The impacts of registration-and-fixation device positioning on the performance of implant placement assisted by dynamic computer-aided surgery: A randomized controlled trial

ObjectivesTo assess the efficacy of dynamic computer-aided surgery (dCAS) in replacing a single missing posterior tooth, we compare outcomes when using registration-and-fixation devices positioned anterior or posterior to the surgical site. Registration is performed on either the anterior or opposite posterior teeth.MethodsForty individuals needing posterior single-tooth implant placement were randomly assigned to anterior or posterior registration. Nine parameters were analyzed to detect the deviations between planned and actual implant placement, using Mann-Whitney and t-tests for nonnormally and normally distributed data, respectively.ResultsThe overall average angular deviation for this study was 2.08 +/- 1.12 degrees, with the respective average 3D platform and apex deviations of 0.77 +/- 0.32 mm and 0.88 +/- 0.32 mm. Angular deviation values for individuals in the anterior and posterior registration groups were 1.58 degrees(IQR: 0.98 degrees-2.38 degrees) and 2.25 degrees(IQR: 1.46 degrees-3.43 degrees), respectively (p = .165), with 3D platform deviations of 0.81 +/- 0.29 mm and 0.74 +/- 0.36 mm (p = .464), as well as 3D apex deviations of 0.89 +/- 0.32 mm and 0.88 +/- 0.33 mm (p = .986). No significant variations in absolute buccolingual (platform, p = .659; apex, p = .063), apicocoronal (platform, p = .671; apex, p = .649), or mesiodistal (platform, p = .134; apex, p = .355) deviations were observed at either analyzed levels.ConclusionsBoth anterior and posterior registration approaches facilitate accurate dCAS-mediated implant placement for single missing posterior teeth. The device's placement (posterior-to or anterior-to the surgical site) did not affect the clinician's ability to achieve the planned implant location.