Open-sleeve templates for computer-assisted implant surgery at healed or extraction sockets: An in vitro comparison to closed-sleeve guided system and free-hand approach.

ABSTRACT

OBJECTIVE: A buccal opening guide provides better view and better irrigation. The aim of this study was to investigate the accuracy of this open-sleeve system. MATERIAL AND METHODS: Thirty duplicated maxillary models, each with six extraction sockets and four healed sites, were used. Based on the same digital plan, three modalities, sCAIS with open-sleeves, closed-sleeves, and free-hand approach, were used to place implants. The global, horizontal, depth, and angular deviations between the virtual and actual implant positions were measured. RESULTS: Both sCAIS groups exhibited better accuracy than the free-hand group in two clinical scenarios. At healed sites, the closed-sleeve group showed a significantly fewer error than the open-sleeve group in global apical (0.68 ± 0.33 vs. 0.96 ± 0.49 mm), horizontal coronal (0.28 ± 0.15 vs. 0.44 ± 0.25 mm), horizontal apical (0.64 ± 0.32 vs. 0.94 ± 0.48 mm), and angular deviations (1.83 ± 0.95 vs. 2.86 ± 1.46°). For extraction sockets, the open-sleeve group exhibited fewer deviations than the closed-sleeve group in terms of global (coronal 0.77 ± 0.29 vs. 0.91 ± 0.22 mm; apical 1.08 ± 0.49 vs. 1.37 ± 0.52 mm) and horizontal (coronal 0.60 ± 0.24 vs. 0.86 ± 0.20 mm; apical 0.95 ± 0.50 vs. 1.32 ± 0.51 mm) deviations. However, the closed-sleeve group was more accurate in the depth control (0.26 ± 0.20 vs. 0.40 ± 0.31 mm). CONCLUSION: In this in vitro investigation, open-sleeve sCAIS proved better accuracy than free-hand surgery for both delayed and immediate implant placement. Compared with a closed-sleeve sCAIS system, open sleeve have the potential of providing better outcomes in extraction sockets but not in healed sites.