The impact of implant macro-design on the implant positional accuracy in static computer-assisted guided implant surgery : an in-vitro study

Abstract

Aim: The primary aim of this study was to investigate the influence of the implant macro-design on the acquired implant position in static computer-assisted guided implant surgery. The secondary aim was to investigate the influence of tooth/implant position in terms of implant accuracy. A pilot study was also included to gather preliminary data on the influence of macro-design on the acquired implant position in extraction sockets. Method: 25 BLX and 25 BLT Straumann® dummy implants were placed in 10 identical partially dentate typodont models for a total of 50 locations (40 ‘healed’ areas, 10 extraction sockets). A CBCT and intraoral scan were taken for each model. Implant planning was carried out on implant planning software (coDiagnostiX, Dental Wings, Montreal, Canada). BLX and BLT implants were placed equally across all locations. Surgical guides of all models were fabricated with a 3D printer (P40, Straumann®), all having one template fixation pin and mid-palatal mucosal rest. 20 of each implant type were included for the main and secondary analysis (‘healed’ areas), whilst the remaining 5 were used for the pilot study analysis (extraction sockets). Results: No significant differences in implant position were recorded between the two implant types, except at the vertical offset at implant entry (primary objective). No significant differences in implant accuracy were recorded in implant position between tooth-bound spaces (n=20), next to one tooth (n=10) and no proximal teeth (n=10). BLT implants experienced significant deviations in implant angle and apex locations in extraction sockets (pilot study). Conclusion: Implant macro-design is not a significant cofactor in implant positional accuracy. However, BLT implants may be subject to higher implant angles and apex deviations in extraction sockets.