Background
Methods
Cases
Treatment steps
Complications
Observation factors
Preoperative planning and measurement of 3D deviation between preoperative simulation and actual placement of the implant body (surrogate endpoints)
Statistical analysis
Results
Cases and complications
Factors related to each surgical guide | SCT method | DCT method | MSCT method | p value |
---|---|---|---|---|
n = 27 | n = 88 | n = 66 | ||
Sex (male/female; number of subjects) | 12/15 | 31/57 | 21/45 | 0.541* |
Age at implant placement surgery (mean ± SD in years) | 55.1 ± 13.2 | 63.6 ± 10.2 | 63.3 ± 11.5 | 0.022† |
Number of remaining teeth (mean ± SD) | 11.4 ± 1.6 | 8.0 ± 3.9 | 7.7 ± 4.3 | < 0.001† |
Number of coronal teeth (mean ± SD) | 11.6 ± 1.7 | 8.5 ± 4.0 | 8.7 ± 4.5 | < 0.001† |
Number of teeth with metal restorations (mean ± SD) | 2.3 ± 2.2 | 4.4 ± 3.3 | 3.9 ± 3.3 | 0.014† |
Number of placed implants (mean ± SD) | 2.0 ± 1.2 | 3.3 ± 2.1 | 2.7 ± 1.9 | < 0.001† |
Dentition defect type (Kennedy Classification Class I/II/III/IV/complete edentulism; number of subjects) | 3/6/16/2/0 | 14/28/23/12/11 | 11/20/21/3/11 | < 0.001* |
Number of fixation pins (mean ± SD) | 2.9 ± 0.9 | 5.8 ± 2.9 | 5.3 ± 2.8 | < 0.001† |
Factors related to each implant body | SCT method | DCT method | MSCT method | p-value |
n = 44 | n = 268 | n = 168 | ||
Shape of implant body (straight/tapered; number of subjects) | 0/44 | 62/206 | 0/168 | < 0.001* |
Implant width (NP/RP/WP; number of subjects) | 10/32/2 | 75/157/36 | 64/101/3 | < 0.001* |
Implant length (mean ± SD) | 10.4 ± 1.3 | 12.4 ± 2.2 | 10.9 ± 1.9 | < 0.001† |
Implant location (anterior/posterior; number of subjects) | 10/34 | 81/187 | 41/127 | 0.312* |
Implant location (maxillary/mandibular; number of subjects) | 19/25 | 163/105 | 79/89 | 0.006* |
Immediate implant placement (with/without; number of subjects) | 0/44 | 23/245 | 4/164 | 0.001* |
Bone augmentation (with/without; number of subjects) | 5/39 | 16/252 | 14/154 | 0.382* |
Alveolar bone quality (1/2/3/4; number of subjects) | 1/5/34/4 | 12/76/90/90 | 2/33/111/22 | < 0.001* |
Distance between guide sleeve bottom to bone surface (4.0/5.5/6.0 mm; number of subjects) | 18/0/26 | 0/268/0 | 87/0/81 | < 0.001* |
Bone surface inclination X (0 ≤ X ≤ 90 degree; mean ± SD) | 64.0 ± 17.5 | 70.2 ± 17.1 | 63.2 ± 17.2 | < 0.001† |
Bone surface inclination Y (0 ≤ Y ≤ 90 degree; mean ± SD) | 69.4 ± 12.6 | 75.5 ± 14.4 | 72.3 ± 14.1 | < 0.001† |
Comparison of 3D deviation between planned and placed implant position (univariate analysis)
The entry of implant body | The tip of implant body | ||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
n | Mean ± SD | Quantiles | 95% CI | p value | n | Mean ± SD | Quantiles | 95% CI | p value | ||||||||||||
0% | 25% | Median | 75% | 100% | 0% | 25% | Median | 75% | 100% | ||||||||||||
a | SCT method | 44 | 0.821 ± 0.431 | 0.108 | 0.623 | 0.788 | 1.008 | 2.315 | 0.690–0.952 | a–b | 0.059 | 44 | 0.996 ± 0.440 | 0.033 | 0.742 | 1.084 | 1.269 | 2.215 | 0.863–1.130 | a-b | 0.430 |
a–c | < 0.001 | a-c | < 0.001 | ||||||||||||||||||
b | DCT method | 268 | 0.690 ± 0.399 | 0.000 | 0.428 | 0.646 | 0.891 | 2.259 | 0.643–0.739 | b–a | 0.059 | 268 | 1.131 ± 0.545 | 0.050 | 0.727 | 1.100 | 1.433 | 3.496 | 1.066–1.198 | b-a | 0.430 |
b–c | 0.002 | b-c | < 0.001 | ||||||||||||||||||
