Freehand Versus Guided Surgery: Factors Influencing Accuracy of Dental Implant Placement
Implant Dentistry: August 2017 - Volume 26 - Issue 4 - p 500–509
Introduction:
Patient anatomy, practitioner
experience, and surgical approach are all factors that influence implant
accuracy. However, the relative importance of each factor is poorly
understood. The present study aimed to identify which factors most
critically determine implant accuracy to aid the practitioner in case
selection for guided versus freehand surgery.
Methods:
One practitioner's ideal implant angulation
and position was compared with his achieved position radiographically
for 450 implants placed using a conventional freehand method. The
relative contribution of 11 demographic, anatomical, and surgical
factors to the accuracy of implant placement was systematically
quantified.
Discussion:
The most important predictors of
angulation and position accuracy were the number of adjacent implants
placed and the tooth-borne status of the site. Immediate placement also
significantly increased position accuracy, whereas cases with narrow
sites were significantly more accurate in angulation. Accuracy also
improved with the practitioner's experience.
Conclusion:
These results suggest tooth-borne,
single-implant cases performed later in the practitioner's experience
are most appropriate for freehand placement, whereas guided surgery
should be considered to improve accuracy for multiple-implant cases in
edentulous or partially edentulous sites.
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