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

IF 3.7 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Implant Dentistry and Related Research Pub Date : 2024-07-05 DOI:10.1111/cid.13360

Alessandro Pozzi, Paolo Carosi, Andrea Laureti, Nikos Mattheos, Atiphan Pimkhaokham, James Chow, Lorenzo Arcuri

{"title":"Accuracy of navigation guided implant surgery for immediate loading complete arch restorations: Prospective clinical trial","authors":"Alessandro Pozzi, Paolo Carosi, Andrea Laureti, Nikos Mattheos, Atiphan Pimkhaokham, James Chow, Lorenzo Arcuri","doi":"10.1111/cid.13360","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objectives</h3>\n \n <p>To assess navigation accuracy for complete-arch implant placement with immediate loading of digitally prefabricated provisional.</p>\n </section>\n \n <section>\n \n <h3> Materials and Methods</h3>\n \n <p>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 <i>p</i>-value <0.05.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>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 (<i>p</i> = 0.0009) and apical (<i>p</i> = 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.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>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.</p>\n </section>\n </div>","PeriodicalId":50679,"journal":{"name":"Clinical Implant Dentistry and Related Research","volume":"26 5","pages":"954-971"},"PeriodicalIF":3.7000,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cid.13360","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Implant Dentistry and Related Research","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/cid.13360","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}

引用次数: 0

Abstract

Objectives

To assess navigation accuracy for complete-arch implant placement with immediate loading of digitally prefabricated provisional.

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.

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.

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.

Abstract Image

查看原文本刊更多论文

导航引导下的种植手术对即刻装载全牙弓修复体的准确性：前瞻性临床试验。

目的评估全牙弓种植体植入的导航准确性，并立即加载数字化预制临时材料：在 2020 年 12 月至 2022 年 1 月期间，对至少需要一颗全牙弓 FDP 的无牙和末牙患者进行连续治疗。通过叠加术前和术后锥形束计算机断层扫描（CBCT）、记录线性（毫米）和角度（度）偏差来评估准确性。进行了T检验，以研究注册算法（基于靶标与无靶标）、无靶标算法的参考类型（牙齿与骨螺钉）、部位特征（愈合后与拔牙后）、种植体角度（轴向与倾斜）、牙弓类型（上颌与下颌）对准确性的潜在影响，P值为结果：25 名患者、36 个完整牙弓和 161 个种植体被植入。总体平均角度偏差为 2.19°（标准偏差为 1.26°）。总体平台和顶点平均偏差分别为 1.17 毫米（标准差 0.57 毫米）和 1.30 毫米（标准差 0.62 毫米）。只有在愈合后和拔牙后的部位才会出现有意义的整体平台（p = 0.0009）和根尖（p = 0.0109）偏差。没有一个分析变量对角度偏差有明显影响。颌骨类型（种植体平台和顶点的 y 轴）、配准算法（y 轴平台和 z 轴偏差）以及无靶标算法的参照类型都会导致轻微的单轴偏差。与种植体角度有关的差异没有统计学意义：在研究限制范围内，使用即刻加载数字预制 FDP 进行全牙弓种植体植入时，导航是可靠的。人工智能驱动的表面解剖学识别和校准协议使无靶标注册与有靶标注册一样准确，牙齿和骨螺钉是相同的参照物。种植部位特征是唯一具有统计学意义的变量，与拔牙后相比，愈合部位的准确性更高。无论种植体角度和颌骨类型如何，实时跟踪导航手术都能提高操作者的表现和准确性。应考虑约1毫米和2°的平均安全空间。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Clinical Implant Dentistry and Related Research 医学-牙科与口腔外科

CiteScore

6.00

自引率

13.90%

发文量

103

审稿时长

4-8 weeks

期刊介绍： The goal of Clinical Implant Dentistry and Related Research is to advance the scientific and technical aspects relating to dental implants and related scientific subjects. Dissemination of new and evolving information related to dental implants and the related science is the primary goal of our journal. The range of topics covered by the journals will include but be not limited to: New scientific developments relating to bone Implant surfaces and their relationship to the surrounding tissues Computer aided implant designs Computer aided prosthetic designs Immediate implant loading Immediate implant placement Materials relating to bone induction and conduction New surgical methods relating to implant placement New materials and methods relating to implant restorations Methods for determining implant stability A primary focus of the journal is publication of evidenced based articles evaluating to new dental implants, techniques and multicenter studies evaluating these treatments. In addition basic science research relating to wound healing and osseointegration will be an important focus for the journal.