Comparative Accuracy of Static vs Dynamic Guidance for Dental Implant Placement on Vascularized Bone Flap Reconstruction: A Retrospective Study.

Purpose: To evaluate and compare the accuracy of dental implant placement on vascularized bone flaps (VBFs) reconstructed for jaw defects using static computer-assisted implant surgery (s-CAIS) and dynamic computer-assisted implant surgery (d-CAIS).

Material and methods: The present retrospective study included patients who underwent s- or d-CAIS implant placement following VBFs reconstruction between October 2021 and October 2023. Accuracy was assessed by comparing the preoperative design and postoperative results from cone-beam computed tomography. Key parameters, such as angulation deviation, global deviation at the platform and apex, and bidirectional deviations (mesiodistal, buccolingual, and apicocoronal), were measured and compared between groups.

Results: A total of 23 patients were included: nine patients (33 implants) in the d-CAIS group and 14 patients (41 implants) in the s-CAIS group. The d-CAIS group demonstrated significantly lower global deviation (p < 0.01) and apicocoronal deviation at the apex (p < 0.05) compared to the s-CAIS group. Superior accuracy was also observed in the d-CAIS group for posterior implants, particularly in apicocoronal deviation at both the platform and apex levels (p < 0.01). Additionally, d-CAIS outperformed s-CAIS for mandibular implants, showing significantly lower buccolingual deviation at both the platform and apex levels (p < 0.05). For implants on iliac flaps, d-CAIS exhibited lower angulation deviation and global deviation at the platform and apex levels (p < 0.05).

Conclusion: When placing implants on VBFs reconstructed jaws, dynamic guidance demonstrated superior precision, particularly in controlling depth and apex deviation.