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Accuracy of Template-Guided Placement of Immediate vs. Late Implants in vitro
EAO Online Library. Pommer B. Oct 9, 2018; 232568; P-BR-22
Bernhard Pommer
Bernhard Pommer
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Predictable results and low positional deviation may be achieved when dental implants are placed via stereolithographic templates in the healed alveolar ridge. However, when guided implant placement into fresh extraction sockets is attempted, drilling precision may be compromised due to the steep angle between drill and alveolar wall.To investigate the influence of drilling protocol as well as angle between drill and bone on the precision of template-guided implant placement in an artificial bone and soft tissue model of a human maxilla.Four different angles between drill and bone surface were investigated (69 drills each)- 10°, 20°, 30° (representing immediate implant placement) and 90° (representing late implant placement). The drilling protocol involved 2mm pilot drills with or without prior use of precision drills. Differences were evaluated via Wilcoxon tests and multivariate regession analysis.No difference in angular deviation of late implants (2.5°) was observed between both drilling protocols. A significantly higher deviation of immediate implants was seen at 10°-30° angle (p<0.001)- a mean deviation of 5.3° after pilot drilling without and 4.3° with prior use of precision drills (p<0.001).A significant 2.2-fold increase of angular deviation must be expected when immediate implants are placed in the maxilla via surgical templates due to the steep angle between the drill and the palatal alveolar wall. The use of precision drills prior to 2 mm pilot drilling may help to significantly reduce positional inaccuracy in guided immediate implant placement.
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