Comparison of learning curve for anterior and posterior implant placement using dynamic computer-assisted surgical implant placement in novice and experienced operators: An in vitro trial.

Abstract

Statement of problem: Dynamic computer-assisted surgical implant placement (dCAIS) facilitates precise implant placement through a real-time tracking system, enabling single-visit treatment. However, an understanding of the learning curve associated with dCAIS in terms of differences between anterior and posterior implant placement is lacking.

Purpose: The purpose of this in vitro trial was to observe the learning curve for anterior and posterior implant placement in novice and experienced operators using dCAIS in a type-III bone model simulated maxilla.

Material and methods: Eight participants, including 4 novice and 4 experienced operators, were randomly assigned in blocks to either the anterior or posterior placement group. Before the experiment, the participants received video-training. Each participant performed 4 single implant placements per session with a 7 ±1 day wash-out period, totaling 5 practice sessions. Three-way repeated-measures analysis of variance (ANOVA) and 2-way ANOVA were used to analyze the effects of practice sessions, operator experience, and implant location on operating time and placement deviation. The operating time, coronal, depth, and angle deviations in each session were recorded and analyzed using repeated-measures ANOVA to express the learning curve (α=.05).

Results: The analysis of 160 implants showed significantly higher coronal and angle deviation in the posterior group than in the anterior group during the first and second practice session (P<.05), with no significant differences observed from the third to the fifth practice session; the anterior group exhibited consistent performance from the first practice session. Novice and experienced operators exhibited statistically different operating times, particularly during the first practice session (P<.05), with no differences in accuracy being observed (P>.05). Operating time decreased with the increasing number of practice sessions in all groups.

Conclusions: A learning curve for placing anterior implants with dCAIS may not be necessary for either novice or experienced operators. However, in posterior implant placement, a minimum of 3 practice sessions was found beneficial for both novice and experienced operators.