Accuracy of a newly developed integrated system for dental implant planning.
OBJECTIVE
To evaluate the accuracy of the first integrated system for cone-beam CT (CBCT) imaging, dental implant planning and surgical template-aided implant placement.


METHODS
On the basis of CBCT scans, a total of 54 implant positions were planned for 10 partially edentulous anatomical patient-equivalent models. Surgical guides were ordered from the manufacturer (SICAT). Two different types of guidance were assessed: for assessment of the SICAT system inherent accuracy vendor's titanium sleeves of 2 mm internal diameter and 5 mm length were utilized for pilot drills. The guide sleeves of the NobelGuide system were implemented for fully guided surgery and implant insertion. Deviations perpendicular to the implant axes at the crestal and apical end, as well as the angle deviations between the virtual planning data and the surgical results, were measured utilizing a follow-up CBCT investigation and referential marker-based registration.


RESULTS
The SICAT system inherent mean deviation rates for the drilled pilot osteotomies were determined to be smaller than 500 mum even at the apical end. Mean angle deviations of 1.18 degrees were determined. Utilizing the NobelGuide sleeve-in-sleeve system for fully guided implant insertion in combination with the investigated template technology enabled to insert dental implants with the same accuracy. Crestal deviations, in general, were significantly lower than the apical deviations.


CONCLUSIONS
Although hardly comparable due to different study designs and measurement strategies, the investigated SICAT system's inherent accuracy corresponds to the most favourable results for computer-aided surgery systems published so far. In combination with the NobelGuide surgical set for fully guided insertion, the same accuracy level could be maintained for implant positioning.
Dreiseidler
Timo
T
Department for Craniomaxillofacial and Plastic Surgery, University of Cologne, Cologne, Germany. dreiseidler@gmx.de
Neugebauer
Jörg
J
Ritter
Lutz
L
Lingohr
Thea
T
Rothamel
Daniel
D
Mischkowski
Robert A
RA
Zöller
Joachim E
JE
D000539:Alveolar Process / Q000601:surgery; D017076:Computer-Aided Design; D054893:Cone-Beam Computed Tomography; D003758:Dental Implantation, Endosseous / Q000295:instrumentation / Q000379:methods*; D003779:Denture Design; D006801:Humans; D021621:Imaging, Three-Dimensional; D007576:Jaw, Edentulous, Partially / Q000534:rehabilitation* / Q000601:surgery; D008334:Mandible; D008437:Maxilla; D003765:Models, Dental; D013516:Oral Surgical Procedures, Preprosthetic / Q000295:instrumentation / Q000379:methods*; D010027:Osteotomy / Q000295:instrumentation / Q000379:methods; D010347:Patient Care Planning; D015203:Reproducibility of Results; D025321:Surgery, Computer-Assisted / Q000295:instrumentation* / Q000379:methods