c | MSCT method | 168 | 0.564 ± 0.304 | 0.077 | 0.338 | 0.522 | 0.738 | 1.978 | 0.518–0.610 | c–a | < 0.001 | 168 | 0.742 ± 0.394 | 0.091 | 0.451 | 0.674 | 0.991 | 2.091 | 0.682–0.803 | c-a | < 0.001 |
c–b | 0.002 | c-b | < 0.001 |
Examination of factors affecting implant accuracy (multivariate analysis with GEEs)
Large 3D deviation at the entry of the implant body | Large 3D deviation at the tip of the implant body | |||||
---|---|---|---|---|---|---|
Mean ± SD | Correlation coefficient | p value | Mean ± SD | Correlation coefficient | p value | |
Factors related to each surgical guide | ||||||
Sex | ||||||
Male | 0.642 ± 0.386 | – | 0.325‡ | 0.976 ± 0.514 | – | 0.763‡ |
Female | 0.667 ± 0.377 | – | 0.987 ± 0.524 | – | ||
Age at implant placement surgery | – | − 0.102 | 0.025§ | – | − 0.082 | 0.073§ |
Number of coronal teeth | – | − 0.137 | 0.003§ | – | − 0.074 | 0.106§ |
Number of teeth with metal restorations | – | − 0.159 | < 0.001§ | – | − 0.037 | 0.418§ |
Number of placed implants | – | 0.094 | 0.039§ | – | 0.056 | 0.224§ |
Dentition defect type | ||||||
Class I | 0.572 ± 0.335 | – | 0.002† | 0.883 ± 0.443 | – | 0.006† |
Class II | 0.680 ± 0.399 | – | 0.996 ± 0.524 | – | ||
Class III | 0.586 ± 0.333 | – | 0.890 ± 0.447 | – | ||
Class IV | 0.691 ± 0.428 | – | 1.217 ± 0.622 | – | ||
Edentulism | 0.761 ± 0.389 | – | 1.044 ± 0.559 | – | ||
Number of fixation pins | – | 0.137 | 0.003§ | – | 0.141 | 0.002§ |
Factors related to each implant body | ||||||
Shape of implant body | ||||||
Straight | 0.665 ± 0.405 | – | 0.876‡ | 1.167 ± 0.642 | – | 0.028‡ |
Tapered | 0.657 ± 0.376 | – | 0.956 ± 0.495 | – | ||
Implant width | ||||||
NP | 0.676 ± 0.376 | 0.702† | 1.003 ± 0.522 | – | 0.836† | |
RP | 0.649 ± 0.383 | – | 0.972 ± 0.514 | – | ||
WP | 0.660 ± 0.376 | – | 0.993 ± 0.567 | – | ||
Implant length | – | 0.103 | 0.024§ | – | 0.253 | < 0.001§ |
Implant location | ||||||
Anterior | 0.682 ± 0.370 | – | 0.301‡ | 1.018 ± 0.545 | – | 0.472‡ |
Posterior | 0.649 ± 0.383 | – | 0.970 ± 0.510 | – | ||
Implant location | ||||||
Maxillary | 0.678 ± 0.383 | – | 0.203‡ | 1.031 ± 0.525 | – | 0.021‡ |
Mandibular | 0.635 ± 0.375 | – | 0.926 ± 0.510 | – | ||
Immediate implant placement | ||||||
With | 0.833 ± 0.395 | – | 0.011‡ | 1.288 ± 0.503 | – | 0.002‡ |
Without | 0.648 ± 0.377 | – | 0.965 ± 0.516 | – | ||
Bone augmentation | ||||||
With | 0.657 ± 0.405 | – | 0.81‡ | 1.095 ± 0.720 | – | 0.510‡ |
Without | 0.658 ± 0.378 | – | 0.974 ± 0.501 | – | ||
Alveolar bone quality | – | − 0.008 | 0.859§ | – | − 0.009 | 0.839§ |
Distance between guide sleeve bottom to bone surface | – | 0.070 | 0.123§ | – | 0.051 | 0.262§ |
Bone surface inclination X | – | − 0.109 | 0.017§ | – | − 0.020 | 0.664§ |
Bone surface inclination Y | – | − 0.141 | 0.002§ | – | − 0.087 | 0.057§ |
p value | Odds ratio | 95% CI | ||
---|---|---|---|---|
Lower limit | Upper limit | |||
Factors related to each surgical guide | ||||
Surgical guide fabrication methods (SCT method/DCT method/MSCT method) | ||||
SCT method | < 0.001 | 1.438 | 1.177 | 1.757 |
DCT method | 0.006 | 1.178 | 1.047 | 1.326 |
MSCT method | 1.000 | |||
Sex (male/female: male) | 0.529 | 0.969 | 0.880 | 1.068 |
Age at implant placement surgery (younger) | 0.036 | 0.995 | 0.991 | 1.000 |
Number of coronal teeth (lower) | 0.131 | 0.981 | 0.957 | 1.006 |
Number of teeth with metal restorations (higher) | 0.892 | 1.001 | 0.983 | 1.020 |
