title: Depth and lateral deviations in guided implant surgery: an RCT comparing guided surgery with mental navigation or the use of a pilot-drill template.
abstract: OBJECTIVE
  To assess the accuracy of guided surgery compared with mental navigation or the use of a pilot-drill template in fully edentulous patients.
  
  
  METHODS
  Sixty consecutive patients (72 jaws), requiring four to six implants (maxilla or mandible), were randomly assigned to one of the following treatment modalities: Materialise Universal(®) mucosa, Materialise Universal(®) bone, Facilitate(™) mucosa, Facilitate(™) bone, mental navigation, or a pilot-drill template. Accuracy was assessed by matching the planning CT with a postoperative CBCT. Deviations were registered in a vertical (depth) and horizontal (lateral) plane. The latter further subdivided into BL (bucco-lingual) and MD (mesio-distal) deviations.
  
  
  RESULTS
  The overall mean vertical deviation for the guided surgery groups was 0.9 mm ± 0.8 (range: 0.0-3.7) and 0.9 mm ± 0.6 (range: 0.0-2.9) in a horizontal direction. For the non-guided groups, this was 1.7 mm ± 1.3 (range: 0.0-6.4) and 2.1 mm ± 1.4 (range 0.0-8.5), respectively (P < 0.05). The overall mean deviation for the guided surgery groups in MD direction was 0.6 mm ± 0.5 (range: 0.0-2.5) and 0.5 mm ± 0.5 (range: 0.0-2.9) in BL direction. For the non-guided groups, this was 1.8 mm ± 1.4 (range: 0.0-8.3) and 0.7 mm ± 0.6 (range 0.0-2.9), respectively. The deviation in MD direction was significantly higher in the non-guided groups (P = 0.0002).
  
  
  CONCLUSIONS
  The most important inaccuracy with guided surgery is in vertical direction (depth). The inaccuracy in MD or BL direction is clearly less. For non-guided surgery, the inaccuracy is significantly higher.
authors.affiliation: Department of Oral Health Sciences, Periodontology, Faculty of Medicine, Catholic University Leuven, University Hospitals Leuven, Leuven, Belgium.
authors.forename: M
authors.initials: M
authors.lastname: Vercruyssen
authors.affiliation: Clinical Biology, Scientific Institute of Public Health, Brussels, Belgium.
authors.forename: W
authors.initials: W
authors.lastname: Coucke
authors.affiliation: Department of Oral Health Sciences, Prosthetic Dentistry, Faculty of Medicine, Catholic University Leuven, University Hospitals Leuven, Leuven, Belgium.
authors.forename: I
authors.initials: I
authors.lastname: Naert
authors.affiliation: OMFS IMPATH research group, Department of Imaging & Pathology, Faculty of Medicine, Catholic University of Leuven, University Hospitals Leuven, Leuven, Belgium.
authors.forename: R
authors.initials: R
authors.lastname: Jacobs
authors.affiliation: Department of Oral Health Sciences, Periodontology, Faculty of Medicine, Catholic University Leuven, University Hospitals Leuven, Leuven, Belgium.
authors.forename: W
authors.initials: W
authors.lastname: Teughels
authors.affiliation: Department of Oral Health Sciences, Periodontology, Faculty of Medicine, Catholic University Leuven, University Hospitals Leuven, Leuven, Belgium.
authors.forename: M
authors.initials: M
authors.lastname: Quirynen
mesh_terms: D000328:Adult; D000368:Aged; D003757:Dental Implantation / Q000379:methods / Q000592:standards; D015921:Dental Implants; D017267:Dental Prosthesis Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D056948:Orthognathic Surgical Procedures; D025321:Surgery, Computer-Assisted / Q000379:methods / Q000592:standards; D016896:Treatment Outcome
chemical_list: D015921:Dental Implants
keywords: CT imaging; accuracy; clinical research; guided implant surgery; surgical techniques