In Vivo Tooth-Supported Implant Surgical Guides Fabricated with Desktop Stereolithographic Printers: Fully Guided Surgery is More Accurate than Partially Guided Surgery

Publication date: Available online 21 February 2018
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Sompop Bencharit, Adam Staffen, Matthew Yeung, Daniel Whitley, Daniel M. Laskin, George R. Deeb
PurposeDesktop stereolithographic printers, in combination with intraoral scanning and implant planning software, promise precise and cost-effective guided implant surgery. The purpose of this study was to determine the overall range of accuracy of tooth-supported guided implant surgery using desktop printed stereolithographic guides.Materials and MethodsA cross-sectional study comparing fully and partially guided implant surgery was conducted. Preoperative cone-beam computed tomography (CBCT) and intraoral scans were used to plan the implant sites. Surgical guides were then fabricated using a desktop stereolithographic 3D printer. Postoperative CBCT was used to evaluate the accuracy of placement. The deviations from planned positions were used as the primary outcome variables. The planning software used, implant systems, and anterior/posterior positions were secondary outcome variables. The differences between the planned and actual implant positions in the mesial, distal, buccal, lingual dimensions, and the bucco-lingual angulations, were determined and the accuracy was compared statistically using one-tail F-test (p=0.01), box plots and 95% confidence interval for means.ResultsSixteen partially edentulous patients requiring placement of 31 implants were included in the study. The implant deviations from the planned positions with the fully guided protocol (n=20) were 0.17+/-0.78mm, 0.44+/-0.78mm, 0.23+/-1.08mm, -0.22+/-1.44mm and -0.32+/-2.36°, respectively. The implant deviations for the partially guided protocol (n=11) were 0.33+/-1.38mm, -0.03+/-1.59mm, 0.62+/-1.15mm, -0.27+/-1.61mm, and 0.59+/-6.83°, respectively. There was a statistically significant difference between the variances of fully and partially guided surgery for the distal and angulation dimension (p=0.006, and p<0.001). There was no statistical difference between software programs. Anterior implants had less variation in deviation than posterior implants.ConclusionsFully guided implant surgery is more accurate then partially guided implant surgery. Implant positional deviation is influenced by implant location, but not implant systems or software. If possible clinicians should use guided surgery protocols that allow placement of implants through a surgical guide.



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