Number of placed implants (lower) | 0.602 | 0.990 | 0.955 | 1.027 |
Dentition defect type (Kennedy classification Class I/II/III/IV/complete edetulism) | ||||
Class I | 0.404 | 0.924 | 0.766 | 1.113 |
Class II | 0.598 | 1.071 | 0.830 | 1.381 |
Class III | 0.830 | 0.968 | 0.720 | 1.301 |
Class IV | 0.835 | 1.034 | 0.756 | 1.414 |
Edentulism | 1.000 | |||
Number of fixation pins (higher) | 0.258 | 1.019 | 0.986 | 1.052 |
Factors related to each implant body | ||||
Shape of implant body (straight/tapered: straight) | 0.793 | 0.982 | 0.855 | 1.128 |
Implant width (NP/RP/WP) | ||||
NP | 0.746 | 1.026 | 0.877 | 1.201 |
RP | 0.835 | 0.985 | 0.858 | 1.132 |
WP | 1.000 | |||
Implant length (longer) | 0.938 | 0.999 | 0.976 | 1.022 |
Implant location (anterior/posterior: posterior) | 0.034 | 1.114 | 1.007 | 1.206 |
Implant location (maxillary/mandibular: maxillary) | 0.726 | 0.974 | 0.838 | 1.131 |
Immediate implant placement (with/without: with) | 0.292 | 0.898 | 0.734 | 1.098 |
Bone augmentation (with/without: with) | 0.961 | 1.005 | 0.819 | 1.233 |
Alveolar bone quality (lower) | 0.785 | 1.009 | 0.947 | 1.075 |
Distance between guide sleeve bottom to bone surface (longer) | 0.922 | 1.003 | 0.942 | 1.068 |
Bone surface inclination X (smaller) | 0.006 | 0.997 | 0.994 | 0.999 |
Bone surface inclination Y (smaller) | 0.397 | 0.999 | 0.997 | 1.001 |
p value | Odds ratio | 95% CI | ||
---|---|---|---|---|
Lower limit | Upper limit | |||
Factors related to each surgical guide | ||||
Surgical guide fabrication methods (SCT method/DCT method/MSCT method) | ||||
SCT method | 0.003 | 1.361 | 1.109 | 1.670 |
DCT method | < 0.001 | 1.418 | 1.230 | 1.633 |
MSCT method | 1.000 | |||
Sex (male/female: male) | 0.770 | 0.982 | 0.870 | 1.109 |
Age at implant placement surgery (younger) | 0.043 | 0.995 | 0.989 | 1.000 |
Number of coronal teeth (lower) | 0.981 | 1.000 | 0.969 | 1.032 |
Number of teeth with metal restorations (higher) | 0.899 | 0.998 | 0.974 | 1.023 |
Number of placed implants (lower) | 0.222 | 0.977 | 0.942 | 1.014 |
Dentition defect type (Kennedy Classifications Class I/II/III/IV/complete edentulism) | ||||
Class I | 1.193 | 0.856 | 0.677 | 1.082 |
Class II | 0.934 | 1.013 | 0.754 | 1.360 |
Class III | 0.538 | 0.902 | 0.650 | 1.252 |
Class IV | 0.492 | 1.107 | 0.829 | 1.477 |
Edentulism | 1.000 | |||
Number of fixation pins (higher) | 0.113 | 1.035 | 0.992 | 1.079 |
Factors related to each implant body | ||||
Shape of implant body (straight/tapered: straight) | 0.710 | 1.035 | 0.862 | 1.243 |
Implant width (NP/RP/WP) | ||||
NP | 0.433 | 1.096 | 0.871 | 1.380 |
RP | 0.669 | 1.046 | 0.851 | 1.286 |
WP | 1.000 | |||
Implant length (longer) | 0.006 | 1.051 | 1.014 | 1.088 |
Implant location (anterior/posterior: posterior) | 0.001 | 1.190 | 1.074 | 1.319 |
Implant location (maxillary/mandibular: maxillary) | 0.240 | 0.886 | 0.725 | 1.084 |
Immediate implant placement (with/without: with) | 0.488 | 0.917 | 0.718 | 1.171 |
Bone augmentation (with/without: with) | 0.464 | 0.904 | 0.690 | 1.184 |
Alveolar bone quality (lower) | 0.976 | 1.001 | 0.917 | 1.093 |
Distance between guide sleeve bottom to bone surface (longer) | 0.906 | 1.005 | 0.930 | 1.086 |
Bone surface inclination X (smaller) | 0.419 | 0.999 | 0.996 | 1.002 |
Bone surface inclination Y (smaller) | 0.088 | 0.998 | 0.995 | 1.000 |