Accuracy of routine digitally guided immediate full-arch rehabilitations: an observational analysis of eight patients
Chow James Kwok Fai, Siu Adam Shui Cheong, Hui Edward, Chow Raymond Lop Keung, Dard Michel,
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( Chow James Kwok Fai ) - Dental Implant and Maxillofacial Centre Department of Oral and Maxillofacial Surgery
( Siu Adam Shui Cheong ) - Dental Implant and Maxillofacial Centre Department of Digital Dentistry
( Hui Edward ) - Dental Implant and Maxillofacial Centre Department of Oral and Maxillofacial Surgery
( Chow Raymond Lop Keung ) - Dental Implant and Maxillofacial Centre Department of Oral and Maxillofacial Surgery
( Dard Michel ) - Columbia University College of Dental Medicine Department of Oral Diagnostic and Rehabilitation Sciences
Abstract
Purpose: Guided surgery might significantly improve the efficacy and predictability of full-arch rehabilitations. This requires highly accurate implant placement. This retrospective statistical analysis of patient records aimed at identifying the factors affecting the implant placement accuracy of guided single and bimaxillary immediate full-arch rehabilitations.
Materials and Methods: Patient, anatomy, procedure, and implant-related parameters that might influence the coronal, apical and angular deviation of the implants and anchoring pins were statistically analyzed using various statistical models: Mixed regression models were used to analyze differences within groups of single parameters individually. Statistically significant associations between placement accuracy and influencing factors after eliminating covariate factors were identified using multivariable mixed regression models.
Results: Patient records of 8 partially edentulous patients treated by four different surgeons and involving 11 procedures, including 61 implants, were analyzed. Average coronal, apical, and angular deviations of (1.16±0.80) mm, (1.49±0.89) mm, and (4.06±2.17)° respectively were measured. From the mixed regression analysis, gender, jaw type, implant position, bone resection, and pinhole drill guide were found to have a statistically significant association with one or more accuracy parameters. As part of the multivariable regression analysis after elimination of covariate parameters, the coronal and apical offsets appeared to be influenced by the use of pinhole drill guides (P<0.001) and angular offsets by the surgeon (P=0.063), age (P=0.027), and implant position (P=0.014).
Conclusions: Digital workflows allow for the successful full-arch rehabilitation of partially and fully edentulous patients. The implant placement accuracy might be improved by considering the identified procedure, anatomic, and patient-related factors.
키워드
Digital; Guided surgery; Accuracy; Immediate
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