Computer aided dental implant surgery using digital technology has become an essential element for safe and reliable dental implant surgery.
There are two types of computer-assisted implant surgery including static and dynamic navigation system. The latter allows the surgeon to visually confirm the three-dimensional position, tilt, and depth of the drill tip and implant body in real time. In recent years, several reports have been published on the accuracy of these navigation systems in implant placement. However, there is still lack of evidence about its accuracy and reliability. Furthermore, there have been no researches that have evaluated the accuracy of multiple dynamic navigation systems (Navident®, ClaroNav; X-Guide®, Nobel Biocare.) in the same experimental system.
To evaluate the in-vivo and in vitro accuracy of dynamic navigation systems, we obtained deviations between implant planning and actual placed implant position. The preoperative implant planning and the postoperative CBCT data were superimposed in order to provide deviations using specific software. We obtained deviations using patient’s postoperative DICOM data retrospectively in in-vivo model and model’s DICOM data which we placed implant randomly in in-vitro model. In both model, dental implants were placed following the guidance of dynamic navigation system.
As a result of in-vivo, the deviations with Navident® were following: Platform (0.95 mm), Apex (3D) (1.42 mm), Apex (Vertical) (0.79 mm), Angle (3.55 degree) and the deviations with X-guide® were following: Platform (0.65 mm), Apex (3D) (1.1 mm), Apex (Vertical) (0.74 mm), Angle (2.94 degree). Furthermore, as a result of in-vitro, the deviations with Navident® were following: Platform (0.95 mm), Apex (3D) (1.02 mm), Apex (Vertical) (0.65 mm), Angle (2.98 degree) and the deviations with X-guide® were following: Platform (0.55 mm), Apex (3D) (0.74 mm), Apex (Vertical) (0.69 mm), Angle (1.78 degree).
In conclusion, the dynamic navigation systems can provide accurate implant placement.
Toshiki Nojiri is engaged as an assistant professor on Department of Prosthodontics and Oral Implantology at Iwate Medical University, Japan. He actively uses dynamic navigation system in his daily clinical practice and conducts research on its accuracy and effect. He studied abroad at Department of Restorative Dentistry and Biomedical Science at Harvard School of dental Medicine. He received his DDS and PhD from the Iwate Medical University, School of Dentistry. He conducted basic research regarding surface modification of titanium dental implant to enhance soft tissue attachment in his PhD program.
