Impact of Surgeons' Experience on Implant Placement Accuracy Using a Dynamic Navigation System: A Cadaver Pilot Study

Objectives: The study's objective was to evaluate the accuracy of dynamic computer-assisted surgical implant placement systems during practical training on fresh defrozen cephali. Methods: Three defrozen cephali with terminal dentition received a total of 26 implants (15 4.3 x 13 mm and 11 4.3 x 13 mm, Nobel Biocare Service AG (Zrich-Flughafen Switzerland)) following a standardized protocol: a digital scanning and planning protocol followed by dynamic navigation surgery (X-Guide, X-Nav Technologies, LLC, Lansdale, PA, USA). All surgical interventions were performed by two surgeons: a senior oral surgeon (OE) with more than 5 years of implant dentistry experience and a non-experienced surgeon (NE). Results: Different linear and angular measurements (i.e., deviation shoulder point; deviation tip point; depth deviation shoulder point; depth deviation tip point; B/L and M/D angular deviations) were calculated in duplicate to estimate the discrepancy of the virtual digital planning with respect to the real clinical scenario. The differences between the two operators were also explored. The results of the bivariate analysis detected clinical negligible differences between the operators, without any statistically significant differences for all investigated parameters (p > 0.05). Conclusions: The preliminary positive findings of this pilot study suggest that the investigated dynamic navigation system could be a viable and safe technique for implant surgery and may offer additional safety benefits to non-experienced operators, despite the required learning.