Validation of implant placement in the edentulous maxilla using a mucosa supported surgical template

Purpose: The aim of this prospective study is to evaluate the clinical accuracy of virtually planned implants placed in the maxilla using a mucosa supported surgical template.

Materials and methods: A total of 114 implants were placed in the maxilla of 24 consecutive edentulous patients using a virtually planned surgical template, based on a cone beam computed tomography (CBCT) scan. In all patients two or four implants were placed, randomly with or without fixation pins. A postoperative CBCT scan was acquired and superimposed upon the preoperative scan. Final implant positions were evaluated against their planned positions and subsequently three-dimensionally depicted. Measurements were conducted in a bucco-lingual, mesio-distal and vertical direction. Furthermore, implant length and template movement were investigated.

Results: The deviation in bucco-lingual direction was 0.55 mm for the implant shoulder and 0.72 mm for the apex. In mesio-distal direction these values were 0.47 mm and 0.63 mm, respectively. Depth deviations ranged from −0.67 mm to −0.77 mm. Angular deviations varied between 1.99° in bucco-lingual and 1.76° in mesio-distal direction. No significant difference was found for implant placement with or without fixation pins. Implants of 15 mm length showed significantly more deviation compared to shorter implant lengths. In 66.7%, deviations were contributed to rotation or translation of the surgical template.

Conclusion: The clinician should be aware of possible deviations between virtual planning and the final implant position, especially when long implants are used. Special attention should be paid to prevent the surgical template from rotating or translating during surgery.

Conflict of interest: None declared.

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Jan 27, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Validation of implant placement in the edentulous maxilla using a mucosa supported surgical template
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