Precision of flapless implant placement using real-time surgical navigation: a case series.
OBJECTIVE
To demonstrate the predictability of flapless surgery using navigation surgery.


METHODS
Computer-generated preoperative implant planning was compared to actual placement by CT (computerized tomography) scanning of patients before and after surgery. Once pre- and postoperative coordinates of virtual implants were obtained, linear distances and angles were calculated. Coronal and apical errors consisted of the shortest distance from the preoperative planning to the postoperative overlay.


RESULTS
Fourteen implants were placed in 6 patients who received CT scans before and after implant placement. Preoperative implant planning using software was compared to actual placement. The average discrepancy of the head of the implant was 0.89 mm +/- 0.53 SD (range, 0.32 to 1.96). The average discrepancy of the apex of the implant was 0.96 mm +/- 0.50 SD (range, 0.25 to 1.99). The average angle discrepancy and standard deviation were 3.78 degrees +/- 2.76 SD (range, 0.60 to 9.87).


CONCLUSIONS
Optical computerized navigation is vulnerable to technological and technical errors. Yet, the present case series suggests that less than 1 mm of mean linear deviation and less than 4 degrees of angular deviation might be attainable.
Elian
Nicolas
N
Division of Implant Dentistry, Department of Periodontology and Implant Dentistry, New York University College of Dentistry, New York, New York, USA.
Jalbout
Ziad N
ZN
Classi
Anthony J
AJ
Wexler
Alon
A
Sarment
David
D
Tarnow
Dennis P
DP
D000328:Adult; D000368:Aged; D001641:Bicuspid; D003724:Dental Arch / Q000601:surgery; D003758:Dental Implantation, Endosseous / Q000295:instrumentation / Q000379:methods*; D015921:Dental Implants; D005260:Female; D005544:Forecasting; D006801:Humans; D007180:Incisor; D008297:Male; D008334:Mandible / Q000601:surgery; D008437:Maxilla / Q000601:surgery; D008875:Middle Aged; D008963:Molar; D010027:Osteotomy / Q000295:instrumentation / Q000379:methods; D010347:Patient Care Planning; D012984:Software; D013165:Splints; D025321:Surgery, Computer-Assisted; D013524:Surgical Flaps; D014057:Tomography, X-Ray Computed; D014584:User-Computer Interface
D015921:Dental Implants