Computer-aid dynamic implant placement surgery – A cases series and technique notes

Background

In recent years, there has been a growing interest in guided implant surgery. The results of several published indicate that static guided surgery is better accuracy than free hand surgery. Poor implant positioning increases the risk of biological complications and biomechanics overload. Guided implant surgery improved the implants placement in a proper position. However, there are several limitations of static guided surgery, such as stability, faulty of ISO caused inaccuracy of image.

Aim/Hypothesis

The aim of this present is to assess the computer-aid dynamic guided implant placement surgery accuracy and clinic efficiency.

Material and Methods

Total 9 partially edentulous patients (4 female, 5 male) were included and received 16 implants placed under computer-aid dynamic guided surgery, One patient had insufficient bone width and height, used navigation to determine the inferior of sinus lateral wall augmentation, performed antrostomy according to the frame design by Navident software. (Navident, ClaroNav, Canada). After cone-beam CT acquisition, DICOM files were imported and merge with predetermined crown STL data, planning restorative driven implant placement. 11 implants placed in healed ridges, 5 implants in immediate placement. Post-operation assessment use the EvaluNav application to evaluate the deviations between the planned and the actual position of the implants. Estimate the deviations of entrance point, apical point (3d), apical point (v) and angle deviations.

Results

The EvaluNav application estimate the mean deviation of entrance point is 0.93 mm, the apical deviation (3d) is 1.61 mm, the apical deviation(v) is 0.90 mm and the angle deviation is 3.43 degree. The application navigation is easily to determine the inferior of the sinus walls, more efficiency for antrostomy and avoid the complications of sinus elevation procedure.

Conclusion and Clinical Implications

Based on the limitations of this presentation, it can be concluded that the accuracy of computer-aid dynamic guided implant surgery is within clinical acceptance, decrease human errors. The safety range of at least 2 mm is need respected. Navigation guided of antrostomy for lateral sinus elevation augmentation is clinic efficiency and save time.