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  • Title: Accuracy of implant placement in the posterior maxilla as related to 2 types of surgical guides: a pilot study in the human cadaver.
    Author: Noharet R, Pettersson A, Bourgeois D.
    Journal: J Prosthet Dent; 2014 Sep; 112(3):526-32. PubMed ID: 24721507.
    Abstract:
    STATEMENT OF PROBLEM: The position of implants may have an effect on obtaining osseointegration without complications and on the outcome of the prostheses. PURPOSE: The purpose of this study was to compare the accuracy of implant placement with computer-guided surgery and freehand surgery in the atrophic area of the posterior maxilla. MATERIAL AND METHODS: Six human cadavers (Kennedy-Applegate class I) were included in the study. The specimens were randomly classified into 2 categories by using a computer: computer-guided surgery (n=3) and freehand surgery (n=3). Thirty-nine implants were planned with the software. Two types of surgeries were performed. The preoperative computed tomography data were matched with the postoperative computed tomography data by using voxel-based registration software. The position of the planned implants was compared to the actual position of the implants. A multivariate analysis was used for each variable (bone density, length of implant, implant angulation, and surgical technique) to evaluate the effect of these variables on the implant accuracy (α=.05). RESULTS: The statistical tests (Kolmogorov-Smirnov bootstrap) found that guided surgery offered significantly better accuracy for the platform (P=.002), apex (P=.001), and angle (P<.001). However, the accuracy of the 2 methods was similar for the depth parameter (P=.186). The bone density did not influence the implant placement accuracy. CONCLUSIONS: Computer-guided surgery was more accurate than a freehand approach for placing implants into bilateral edentulous zones in the posterior maxilla.
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