential effect of the registration algorithm (fiducial-based vs. fiducial-free), type of references for the fiducial-free algorithm (teeth vs. bone screws), site characteristic (healed vs. post-extractive), implant angulation (axial vs. tilted), type of arch (maxilla vs. mandible) on the accuracy with p-value <0.05.<br />Results: Twenty-five patients, 36 complete-arches, and 161 implants were placed. The overall mean angular deviation was 2.19° (SD 1.26°). The global platform and apex mean deviations were 1.17 mm (SD 0.57 mm), and 1.30 mm (SD 0.62 mm). Meaningful global platform (p = 0.0009) and apical (p = 0.0109) deviations were experienced only between healed and post-extraction sites. None of the analyzed variables significantly influenced angular deviation. Minor single-axis deviations were reported for the type of jaw (y-axis at implant platform and apex), registration algorithm (y-axis platform and z-axis deviations), and type of references for the fiducial-free algorithm. No statistically significant differences were found in relation to implant angulation.<br />Conclusions: Within the study limitations navigation was reliable for complete-arch implant placement with immediate loading digitally pre-fabricated FDP. AI-driven surface anatomy identification and calibration protocol made fiducial-free registration as accurate as fiducial-based, teeth and bone screws equal as references. Implant site characteristics were the only statistically significant variable with healed sites reporting higher accuracy compared to post-extractive. Live-tracked navigation surgery enhanced operator performance and accuracy regardless of implant angulation and type of jaw. A mean safety room of about 1 mm and 2° should be considered.<br /> (© 2024 The Author(s). Clinical Implant Dentistry and Related Research published by Wiley Periodicals LLC.)

Details

Language :
English
ISSN :
1708-8208
Volume :
26
Issue :
5
Database :
MEDLINE
Journal :
Clinical implant dentistry and related research
Publication Type :
Academic Journal
Accession number :
38967100
Full Text :
https://doi.org/10.1111/cid.13360