Influence of digital design and fabrication of surgical guides on the accuracy of implant placement

Abstract

The aim of the present thesis was to study whether the use of digital design and fabrication of surgical templates can improve the accuracy of dental implant placement. The dissertation consists of three experiments were different guided implant surgery software and production methods were applied in a clinical setting. Manual labor processes were a significant part of the planning and production in study No 1 and the degree of digitalization of the procedures increased in the following studies. The dental implants were installed in humans and the postoperative position of the implants were compared with the planned position in the software.

All included implants were compared, and four common parameters were measured: The position of the implant collar and apex, the depth of the implant and the angle of their long axis.

Study No 1 revealed that it is possible to plan and place implants with a high degree of accuracy based on a mainly manual procedure. Study No 2 and 3 resulted in an increased discrepancy demonstrating that the metric discrepancy between the achieved and planned placement of the dental implants increased with the introduction of digital procedures in planning and production. The highest statistically significant difference between study No 1 and the two latter studies were in the vertical direction.

The highly significant differences in the vertical direction indicate that the surgical guides, in a clinical situation, are not placed in the correct position in the patient’s mouth but are placed too high compared to the digital plan. The significant difference in median depth deviations between the studies indicate that the deviations associated with the stereolithographic production of the surgical guides are the most prominent.