Navigated vs. conventional implant insertion for maxillary single tooth replacement.
Abstract Introduction: Computer-guided navigation has proven a valuable tool in several surgical disciplines. During oral implant placement, its application is intended to accomplish optimal implant localization and to reduce the risk of damage to adjacent structures. The aim of this study was to compare the precision limits of conventional vs. navigated implant insertion in practice.


METHODS
In cast models of the maxilla, implants were inserted to replace the left central incisor (n = 40) and the right canine (n = 40); each of those were inserted either conventionally (n = 20) or navigated (n = 20). Implant position, angulation and insertion depth were calculated from computer tomography scans of the implants that were connected to an index abutment of 40 cm length.


RESULTS
The variations of implant positions were reduced for implants that were inserted by navigation (P < 0.05). In both the axial and the transversal plane, the variations of implant angulations were reduced for implants that were inserted by a navigation protocol (P < 0.05). The variations of insertion depth were less (P < 0.05) when the implants were placed by navigation in comparison with conventional insertion procedures.


CONCLUSIONS
Given the experimental conditions, although they tried to mimic a clinical situation, no final conclusions can be drawn. The in vitro application of a navigation system resulted in an improved precision of insertion surgery regarding the position, angulation and depth of an implant. Clinical studies will have to prove if routine image guidance will result in superior surgical outcome.
Kramer
Franz-Josef
FJ
Department of Oral and Maxillofacial Surgery, Medical University of Hannover, Carl-Neuberg-Str. 1, D-30625 Hannover, Germany. Kramer.Franz@MH-Hannover.de
Baethge
Carola
C
Swennen
Gwen
G
Rosahl
Steffen
S
D003481:Cuspid; D000044:Dental Abutments; D003758:Dental Implantation, Endosseous / Q000379:methods*; D019250:Dental Implants, Single-Tooth; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007180:Incisor; D008437:Maxilla / Q000000981:diagnostic imaging / Q000601:surgery; D008953:Models, Anatomic; D003765:Models, Dental; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed; D020390:Tooth Socket / Q000601:surgery