The implant position accuracy between using only surgical drill guide and surgical drill guide with implant guide in fully digital workflow: a randomized clinical trial

Abstract

Background: To evaluate and compare accuracy in position and inclination of a single-tooth implant placement using tooth-supported surgical drill guide (SDG) and surgical drill guide with implant insertion guide (SDIG) in fully digital workflow. Materials and methods: Thirty partially single edentulous patients were recruited. After randomization, participants were divided into 2 groups equally. The first group underwent implant placement through SDG only, while the second group was subjected to SDIG. All procedure proceeded under a fully digital workflow as the combination of digital scanning from an intraoral scanner, 3D radiographic images from cone-beam computed tomography (CBCT), implant planning software, and a 3D manufacturing machine. A post-operative CBCT was performed to compare the deviations (7 parameters) between planned and actual implant positions. Results: The mean global deviations at the shoulder and apex were 0.74 ± 0.36 and 1.29 ± 0.61 mm, respectively in the SDG group and 0.48 ± 0.22 mm and 0.71 ± 0.31 mm, respectively in the SDIG group. Likewise, the other parameters in the SDIG group showed fewer deviations than SDG for all measurements. Statistically significant differences were indicated by all parameters except for the horizontal deviation at the implant shoulder (p <.05). Conclusion: In single-tooth implant placement with a tooth-supported guide using a computer-assisted (static) system with the SDIG could reduce deviations of actual implant position when compared with using SDG only. Besides, guided implant surgery by fully digital workflow is a practical procedure and provides precise implant position regarding the prosthetic-driven concept.