Accuracy of dental implant placement with CAD-CAM 3D printed and conventional thermoplastic surgical pilot guides: A clinical comparative trial

Dental implant placement is routinely guided by using 2-dimensional radiographs and thermoplastic surgical guides (CTGs), which may lack accuracy. Three-dimensionally (3D) printed surgical guides (3DGs) have been recommended to improve accuracy. However, they require additional training on specific technology. The current knowledge on indications for CTGs and 3DGs is limited. The purposes of this clinical comparative trial were to compare the accuracy of implant placement using a CTG or 3DG pilot surgical guide (3DGp) and to evaluate clinical outcomes related to the surgical procedure. Patients planned for a single implant were recruited and assigned to either the CTG or 3DGp group. The ideal implant position was determined through virtual treatment planning using intraoral digital scans and cone beam computed tomography (CBCT). Deviations were determined by superimposing the postsurgical digital scans and the virtually planned implant position. The Mann Whitney U Test was performed for each measure (α=.05). A linear regression model was performed to estimate and control for the effect of covariables. Twenty participants were recruited (10 CTG and 10 3DGp). Mean initial ISQ values were 69 ±13 and 76 ±8 for the CTG and 3DGp group, respectively. There was no significant difference in primary (P=.15) or secondary (P=.383) stability between the CTG and 3DGp groups. Data revealed minimal deviations for both groups (P>.05). Bone type (P=.026) and secondary stability (P=.031) had a significant effect on angular deviation. CTG accuracy was similar to that of 3DGp. Reduced angular deviation was noted in the presence of softer bone type and higher secondary stability.