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Volume 23 , Issue 6
November/December 2008

Precision of Flapless Implant Placement Using Real-Time Surgical Navigation: A Case Series

Nicolas Elian, DDS/Ziad N. Jalbout, DDS/Anthony J. Classi, DMD/Alon Wexler, DMD/ David Sarment, DDS, MS/Dennis P. Tarnow, DDS

PMID: 19216283

Purpose: To demonstrate the predictability of flapless surgery using navigation surgery. Materials and Methods: Computer-generated preoperative implant planning was compared to actual placement by CT (computerized tomography) scanning of patients before and after surgery. Once pre- and postoperative coordinates of virtual implants were obtained, linear distances and angles were calculated. Coronal and apical errors consisted of the shortest distance from the preoperative planning to the postoperative overlay. Results: Fourteen implants were placed in 6 patients who received CT scans before and after implant placement. Preoperative implant planning using software was compared to actual placement. The average discrepancy of the head of the implant was 0.89 mm 0.53 SD (range, 0.32 to 1.96). The average discrepancy of the apex of the implant was 0.96 mm 0.50 SD (range, 0.25 to 1.99). The average angle discrepancy and standard deviation were 3.78 degrees 2.76 SD (range, 0.60 to 9.87). Conclusion: Optical computerized navigation is vulnerable to technological and technical errors. Yet, the present case series suggests that less than 1 mm of mean linear deviation and less than 4 degrees of angular deviation might be attainable. Int J Oral Maxillofac Implants 2008;23: 11231127. Key words: computerized tomography, computer-aided diagnosis, dental implants, flapless surgery, implant placement, surgical navigation

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