Accuracy of dynamic computer-assisted implant surgery in fully edentulous patients: An in vitro study

Objectives: To compare miniscrew versus bone tracing registration methods on dental implant placement accuracy and time efficiency in edentulous jaws using a dynamic computer-assisted implant surgery (d-CAIS) system. Methods: Twelve fully edentulous maxillary models were allocated into two groups: miniscrew tracing (MST) group, where registration was performed by tracing four miniscrews; and bone tracing (BT) group, where registration was conducted by tracing maxillary bone fiducial landmarks. Six implants were placed on each model using the X-Guide (R) d-CAIS system. Pre- and postoperative cone-beam computed tomography (CBCT) scans were superimposed to evaluate implant placement accuracy. The time required for registration and the overall surgery time were also recorded. Results: Thirty-six implants were placed in each group. The MST group showed significantly lower mean angulation deviations (mean difference (MD): -3.33 degrees; 95 % confidence interval (CI): -6.56 to -0.09); p = 0.044), 3D platform deviations (MD: -1.01 mm; 95 % CI: -1.74 to -0.29; p = 0.006), 2D platform deviations (MD: -0.97 mm; 95 % CI: -1.71 to -0.23; p = 0.010), and 3D apex deviations (MD: -1.18 mm; 95 % CI: -1.92 to -0.44; p = 0.002) versus the BT group. The overall surgery time was similar for both groups (MD: 6.10 min.; 95 % CI: -0.31 to 12.51; p = 0.06), though bone tracing required significantly more time compared with miniscrew registration (MD: 4.79 min.; 95 % CI: 2.96 to 6.62; p < 0.05). Conclusions: Registration with MST increases the accuracy of implant placement with a d-CAIS system in edentulous jaws compared with the BT method, and slightly reduces the overall surgery time.