Analysis of implant placement accuracy using freehand in 68 consecutive patients with 97 implants

doi:10.19439/j.sjos.2020.04.022

Abstract

Abstract: PURPOSE: To analyze the accuracy of implant position in simple cases by freehand. METHODS: Ninety-seven implants of 68 patients from 3 surgeons were selected.After operation,the deviations of implant position at shoulder apex and angle were measured using cone-beam CT(CBCT).The mean of three parameters were calculated with SPSS 22.0 software package, and the differences were analyzed between three surgeons,three operation areas,free-end missing and non free-end missing. RESULTS: The deviations of 97 implants were (0.76±0.57)mm,(1.41±0.90)mm,(4.76±3.68)° at shoulder, apex and angle.The deviation of shoulder apex and angle between three surgeons was significantly different(P<0.05). The deviations between left and right group were not significantly different (P>0.05); the deviations between anterior group and left group were significantly different(P<0.05); the deviations between anterior group and right group were not significantly different(P>0.05). The deviation of shoulder between free-end missing area and non free-end missing area was significantly different(P<0.05),other parameters between the two groups were not significantly different(P>0.05).CONCLUSIONS: The deviation of implant placement between surgical guide and mental guide were similar in simple cases. The experience of surgeon was important during freehand implant placement. The deviations were lower when missing tooth is in anterior area than in posterior area, whereas the same at shoulder in non free-end missing area than in free-end missing area.

Key words: Freehand implant, Deviation, Experience, Area of missing tooth

CLC Number:

R782.1

HAN Xiang-yong, XU Xiao-ming, JU Ya-qiong, TIAN Zhi-juan. Analysis of implant placement accuracy using freehand in 68 consecutive patients with 97 implants[J]. Shanghai Journal of Stomatology, 2020, 29(4): 440-444.

References

[1] Canullo L, Tallarico M, Radovanovic S, et al.Distinguishing predictive profiles for patient-based risk assessment and diagnostics of plaque induced, surgically and prosthetically triggered peri-implantitis[J]. Clin Oral Implants Res, 2016, 27(10): 1243-1250.
[2] Van Assche N, Vercruyssen M, Coucke W, et al.Accuracy of computer-aided implant placement[J]. Clin Oral Implants Res, 2012, 23(Suppl 6): 112-123.
[3] Tahmaseb A, Wismeijer D, Coucke W, et al.Computer technology applications in surgical implant dentistry:a systematic review[J]. Int J Oral Maxillofac Implants, 2014, 29(Suppl): 25-42.
[4] Noharet R, Pettersson A, Bourgeois D.Accuracy of implant placement in the posterior maxilla as related to 2 types of surgical guides: A pilot study in the human cadaver[J]. J Prosthet Dent, 2014, 112(3): 526-532.
[5] Vercruyssen M, Cox C, Coucke W, et al.A randomized clinical trial comparing guided implant surgery (bone- or mucosa-supported) with mental navigation or the use of a pilot-drill template[J]. J Clin Periodontol, 2014, 41(7): 717-723.
[6] Kühl S, Zürcher S, Mahid T, et al.Accuracy of full guided vs. half-guided implant surgery[J]. Clin Oral Implants Res, 2013, 24(7): 763-769.
[7] Block MS, Emery RW, Cullum DR, et al.Implant placement is more accurate using dynamic navigation[J]. J Oral Maxillofac Surg, 2017, 75(7): 1377-1386.
[8] Choi W, Nguyen BC, Doan A, et al.Freehand versus guided surgery: factors influencing accuracy of dental implant placement[J]. Implant Dent, 2017, 26(4): 500-509.
[9] Bover-Ramos F, Vina-Almunia J, Cervera-Ballester J, et al.Accuracy of implant placement with computer-guided surgery: a systematic review and meta-analysis comparing cadaver, clinical, and in vitro studies[J]. Int J Oral Maxillofac Implants, 2018, 33(1): 101-115.
[10] Nickenig HJ, Wichmann M, Hamel J, et al.Evaluation of the difference in accuracy between implant placement by virtual planning data and surgical guide templates versus the conventional free-hand method-a combined in vivo-in vitro technique using cone-beam CT (Part II)[J]. J Craniomaxillofac Surg, 2010, 38(7): 488-493.
[11] Schulz MC, Rittmann L, Range U, et al.The use of orientation templates and free-hand implant insertion in artificial mandibles-an experimental laboratory examination in fifth-year dental students[J]. Dent J(Basel), 2018, 6(3): 43.
[12] Hinckfuss S, Conrad HJ, Lin L, et al.Effect of surgical guide design and surgeon's experience on the accuracy of implant placement[J]. J Oral Implantol, 2012, 38(4): 311-323.
[13] Diago MP, Ferrín LM, Oltra DP, et al.Tilted implants for the restoration of posterior mandibles with horizontal atrophy:an alternative treatment[J]. J Oral Maxillofac Surg, 2013, 71(5): 856-864.
[14] Younes F, Cosyn J, De Bruyckere T, et al.A randomized controlled study on the accuracy of free-handed, pilot-drill guided and fully-guided implant surgery in partially edentulous patients[J]. J Clin Periodontol, 2018, 45(6): 721-732.
[15] Staubli N, Walter C, Schmidt JC, et al.Excess cement and the risk of peri-implant disease-a systematic review[J]. Clin Oral Implants Res, 2017, 28(10): 1278-1290.
[16] Schnitman PA, Hayashi C, Han RK.Why guided when freehand is easier, quicker, and less costly?[J]. J Oral Implantol, 2014, 40(6): 670-678.
[17] Jacques V.The accuracy of implant placement by experienced surgeons: guided vs freehand approach in a simulated plastic model[J]. Int J Oral Maxillofac Implants, 2017, 32(3): 617-624.
[18] Chen S, Ou Q, Lin X, et al.Comparison between a computer-aided surgical template and the free-hand method: a systematic review and meta-analysis[J]. Implant Dent, 2019, 28(6): 578-589.