The effect of surgical guide design and surgeon’s experience on the experience on the accuracy of implant placement.

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The effect of surgical guide design and surgeon’s experience on the experience on the accuracy of implant placement.

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2010-05

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Abstract

Implant position is a key determinant of esthetic and functional success. Achieving the goal of ideal implant position may be affected by case selection, prosthodontically driven treatment planning, site preparation, surgeon’s experience and use of a surgical guide. The combined effect of surgical guide design, surgeon’s experience, and size of the edentulous area on the accuracy of implant placement was evaluated in a simulated clinical setting. Twenty-one volunteer surgeons were recruited to participate in this study. They were divided equally into 3 groups (Novice, Intermediate, and Experienced). Each surgeon placed implants in single- and double-sites using 4 different surgical guide designs (No guide, Tube, Channel, and Guided) utilizing written instructions describing the ideal implant positions. A definitive typodont was constructed that had 3 implants in prosthetically determined ideal positions of single- and double-sites. The position and angulation of implants placed by the surgeons in the duplicate typodonts were measured using a computerized coordinate measuring machine and compared to the definitive typodont. The mean absolute positional error for all guides was 0.273, 0.340, Implant position is a key determinant of esthetic and functional success. Achieving the goal of ideal implant position may be affected by case selection, prosthodontically driven treatment planning, site preparation, surgeon’s experience and use of a surgical guide. The combined effect of surgical guide design, surgeon’s experience, and size of the edentulous area on the accuracy of implant placement was evaluated in a simulated clinical setting. Twenty-one volunteer surgeons were recruited to participate in this study. They were divided equally into 3 groups (Novice, Intermediate, and Experienced). Each surgeon placed implants in single- and double-sites using 4 different surgical guide designs (No guide, Tube, Channel, and Guided) utilizing written instructions describing the ideal implant positions. A definitive typodont was constructed that had 3 implants in prosthetically determined ideal positions of single- and double-sites. The position and angulation of implants placed by the surgeons in the duplicate typodonts were measured using a computerized coordinate measuring machine and compared to the definitive typodont. The mean absolute positional error for all guides was 0.273, 0.340 Implant position is a key determinant of esthetic and functional success. Achieving the goal of ideal implant position may be affected by case selection, prosthodontically driven treatment planning, site preparation, surgeon’s experience and use of a surgical guide. The combined effect of surgical guide design, surgeon’s experience, and size of the edentulous area on the accuracy of implant placement was evaluated in a simulated clinical setting. Twenty-one volunteer surgeons were recruited to participate in this study. They were divided equally into 3 groups (Novice, Intermediate, and Experienced). Each surgeon placed implants in single- and double-sites using 4 different surgical guide designs (No guide, Tube, Channel, and Guided) utilizing written instructions describing the ideal implant positions. A definitive typodont was constructed that had 3 implants in prosthetically determined ideal positions of single- and double-sites. The position and angulation of implants placed by the surgeons in the duplicate typodonts were measured using a computerized coordinate measuring machine and compared to the definitive typodont. The mean absolute positional error for all guides was 0.273, 0.340, 0.197 mm in mesial-distal, buccal-lingual, vertical positions, respectively with an overall range of 0.00 to 1.81 mm. The mean absolute angle error for all guides was 1.61 and 2.39 degrees in the mesial-distal and buccal-lingual angulations respectively with an overall range of 0.01 to 9.7 degrees. Surgical guide design had a statistically significant effect on the accuracy of implant placement regardless of the surgeon’s experience level. Experienced surgeons had significantly less error in buccal-lingual angulation. The size of the edentulous sites was found to affect both implant angle and position significantly. The magnitude of error in position and angulation caused by surgical guide design, surgeon’s experience and site size reported in this study are possibly not large enough to be clinically significant. However, it is likely that errors would be magnified in clinical practice. Future research is recommended to evaluate the effect of surgical guide design in vivo on implant angulation and position error. Key Words: Surgical guide, implant placement

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University of Minnesota M.S. thesis. May 2010. Major: Dentistry. Advisors: Dr James E Hinrichs and Dr Wook-Jin Seong. 1 computer file (PDF); viii, 40 pages, appendices 1-2. Ill. (some col.)

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Hinckfuss, Simon Robert. (2010). The effect of surgical guide design and surgeon’s experience on the experience on the accuracy of implant placement.. Retrieved from the University Digital Conservancy, https://hdl.handle.net/11299/93149.

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