Accuracy of computer-aided template-guided oral implant placement: a prospective clinical study

Purpose: The aim of the present study was to evaluate the in vivo accuracy of flapless, computer-aided implant placement by comparing the three-dimensional (3D) position of planned and placed implants through an analysis of linear and angular deviations. Methods: Implant position was virtually planned using 3D planning software based on the functional and aesthetic requirements of the final restorations. Computer-aided design/computer-assisted manufacture technology was used to transfer the virtual plan to the surgical environment. The 3D position of the planned and placed implants, in terms of the linear deviations of the implant head and apex and the angular deviations of the implant axis, was compared by overlapping the pre- and postoperative computed tomography scans using dedicated software. Results: The comparison of 14 implants showed a mean linear deviation of the implant head of 0.56 mm (standard deviation [SD], 0.23), a mean linear deviation of the implant apex of 0.64 mm (SD, 0.29), and a mean angular deviation of the long axis of 2.42 degrees (SD, 1.02). Conclusions: In the present study, computer-aided flapless implant surgery seemed to provide several advantages to the clinicians as compared to the standard procedure; however, linear and angular deviations are to be expected. Therefore, accurate presurgical planning taking into account anatomical limitations and prosthetic demands is mandatory to ensure a predictable treatment, without incurring possible intra- and postoperative complications.