The impacts of registration‐and‐fixation device positioning on the performance of implant placement assisted by dynamic computer‐aided surgery: A randomized controlled trial

• Published in: Clinical oral implants research Vol. 35; no. 4; pp. 386 - 395
• Main Authors: Wu, Bin‐Zhang, Sun, Feng
• Format: Journal Article
• Language: English
• Published: Denmark Wiley Subscription Services, Inc 01.04.2024
• Subjects: accuracy; Deviation; dynamic navigation; implant surgery; Registration; registration‐and‐fixation; Surgery; Teeth; two‐in‐one; accuracy; registration; registration-and-fixation; two-in-one; implant surgery; dynamic navigation
• ISSN: 0905-7161; 1600-0501; 1600-0501
• DOI: 10.1111/clr.14237

Objectives To assess the efficacy of dynamic computer‐aided surgery (dCAS) in replacing a single missing posterior tooth, we compare outcomes when using registration‐and‐fixation devices positioned anterior or posterior to the surgical site. Registration is performed on either the anterior or opposite posterior teeth. Methods Forty individuals needing posterior single‐tooth implant placement were randomly assigned to anterior or posterior registration. Nine parameters were analyzed to detect the deviations between planned and actual implant placement, using Mann–Whitney and t‐tests for nonnormally and normally distributed data, respectively. Results The overall average angular deviation for this study was 2.08 ± 1.12°, with the respective average 3D platform and apex deviations of 0.77 ± 0.32 mm and 0.88 ± 0.32 mm. Angular deviation values for individuals in the anterior and posterior registration groups were 1.58°(IQR: 0.98°–2.38°) and 2.25°(IQR: 1.46°–3.43°), respectively (p = .165), with 3D platform deviations of 0.81 ± 0.29 mm and 0.74 ± 0.36 mm (p = .464), as well as 3D apex deviations of 0.89 ± 0.32 mm and 0.88 ± 0.33 mm (p = .986). No significant variations in absolute buccolingual (platform, p = .659; apex, p = .063), apicocoronal (platform, p = .671; apex, p = .649), or mesiodistal (platform, p = .134; apex, p = .355) deviations were observed at either analyzed levels. Conclusions Both anterior and posterior registration approaches facilitate accurate dCAS‐mediated implant placement for single missing posterior teeth. The device's placement (posterior‐to or anterior‐to the surgical site) did not affect the clinician's ability to achieve the planned implant location.