Evaluation of the difference in accuracy between implant placement by virtual planning data and surgical guide templates versus the conventional free-hand method – a combined in vivo – in vitro technique using cone-beam CT (Part II)

Summary Purpose The purpose of this study was to assess the accuracy of implant placement after virtual planning of implant positions using cone-beam CT data and surgical guide templates, and to match the results with those achieved with the conventional free-hand method. Materials and methods Twenty-three implants were placed in 10 patients with a Kennedy Class II with 3-dimensional (3-D) planned surgical guide template. Manual implantation was performed in anatomical casts of the same patients by a prosthodontist and a maxillofacial surgeon. Postoperative images of casts were superimposed onto the preoperative image of virtual planned ideal position of the implant. Results The 3-D surgical guide template produced significantly smaller variation between the planned and actual implant positions at the implant shoulder (0.9 mm (0–4.5)) and apex (0.6–0.9 mm (0.0–3.4)) compared with the free-hand implantation (2.4–3.5 mm (0.0–7.0); p = 0.000 and 2.0–2.5 mm (0.0–7.7); p = 0.002). Accuracy of axis was also significantly improved. Conclusions Accuracy of implant placement after virtual planning of implant position using cone-beam CT data and surgical templates is high and significantly more accurate than free-hand insertion. The demonstrated method of superimposing radiographic images of postoperative casts and virtual planning images is a useful method, which allows reduced patient radiation exposure.