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Influence of template design on the accuracy of static computer-assisted implant surgery

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Purpose. This study aimed to evaluate the accuracy of static computer-assisted implant surgery (s-CAIS) by comparing the planned and actual positions of implants placed in a partially edentulous model using surgical templates with different sleeve designs. Materials and methods. Forty-nine mandibular partially edentulous models were scanned using a model scanner to create standard tessellation language (STL) files. The models were divided into seven groups based on sleeve design: Group 1-4 (Open non-metal sleeves with varying heights (3 mm, 6 mm) and buccal widths (5 mm, 6 mm)), Group 5-6 (Closed non-metal sleeves with heights of 3 mm and 6 mm), and Group 7 (Closed metal sleeve). After implant placement at #45 and #47, STL files were generated and analyzed using 3D measurement software. Deviations were measured in terms of horizontal deviation (coronal and apical), vertical deviation, and angular deviation. Statistical significance was evaluated using the Wilcoxon rank sum test, Kruskal-Wallis test, and multiple generalized linear models. Results. While height differences showed no significant deviations (P > .05), there was a tendency for larger apical deviation with increased sleeve height (P < .1). Closed metal and closed non-metal sleeves showed smaller deviations compared to open non-metal sleeves, except in vertical deviation. Conclusion. Closed sleeves demonstrated greater accuracy in s-CAIS compared to open sleeves. Higher sleeves may improve implant placement accuracy, but buccal insertion width did not significantly affect accuracy.

Abstract

Purpose. This study aimed to evaluate the accuracy of static computer-assisted implant surgery (s-CAIS) by comparing the planned and actual positions of implants placed in a partially edentulous model using surgical templates with different sleeve designs. Materials and methods. Forty-nine mandibular partially edentulous models were scanned using a model scanner to create standard tessellation language (STL) files. The models were divided into seven groups based on sleeve design: Group 1-4 (Open non-metal sleeves with varying heights (3 mm, 6 mm) and buccal widths (5 mm, 6 mm)), Group 5-6 (Closed non-metal sleeves with heights of 3 mm and 6 mm), and Group 7 (Closed metal sleeve). After implant placement at #45 and #47, STL files were generated and analyzed using 3D measurement software. Deviations were measured in terms of horizontal deviation (coronal and apical), vertical deviation, and angular deviation. Statistical significance was evaluated using the Wilcoxon rank sum test, Kruskal-Wallis test, and multiple generalized linear models. Results. While height differences showed no significant deviations (P > .05), there was a tendency for larger apical deviation with increased sleeve height (P < .1). Closed metal and closed non-metal sleeves showed smaller deviations compared to open non-metal sleeves, except in vertical deviation. Conclusion. Closed sleeves demonstrated greater accuracy in s-CAIS compared to open sleeves. Higher sleeves may improve implant placement accuracy, but buccal insertion width did not significantly affect accuracy.

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