Alessandro Pozzi, Paolo Carosi, Andrea Laureti, Nikos Mattheos, Atiphan Pimkhaokham, James Chow, Lorenzo Arcuri
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T-tests were performed to investigate the potential effect of the registration algorithm (fiducial-based vs. fiducial-free), type of references for the fiducial-free algorithm (teeth vs. bone screws), site characteristic (healed vs. post-extractive), implant angulation (axial vs. tilted), type of arch (maxilla vs. mandible) on the accuracy with <i>p</i>-value <0.05.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Twenty-five patients, 36 complete-arches, and 161 implants were placed. The overall mean angular deviation was 2.19° (SD 1.26°). The global platform and apex mean deviations were 1.17 mm (SD 0.57 mm), and 1.30 mm (SD 0.62 mm). Meaningful global platform (<i>p</i> = 0.0009) and apical (<i>p</i> = 0.0109) deviations were experienced only between healed and post-extraction sites. None of the analyzed variables significantly influenced angular deviation. Minor single-axis deviations were reported for the type of jaw (y-axis at implant platform and apex), registration algorithm (y-axis platform and z-axis deviations), and type of references for the fiducial-free algorithm. No statistically significant differences were found in relation to implant angulation.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Within the study limitations navigation was reliable for complete-arch implant placement with immediate loading digitally pre-fabricated FDP. AI-driven surface anatomy identification and calibration protocol made fiducial-free registration as accurate as fiducial-based, teeth and bone screws equal as references. Implant site characteristics were the only statistically significant variable with healed sites reporting higher accuracy compared to post-extractive. Live-tracked navigation surgery enhanced operator performance and accuracy regardless of implant angulation and type of jaw. A mean safety room of about 1 mm and 2° should be considered.</p>\n </section>\n </div>","PeriodicalId":50679,"journal":{"name":"Clinical Implant Dentistry and Related Research","volume":"26 5","pages":"954-971"},"PeriodicalIF":3.7000,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cid.13360","citationCount":"0","resultStr":"{\"title\":\"Accuracy of navigation guided implant surgery for immediate loading complete arch restorations: Prospective clinical trial\",\"authors\":\"Alessandro Pozzi, Paolo Carosi, Andrea Laureti, Nikos Mattheos, Atiphan Pimkhaokham, James Chow, Lorenzo Arcuri\",\"doi\":\"10.1111/cid.13360\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Objectives</h3>\\n \\n <p>To assess navigation accuracy for complete-arch implant placement with immediate loading of digitally prefabricated provisional.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Materials and Methods</h3>\\n \\n <p>Consecutive edentulous and terminal dentition patients requiring at least one complete-arch FDP were treated between December 2020 and January 2022. 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引用次数: 0
摘要
目的评估全牙弓种植体植入的导航准确性，并立即加载数字化预制临时材料：在 2020 年 12 月至 2022 年 1 月期间，对至少需要一颗全牙弓 FDP 的无牙和末牙患者进行连续治疗。通过叠加术前和术后锥形束计算机断层扫描（CBCT）、记录线性（毫米）和角度（度）偏差来评估准确性。进行了T检验，以研究注册算法（基于靶标与无靶标）、无靶标算法的参考类型（牙齿与骨螺钉）、部位特征（愈合后与拔牙后）、种植体角度（轴向与倾斜）、牙弓类型（上颌与下颌）对准确性的潜在影响，P值为 结果：25 名患者、36 个完整牙弓和 161 个种植体被植入。总体平均角度偏差为 2.19°（标准偏差为 1.26°）。总体平台和顶点平均偏差分别为 1.17 毫米（标准差 0.57 毫米）和 1.30 毫米（标准差 0.62 毫米）。只有在愈合后和拔牙后的部位才会出现有意义的整体平台（p = 0.0009）和根尖（p = 0.0109）偏差。没有一个分析变量对角度偏差有明显影响。颌骨类型（种植体平台和顶点的 y 轴）、配准算法（y 轴平台和 z 轴偏差）以及无靶标算法的参照类型都会导致轻微的单轴偏差。与种植体角度有关的差异没有统计学意义：在研究限制范围内，使用即刻加载数字预制 FDP 进行全牙弓种植体植入时，导航是可靠的。人工智能驱动的表面解剖学识别和校准协议使无靶标注册与有靶标注册一样准确，牙齿和骨螺钉是相同的参照物。种植部位特征是唯一具有统计学意义的变量，与拔牙后相比，愈合部位的准确性更高。无论种植体角度和颌骨类型如何，实时跟踪导航手术都能提高操作者的表现和准确性。应考虑约1毫米和2°的平均安全空间。
Accuracy of navigation guided implant surgery for immediate loading complete arch restorations: Prospective clinical trial
Objectives
To assess navigation accuracy for complete-arch implant placement with immediate loading of digitally prefabricated provisional.
Materials and Methods
Consecutive edentulous and terminal dentition patients requiring at least one complete-arch FDP were treated between December 2020 and January 2022. Accuracy was evaluated by superimposing pre-operative and post-operative cone beam computed tomography (CBCT), recording linear (mm) and angular (degrees) deviations. T-tests were performed to investigate the potential effect of the registration algorithm (fiducial-based vs. fiducial-free), type of references for the fiducial-free algorithm (teeth vs. bone screws), site characteristic (healed vs. post-extractive), implant angulation (axial vs. tilted), type of arch (maxilla vs. mandible) on the accuracy with p-value <0.05.
Results
Twenty-five patients, 36 complete-arches, and 161 implants were placed. The overall mean angular deviation was 2.19° (SD 1.26°). The global platform and apex mean deviations were 1.17 mm (SD 0.57 mm), and 1.30 mm (SD 0.62 mm). Meaningful global platform (p = 0.0009) and apical (p = 0.0109) deviations were experienced only between healed and post-extraction sites. None of the analyzed variables significantly influenced angular deviation. Minor single-axis deviations were reported for the type of jaw (y-axis at implant platform and apex), registration algorithm (y-axis platform and z-axis deviations), and type of references for the fiducial-free algorithm. No statistically significant differences were found in relation to implant angulation.
Conclusions
Within the study limitations navigation was reliable for complete-arch implant placement with immediate loading digitally pre-fabricated FDP. AI-driven surface anatomy identification and calibration protocol made fiducial-free registration as accurate as fiducial-based, teeth and bone screws equal as references. Implant site characteristics were the only statistically significant variable with healed sites reporting higher accuracy compared to post-extractive. Live-tracked navigation surgery enhanced operator performance and accuracy regardless of implant angulation and type of jaw. A mean safety room of about 1 mm and 2° should be considered.
期刊介绍：
The goal of Clinical Implant Dentistry and Related Research is to advance the scientific and technical aspects relating to dental implants and related scientific subjects. Dissemination of new and evolving information related to dental implants and the related science is the primary goal of our journal.
The range of topics covered by the journals will include but be not limited to:
New scientific developments relating to bone
Implant surfaces and their relationship to the surrounding tissues
Computer aided implant designs
Computer aided prosthetic designs
Immediate implant loading
Immediate implant placement
Materials relating to bone induction and conduction
New surgical methods relating to implant placement
New materials and methods relating to implant restorations
Methods for determining implant stability
A primary focus of the journal is publication of evidenced based articles evaluating to new dental implants, techniques and multicenter studies evaluating these treatments. In addition basic science research relating to wound healing and osseointegration will be an important focus for the journal.
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