A randomized clinical trial comparing guided implant surgery (bone‐ or mucosa‐supported) with mental navigation or the use of a pilot‐drill template

Abstract

Aim: To assess the accuracy of guided surgery (mucosa and bone‐supported) compared to mental navigation or the use of a surgical template, in fully edentulous jaws, in a randomized controlled study. Material and Methods: Fifty‐nine patients (72 jaws), requiring four to six implants (maxilla or mandible), were consecutively recruited and randomly assigned to one of the following treatment groups; guidance via Materialise Universal®/mucosa, Materialise Universal®/bone, Facilitate™/mucosa, Facilitate™/bone, or mental navigation or a pilot‐drill template. The precision was assessed by matching the planning computed tomography (CT) with a post‐operative cone beam CT. Results: A significant lower mean deviation at the entry point (1.4 mm, range: 0.3–3.7), at the apex (1.6 mm, range: 0.2–3.7) and angular deviation (3.0°, range: 0.2–16°) was observed for the guiding systems when compared to mental navigation (2.7 mm, range: 0.3–8.3; 2.9 mm, range: 0.5–7.4 and 9.9°, range: 1.5–27.8) and to the surgical template group (3.0 mm, range: 0.6–6.6; 3.4 mm, range: 0.3–7.5 and 8.4°, range: 0.6–21.3°). Differences between bone and mucosa support or type of guidance were negligible. Jaw and implant location (posterior–anterior, left–right), however, had a significant influence on the accuracy when guided. Conclusion: Based on these findings, guided implant placement appears to offer clear accuracy benefits.