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Accuracy of Computer-Guided Implantology with Pilot Drill Surgical Guide: Retrospective 3D Radiologic Investigation in Partially Edentulous Patients

Authors :
Federico Gelpi
Nicolò Modena
Alessandro Poscolere
Fabio Bernardello
Lorena Torroni
Daniele De Santis
Source :
Medicina, Vol 59, Iss 4, p 738 (2023)
Publication Year :
2023
Publisher :
MDPI AG, 2023.

Abstract

Background and Objectives: Implant placement with static navigation enables the reaching of a correct position of implants from an anatomical and prosthetic point of view. Different approaches of static navigation are described in the scientific literature, and the pilot-guided approach is one of the least investigated. The aim of the present study is the evaluation of the accuracy of implant insertion using a pilot drill template. Materials and Methods: Fifteen partially edentulous patients, requiring an implant rehabilitation of at least one implant, were enrolled. Pre- and post-operative low-dose CTs were acquired to measure the differences between final positions of implants and virtually planned ones. Three linear discrepancies (coronal, apical, and depth), two angular ones (bucco-lingual and mesio-distal), and the imprecision area were evaluated. Correlations between accuracy and rehabilitated jaws, sectors, and implant length and diameters were also analyzed. Results: Forty implants were inserted in fifteen patients using pilot drill templates. Mean coronal deviation was 1.08 mm, mean apical deviation was 1.77 mm, mean depth deviation was −0.48 mm, mean bucco-lingual angular deviation was 4.75°, and mean mesio-distal one was 5.22°. The accuracy was statistically influenced only by the rehabilitated jaw for coronal discrepancy and sectors and implant diameter for bucco-lingual angular deviations. Conclusions: The pilot drill template could represent a predictable solution to obtain a correct implant placement. Nonetheless, a safety margin of at least 2 mm should be respected during implant planning to prevent damages to anatomical structures. Therefore, the tool is helpful in order to prosthetically drive the implants; still, great attention must be paid in fully relying on this procedure when approaching dangerous structures such as nerves and vessels.

Details

Language :
English
ISSN :
16489144 and 1010660X
Volume :
59
Issue :
4
Database :
Directory of Open Access Journals
Journal :
Medicina
Publication Type :
Academic Journal
Accession number :
edsdoj.0d46bc17e5e4638af5c0678efb45dfc
Document Type :
article
Full Text :
https://doi.org/10.3390/medicina59040738