In Vitro Comparison of Time and Accuracy of Implant Placement Using Trephine and Conventional Drilling Techniques Under Dynamic Navigation
The aim of this randomized in vitro study was to compare the time and accuracy of implant-site preparation and implant placement using a trephine drill versus a conventional drilling technique under dynamic navigation. In total, 42 implants were placed in simulation jaw models with the 2 drilling techniques by 2 operators who had previous experience with dynamic navigation. The timing of each implant placement was recorded, and horizontal, vertical, and angulation discrepancies between the planned and placed implants were compared. There was no significant difference in time or accuracy between the trephine and conventional drilling techniques. Implant-site preparation with a single trephine drill using dynamic navigation was as accurate under in vitro experimental conditions as a conventional drilling sequence.
Figure 1. Upper and lower simulation jaw model with placed implants and metallic fiducial sphere markers to be used for accurate superimposition of the preoperative and postoperative cone-beam computerized tomography scans. Figure 2. (a) The single trephine 3.5 × 10 mm drill (Bangkok Bone Harvest) and final shaping drill (Zimmer Biomet Dental). (b) Drills used for the conventional drilling sequence technique performed by using 5 drills of sequentially expanding diameter size and implant carrier (Zimmer Biomet Dental). Figure 3. Superimposition of planned preoperative cone-beam computerized tomography (CBCT) scan over a postoperative CBCT scan with a comparison of horizontal, vertical, and angulation discrepancies of planned and placed implant positions. Figure 4. Deviation parameters for assessing horizontal, vertical, and angulation discrepancies between planned and placed implants.
Figure 5. Estimated average deviations and placement time by instrument type. The error bars represent standard errors. Figure 6. Average time to place the implant shown by implant site and drill technique. The error bars represent standard errors.
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