Editorial Type:
Article Category: Research Article
 | 
Online Publication Date: 10 Dec 2024

Effect of Clinical Experience on Accuracy of Implant Placement Using Dynamic Navigation and Static Guidance: An In Vitro Study

DDS, MSD,
DDS,
DDS, MS,
DDS, MS, and
DDS, MSD, PhD
Page Range: 626 – 635
DOI: 10.1563/aaid-joi-D-23-00181
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This study aimed to investigate the accuracy of implants placed by clinicians with varying dental implant experience using dynamic navigation (DN) and static guidance (SG). Sixty identical custom-made, drillable maxillary models were fabricated, missing the right central incisor (#8) and left first molar (#14) with simulated gingival tissue. Models planned with a DN system and guided surgery software were randomly allocated to an experienced clinician, an inexperienced clinician, and a nonexperienced clinician. The accuracy of implant placement was evaluated by overlaying the preoperative virtual surgical plan with the postoperative cone beam computerized tomography scan. Deviations between the placed and planned implants were quantified using a mathematical algorithm. Independent-sample t tests revealed significant differences (p < .001) in angular deviation but not in coronal and apical deviations when comparing DN with SG for all 3 clinicians. One-way analysis of variance and Tukey post hoc test found no significant differences between clinicians of varying dental implant experience in DN and SG groups. The study concluded that the level of dental implant experience and surgical site do not significantly impact the accuracy of implant placement when either DN or SG is used, and DN produced less angular deviation in comparison with SG. This finding suggests DN could benefit clinical settings, particularly for less experienced clinicians.

Figure 1.
Figure 1.

Partially edentulous (missing right central incisor and left first molar) maxillary drillable model with tissue-like coating.


Figure 2.
Figure 2.

Maxillary drillable model mounted with simple manikin and mandibular typodont in a dental chair to simulate real clinical situation.


Figure 3.
Figure 3.

#8 and #14 implant placement planned by Inliant dynamic navigation system.


Figure 4.
Figure 4.

A fiducial affixed to the maxillary model for cone-beam computerized tomography scan.


Figure 5.
Figure 5.

A patient tracker attached to the fiducial for dynamic tracking during procedure.


Figure 6.
Figure 6.

The dynamic navigation system in process.


Figure 7.
Figure 7.

Stereolithographic fully guided static surgical stent.


Figure 8.
Figure 8.

Static guidance surgical procedure. The drill was restricted within the drilling hole.


Figure 9.
Figure 9.

Illustration of accuracy analysis; α indicates angular deviation (degree). (a) Apical deviation (mm). (b) Coronal deviation (mm). (c) Central axis of planned implant. (d) Central axis of delivered implant.


Figure 10.
Figure 10.

Box plots of comparison between dynamic navigation and static guidance in angular deviation.


Figure 11.
Figure 11.

Box plots of comparison between dynamic navigation and static guidance in coronal deviation.


Figure 12.
Figure 12.

Box plots of comparison between dynamic navigation and static guidance in apical deviation.


Figure 13.
Figure 13.

Box plots of coronal deviation of #8 and #14 observed in experienced clinician.


Contributor Notes

Corresponding author, e-mail: qiaofang@uic.edu
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