title: Accuracy of CAD/CAM-guided surgical template implant surgery on human cadavers: Part I.
abstract: BACKGROUND
  An optimal method for approaching the clinical surgical situation, when using preoperatively, virtually planned implant positioning, is to transfer data to a CAD/CAM-guided surgical template with the definitive position of the implant placed after surgery. The accuracy of CAD/CAM-guided surgeries must be determined to provide safe treatment.
  
  
  OBJECTIVE
  The purpose of this study was to compare the deviation between the position of virtually planned implants and the position of implants placed with a CAD/CAM-guided surgical template in the mandible and the maxilla in human cadavers.
  
  
  METHODS
  Ten maxillae and 7 mandibles, from completely edentulous cadavers, were scanned with CT, and 145 implants (Brånemark RP Groovy) were planned with software and placed with the aid of a CAD/CAM-guided surgical template. The preoperative CT scan was matched with the postoperative CT scan using voxel-based registration. The positions of the virtually planned implants were compared with the actual positions of the implants. Data were analyzed with a t test (alpha=.05).
  
  
  RESULTS
  The mean measurement differences between the computer-planned implants and implants placed after surgery for all implants placed were 1.25 mm (95% CI: 1.13-1.36) for the apex, 1.06 mm (95% CI: 0.97-1.16) for the hex, 0.28 mm (95% CI: 0.18-0.38) for the depth deviation, 2.64 degrees (95% CI: 2.41-2.87) for the angular deviation, and 0.71 mm (95% CI: 0.61-0.81 mm) for the translation deviation.
  
  
  CONCLUSIONS
  The results demonstrated a statistically significant difference between mandibles and maxillae for the hex, apex, and depth measurements in the variation between the virtually planned implant positions and the positions of the implants placed after surgery with a CAD/CAM-guided surgical template.
authors.affiliation: Section for Image and Functional Odontology, Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden. andreas.pettersson@ki.se
authors.forename: Andreas
authors.initials: A
authors.lastname: Pettersson
authors.forename: Timo
authors.initials: T
authors.lastname: Kero
authors.forename: Luc
authors.initials: L
authors.lastname: Gillot
authors.forename: Bernard
authors.initials: B
authors.lastname: Cannas
authors.forename: Jenny
authors.initials: J
authors.lastname: Fäldt
authors.forename: Rikard
authors.initials: R
authors.lastname: Söderberg
authors.forename: Karin
authors.initials: K
authors.lastname: Näsström
mesh_terms: D002102:Cadaver; D017076:Computer-Aided Design; D003758:Dental Implantation, Endosseous / Q000379:methods*; D006801:Humans; D021621:Imaging, Three-Dimensional; D007575:Jaw, Edentulous / Q000000981:diagnostic imaging* / Q000601:surgery; D008334:Mandible / Q000601:surgery; D008437:Maxilla / Q000601:surgery; D008953:Models, Anatomic; D003765:Models, Dental; D010347:Patient Care Planning; D011859:Radiography; D011873:Radiology Information Systems; D012984:Software; D018709:Statistics, Nonparametric; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014584:User-Computer Interface