Comparing Accuracy of Implant Installation with a Navigation System (NS), a Laboratory Guide (LG), NS with LG, and Freehand Drilling.

The aim of this study was to compare the accuracy of implant placement by using the conventional freehand method, the surgical guide alone, the dental navigation system alone, and the dental navigation system with a surgical guide. The participants were aged 20 years or older and were requiring dental implant surgery according to an assessment made by a dentist between July 2014 and December 2017. A total of 128 dental implants were inserted, 32 dental implants in each group, and participants with similar or identical age (i.e., 20-50 years or 50 years or above) and missing tooth locations were paired for comparison. Accuracy was measured by overlaying the real position in the postoperative Cone Beam Computerized Tomography (CBCT) on the virtual presurgical placement of the implant in a CBCT image. Using the dental navigation system with a surgical guide could help dentists to position implants more accurately. Total, longitudinal, and angular error deviation were significantly different (p < 0.0001). The same level of accuracy could be obtained for the different jaws and tooth positions. The one-way analysis of variance (ANOVA) showed that the total, longitudinal, and angular errors differed significantly (p < 0.0001). A comparison of the four dental implant surgical methods indicated that the combination of a dental implant navigation system and a surgical guide kit achieved the highest accuracy in terms of the different tooth positions and jaws.

The influence of dental experience on a dental implant navigation system.

BACKGROUND: This study evaluated the operating performance of an implant navigation system used by dental students and dentists of prosthodontic background with varying levels of experience. A surgical navigation system and optical tracking system were used, and dentists' accuracies were evaluated in terms of differences between the positions of actually drilled holes and those of the holes planned using software before surgeries. METHODS: The study participants were 5 dental students or dentists who had studied in the same university and hospital but had different experience levels regarding implants. All participants were trained in operating the AqNavi system in the beginning of the study. Subsequently, using 5 pairs of dental models, each participant drilled 5 implant holes at 6 partially edentulous positions (11, 17, 26, 31, 36, and 47). In total, each participant conducted 30 drilling tests. RESULTS: In total, 150 tests among 5 dentists at 6 tooth positions (11, 17, 26, 31, 36, and 47) were conducted. Although a comparison of the tests revealed significant differences in the longitudinal error (P < .0001) and angular error (P = .0011), no significant difference was observed in the total error among the dentists. CONCLUSIONS: A relatively long operating time was associated with relatively little implant experience. Through the dental navigation system, dental students can be introduced to dental implant surgery earlier than what was possible in the past. The results demonstrated that the operational accuracy of the dental implant navigation system is not restricted by participants' implant experience levels. The implant navigation system assists the dentist in the ability to accurately insert the dental implant into the correct position without being affected by his/her own experience of implant surgery.

Dental implant navigation system guide the surgery future.

No study has investigated the effect of learning curves on the accuracy of dental implant navigation systems. This study evaluated the accuracy of the dental implant navigation system and established the learning curve according to operation site and operating time. Each dental model was used for drilling 3 missing tooth positions, and a patient tracking module was created. The same dentist performed the drilling test for 5 sets of dental models. CT back scanning was performed on the dental models. Customized implants based on the drilled holes were inserted. The relative error between the preoperative planning and actual implant was calculated. Using the dental navigation system could help dentists position implants more accurately. Increasing the frequency with which a dentist used the navigation system resulted in shorter operations. Longitudinal and angular deviation were significantly (P < 0.0001 and P = 0.0164). We found that the same level of accuracy could be obtained for the maxilla and mandible implants. The Student's t test demonstrated that the longitudinal error, but not the total or angular error, differed significantly (P = 0.0012). The learning curve for the dental implant navigation system exhibited a learning plateau after 5 tests. The current system exhibited similar accuracy for both maxillary and mandibular dental implants in different dental locations. The one-way ANOVA revealed that the total, longitudinal, and angular errors differed significantly (P < 0.0001, P < 0.0001 and P = 0.0153). In addition, it possesses high potential for future use in dental implant surgery and its learning curve can serve as a reference for dentists.