Accuracy of dental implant surgery with freehand, static computer-aided, dynamic computer-aided, and robotic computer-aided implant systems: An in vitro study.

Statement of problem: The static computer-aided implant system (S-CAIS), dynamic computer-aided implant system (D-CAIS), and robotic computer-aided implant system (R-CAIS) have been used to improve the accuracy of implant placement. However, the accuracy of freehand (FH),S-CAIS, D-CAIS, and R-CAIS implant placement has not been compared and verified under identical conditions.

Purpose: The purpose of this in vitro study was to compare the accuracy of dental implant placement using S-CAIS, D-CAIS, R-CAIS, and FH techniques under identical conditions.

Material and methods: A total of 60 standardized polyurethane resin models with missing mandibular teeth were prepared and divided into 4 groups: FH, S-CAIS, D-CAIS, and R-CAIS, each consisting of 15 models. Preoperative implant planning was performed using cone beam computed tomography (CBCT), and 2 implants were placed in each model using the FH, S-CAIS, D-CAIS, and R-CAIS techniques, respectively. Postoperatively, CBCT scans were made for analysis of the entry, apical, and angle deviations. The error results among groups were compared using 1-way analysis of variance or a nonparametric test. The Dunnett test was used for post hoc comparison (α=.05).

Results: The mean ±standard deviation values for entry deviation were 1.09 ±0.33 mm for the FH group, 0.72 ±0.33 mm for S-CAIS, 0.69 ±0.29 mm for D-CAIS, and 0.48 ±0.18 mm for R-CAIS (P<.05). The mean (quartiles) apical deviations were 1.01 (0.94 -1.22) for the FH group, and the mean ±standard deviation values were 0.87 ±0.07 mm for the S-CAIS group, 0.64 ±0.05 mm for D-CAIS, and 0.47 ±0.03 mm for R-CAIS (P<.05). The mean ±standard deviation values for angle deviation for the FH group were 2.74 ±0.84 degrees, 1.99 ±0.76 degrees for S-CAIS, 0.85 ±0.46 degrees for D-CAIS, and 0.53 ±0.20 degrees for R-CAIS (P<.05).

Conclusions: R-CAIS is a reliable implant placement method, demonstrating better implant accuracy compared with the S-CAIS, D-CAIS, and FH techniques.