Clinical study of precision analysis and deviation control of a domestic guide plate-assisted edentulous implant surgery.

PURPOSE: To evaluate the accuracy of a domestic digital implant guide plate to assist edentulous implant surgery, analyze the sources of deviation, and reduce the deviation of the guide plate. METHODS: In total, 14 edentulous patients were selected, and 100 implant sites were measured. The preoperative cone beam computerized tomography (CBCT) data were imported into the software to design and fabricate the guide plate. After implant surgery,the data were imported for 3D reconstruction and alignment model was exported into the Geomagic Studio software for deviation measurement. RESULTS: Analysis of the overall accuracy of the domestic guide plate showed deviation of the implant neck center, horizontal direction, implant base center, depth, and angle of 0.83 ± 0.27 mm, 0.39 ± 0.17 mm, 1.11 ± 0.35 mm, 0.45 ± 0.19 mm, and 3.16 ± 1.73°. There were not statistically significant difference (p>0.05) between the tooth/mucosa-supported guide plate and the mucosa-supported, mandibular guide plate and maxillary, vertical implantation and inclined, anterior implant sites and posterior teeth. There was a statistically significant difference (p<0.05) between the use of the modified non-pressure plate tool box and the pressure plate tool box. CONCLUSION: First, the domestic implant guide plate can significantly improve the accuracy and efficiency in edentulous implant surgery. Second, the accuracy of the tooth/mucosa-supported guide plate is higher than mucosa-supported guide plate. Third, the accuracy of the new tool box without pressure plate is improved.

[Accuracy of 6D computed-derived implant guides made in China for dental implant surgery in edentulous patients].

PURPOSE: To evaluate the accuracy of 6D computed-derived implant guides made in China, in order to provide methods and basis for reducing deviation. METHODS: 3D rapid prototyping technique was used to fabricate implant guides for auxiliary surgical implantation in edentulous patients, and the position deviation between the preoperative design and the actual implant was measured. Sixteen edentulous patients with 172 implantation sites were measured. In 10 patients, six implants were implanted in the maxilla, 4 implants in the mandible, and 6 implants were implanted both in the maxilla and mandible of 6 patients. A total of 28 implants were tilted implant in 14 patients. Preoperative cone-beam CT(CBCT) data were imported into the 6D Dental Planning Software to design and make the implant guides. Digital guides were used to assist implant placement. Preoperative design and postoperative CBCT were imported into the software for 3D reconstruction and registration, and then exported to Geomagic Studio software for analysis to obtain the deviation between the preoperative design and the implantation, so as to analyze the accuracy of the guides. The differences were analyzed by SPSS 25.0 software package with paired t-test and single factor analysis of variance. RESULTS: The distance deviation of implant neck center point was (0.83±0.27) mm and the horizontal deviation was (0.60±0.21) mm. The distance deviation of implant bottom center point was (1.11±0.35) mm, and the vertical deviation was (0.45±0.19) mm. The angle deviation was (3.16±1.73)°. CONCLUSIONS: The 6D computed-derived implant guides made in China can improve the accuracy and efficiency of implant surgery for edentulous patients and obtain a better long-term clinical effect to meet clinical requirements well. Since the deviation is similar to other implant guide plate systems that reported aborad, it must be taken into account in the process of clinical design, in order to avoid risks and unnecessary complications. This method is worthy of wide clinical application.