Comparative evaluation of accuracy between dynamic navigation and freehand method during orthodontic implant placement: a split-mouth study.

Abstract

Objectives: To assess and compare the accuracy of infrazygomatic crest screws (IZC) placed with and without a dynamic navigation system.

Materials and methods: Preoperative cone-beam computed tomography (CBCT) and intraoral scan of the maxillary arch were obtained for 12 patients requiring therapeutic first premolar extraction after leveling and alignment. Virtual planning of the final IZC screw position on both sides was done using Evalunav software. Maxillary left and right arches for each patient were randomized into experimental and control sides. A 12 × 2 mm dimension IZC screw was positioned with and without use of a dynamic navigation system randomly on either side. A postoperative CBCT was taken immediately to assess the final screw position. Preoperative and postoperative CBCTs were compared for deviation in the entry point, apical point, and angular point for experimental and control sides. Mean value deviations obtained were subjected to statistical analysis using SPSS 20.0 to describe the data.

Results: Paired t-tests were used to analyze the comparisons. Dynamic navigation showed a statistically significant difference in entry point and angular point compared to the freehand approach during implant placement.

Conclusions: IZC screws implanted with the dynamic navigation system offered better control with less deviation and greater accuracy in all three planes of space. However, further studies are necessary to determine the stability and anchor value of implants placed with a dynamic navigation system.