Prospective Clinical Study on the Accuracy of Static Computer-Assisted Implant Surgery in Patients With Distal Free-End Implants. Conventional Versus CAD-CAM Surgical Guides.

IF 4.8 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE
García-Mira Berta, Canullo Luigi, Peñarrocha-Diago Miguel, Balaguer-Martí José Carlos
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Abstract

Objectives: To compare the accuracy of CAD-CAM and conventional guides in the static computer-assisted implant surgery (sCAIS) placement of distal free-end implants.

Material and methods: A prospective, controlled, and blinded quasi-experimental study was done involving 27 patients (76 implants) distributed into two groups according to the surgical guide manufacturing approach used: conventional (control group [CG]) or CAD-CAM (test group [TG]). The implants were planned in the software and the surgical guides were manufactured. Fully guided implant placement was carried out and the deviations were measured along with secondary variables as potential confounding factors. Descriptive analyses were performed on mean, standard deviation (SD), and interquartile range (IQR). In the comparative/inferential analysis hypothesis, contrasts were made of the quantitative and qualitative variables and multiple linear models were generated to adjust for the different confounding variables recorded.

Results: Coronal horizontal deviation (CHD) was significantly greater in CG (1.52 mm) versus TG (1.04 mm) (p = 0.004). Apical horizontal deviation (AHD) in turn was 1.67 versus 1.46 mm, respectively; angular deviation was 2.87 versus 3.64; and vertical deviation was -0.1 versus -0.05 mm, with no significant differences between the groups (p > 0.05). A greater sleeve height, positioning in premolars versus molars, and the use of shorter implants, were associated with greater accuracy in relation to CHD and/or AHD (p < 0.05). The implant success rate at 1 year was 92.1%, 90.7% in TG, and 100% in CG, being statistically significant (p = 0.026) at the implant level, but not significant at the patient level.

Conclusions: The CAD-CAM surgical guides proved to be more accurate than the conventional guides in the sCAIS placement of distal free-end implants, with statistically significant differences being observed in terms of CHD. All implant failures occurred in TG (6 implants/3 patients).

Trial registration: ClinicalTrials.gov identifier: NCT06404385.

关于计算机辅助静态种植手术对远端游离端种植体患者准确性的前瞻性临床研究。传统与 CAD-CAM 手术导板的对比。
目的比较 CAD-CAM 和传统导板在计算机辅助种植手术(sCAIS)中植入远端自由端种植体的准确性:该研究是一项前瞻性、对照和盲法准实验研究,共涉及 27 名患者(76 个种植体),根据所使用的手术导板制造方法分为两组:常规组(对照组 [CG])或 CAD-CAM 组(测试组 [TG])。在软件中对种植体进行规划,并制作手术导板。在完全引导下进行种植体植入,并测量偏差以及作为潜在混杂因素的次要变量。对平均值、标准差(SD)和四分位数间距(IQR)进行了描述性分析。在比较/推理分析假设中,对定量和定性变量进行了对比,并建立了多重线性模型,以调整记录的不同混杂变量:结果:CG(1.52 毫米)与 TG(1.04 毫米)相比,冠状水平偏差(CHD)明显更大(p = 0.004)。顶端水平偏差(AHD)分别为 1.67 mm 对 1.46 mm;角度偏差为 2.87 mm 对 3.64 mm;垂直偏差为 -0.1 mm 对 -0.05 mm,组间差异不显著(P > 0.05)。套筒高度越大,定位在前磨牙与磨牙之间,以及使用较短的种植体,与CHD和/或AHD相关的精确度越高(p 结论:CAD-CAM手术导板的精确度与CHD和/或AHD相关:事实证明,CAD-CAM手术导板在sCAIS植入远端自由端种植体时比传统导板更准确,在CHD方面有显著的统计学差异。所有植入失败均发生在TG(6例植入/3例患者):试验注册:ClinicalTrials.gov identifier:试验注册:ClinicalTrials.gov identifier:NCT06404385。
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来源期刊
Clinical Oral Implants Research
Clinical Oral Implants Research 医学-工程:生物医学
CiteScore
7.70
自引率
11.60%
发文量
149
审稿时长
3 months
期刊介绍: Clinical Oral Implants Research conveys scientific progress in the field of implant dentistry and its related areas to clinicians, teachers and researchers concerned with the application of this information for the benefit of patients in need of oral implants. The journal addresses itself to clinicians, general practitioners, periodontists, oral and maxillofacial surgeons and prosthodontists, as well as to teachers, academicians and scholars involved in the education of professionals and in the scientific promotion of the field of implant dentistry.
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