An in vitro comparative evaluation between virtually planned implant positions on interactive implant software versus actual implant positions achieved using sterolithographic open guide system.
Purpose
To evaluate and compare the positional and angular accuracy of virtual implant positions planned on cone-beam computed tomography and final implant positions achieved using a universal open guide system.


Materials and Methods
A dual scan of a partially edentulous jaw model along with prosthesis was done, and virtual implant planning was performed. Three implant positions in relation to 35, 36, and 37 were simulated (Group A). In total, 24 implants were placed in eight replaceable bone blocks (Group B) in the same region on the model using an open stereolithographic template. The linear positions and angulation of the placed implants were determined using Vision Measuring Machine. Deviations between virtually planned and surgically placed implants were analyzed in terms of linear and angular measurements. Data were analyzed with the independent-sample t-test with differences P ≤ 0.05 being considered statistically significant.


Results
The linear distance (mean ± standard deviation [SD]) in mesiodistal direction between implants in relation to 35 and 36, 36 and 37, 35 and 37 in Group A was 8.79 ± 0 mm, 8.71 ± 0 mm, and 17.50 ± 0 mm, respectively, and in Group B was 7.70 ± 0.58 mm, 8.11 ± 0.30 mm, and 15.80 ± 0.48 mm. All these above values were found to be statistically significant (P ≤ 0.05). The linear distance (mean ± SD) in the vertical direction (mesial) for implants placed in the region of 35, 36, 37 for Group A was 1.51 ± 0 mm, 1.51 ± 0 mm, and 2.47 ± 0 mm, respectively, and for Group B was 1.37 ± 0.32 mm, 1.65 ± 0.48 mm, and 1.79 ± 0.36 mm, respectively. The linear distance (mean ± SD) in the vertical direction (distal) for implants placed in the region of 35, 36, 37 for Group A was 3.37 ± 0 mm, 1.51 ± 0 mm, and 1.51 ± 0 mm, respectively, and for Group B was 1.86 ± 0.48 mm (P ≤ 0.05), 1.56 ± 0.23 mm, and 1.29 ± 0.39 mm (P ≤ 0.05), respectively. The angular deviation (perpendicularity) values for virtually planned implants (Group A) were 90.00° ± 0° and for implants placed in the region of 35, 36, and 37 (Group B) were 84.52° ± 5.4°, 83.57° ± 1.52°, and 80.41° ± 2.37°, respectively, which are highly significant (P ≤ 0.05).


Conclusions
The stereolithographic universal open guide used in the study may be considered accurate for placement of implants in mesiodistal position and also in terms of perpendicularity but not in the vertical position. Stereolithographic open guide may be recommended for more accurate implant position, especially for the placement of multiple implants.
['Sharma|Avni|A|', 'Agarwal|Subodh Kumar|SK|', 'Parkash|Hari|H|', 'Mehra|Praful|P|', 'Nagpal|Abhishek|A|']
D017076:Computer-Aided Design D054893:Cone-Beam Computed Tomography D003758:Dental Implantation, Endosseous D015921:Dental Implants D021621:Imaging, Three-Dimensional D010347:Patient Care Planning D019736:Prostheses and Implants D012984:Software D025321:Surgery, Computer-Assisted
open guide system model vision measuring machine Dental implant stereolithography universal surgical guide