Three-Dimensional Deviations in Immediate Implant Surgery Under the Aid of Traditional Surgical Stents

Abstract

This in vitro study aimed to evaluate the angular and positional deviations of immediate implant surgery under the aid of traditional surgical stents, and whether the surgeon’s experience affects the accuracy of placement was also evaluated. Materials and Methods: Implants were placed in fourteen maxillary models simulating immediate placement in the esthetic area by 3 groups of participants with different levels of surgical experiences under the aid of a traditional surgical stent. The cone-beam computed tomography (CBCT) scans of all models were superimposed to a previously planned virtual ideal position. The coronal/apical global deviations and angular deviations between simulated- and placed-position were measured and analyzed statistically. Results: The overall mean global deviations were 2.25 ± 0.67 mm at the platform and 2.79 ± 0.87 mm at the apex. The actual placement deviated significantly toward a distal and buccal angulation from the planned position, with the mean angular difference of -3.63 ± 5.56°and 2.80 ± 3.06 °, respectively (p < 0.001). The degree of distally angulated deviation together with coronal/apical global linear deviations and surgeons’ experience level were significantly negatively correlated (p < 0.001). The distal and buccal danger zones were mostly entered in cases handled by less experienced participants. Conclusion: In this in vitro study, the placement of immediate implants under the aid of traditional surgical stents tends to deviate toward distal and buccal angulations. Practitioners with less experience place implants into esthetic danger zones.