Accuracy of Computer-Assisted Dynamic Navigation as a Function of Different Intraoral Reference Systems: An In Vitro Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Implantation Planning and Models
2.2. Process Chains
2.3. Registering the Implant Position
2.4. Analysis of the Implant Position
- 3D deviation: the three-dimensional deviation of the midpoints between implant planning and the clinically-achieved implant position, measured at the implant shoulder and apex (corresponding to the Euclidean distance).
- Apico-coronal deviation (height difference): vertical spatial offset measured at the center of the implant shoulder.
- Axis deviation: Angular deviation of the implant axes between the planned and clinically-achieved implant positions.
- The two-dimensional deviations in the mesio-distal and bucco-lingual directions were measured at the implant shoulder and at the implant axis.
2.5. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Workflow | |||||
---|---|---|---|---|---|
A | B_1 | B_2 | C | ||
Data Generation | CBCT | CBCT image with marker | CBCT image | CBCT image | CBCT image |
On the patient | Intraoral scan | Two intraoral scans (with and without marker) | Alginate impression | Intraoral scan | |
Virtually | Creation of a digital marker template | ||||
In the laboratory | Two model scans (with and without marker) | 3D printing of a marker template | |||
Reference marker in surgery | Surgery with Denatray | Surgery with Denatray | Surgery with Denatray | Surgery with marker template |
Total n = 60 Models/120 Implants | Region 45 n = 60 Models/60 Implants | Region 47 n = 60 Models/60 Implants | p-Value | |||||||
---|---|---|---|---|---|---|---|---|---|---|
Mean (SD) | 95% CI | Min–Max | Mean (SD) | 95% CI | Min–Max | Mean (SD) | 95% CI | Min–Max | ||
Deviation at implant shoulder (mm) | ||||||||||
3D | 1.53 (0.70) | 1.40–1.66 | 0.20–4.02 | 1.52 (0.64) | 1.36–1.69 | 0.26–4.02 | 1.54 (0.77) | 1.34–1.74 | 0.20–3.75 | 0.923 |
Mesio-distal | 0.70 (0.59) | 0.59–0.80 | 0.02–3.06 | 0.63 (0.57) | 0.48–0.78 | 0.02–2.37 | 0.77 (0.62) | 0.61–0.93 | 0.04–3.06 | 0.208 |
Bucco-lingual | 0.98 (0.68) | 0.86–1.11 | 0.00–2.81 | 1.09 (0.66) | 0.91–1.25 | 0.00–2.52 | 0.87 (0.70) | 0.71–1.07 | 0.00–2.81 | 0.116 |
Apico-coronal | 0.57 (0.50) | 0.48–0.67 | 0.00–2.34 | 0.48 (0.43) | 0.37–0.60) | 0.00–2.17 | 0.66 (0.54) | 0.51–0.80 | 0.00–2.34 | 0.059 |
Deviation at implant apex (mm) | ||||||||||
3D | 1.79 (0.80) | 1.64–1.94 | 0.29–4.05 | 1.81 (0.74) | 1.78–2.00 | 0.29–4.05 | 1.77 (0.86) | 1.54–1.99 | 0.29–3.74 | 0.766 |
Mesio-distal | 0.81 (0.70) | 0.68–0.93 | 0.01–3.73 | 0.80 (0.71) | 0.62–0.98 | 0.04–3.73 | 0.82 (0.69) | 0.64–1.00 | 0.01–3.26 | 0.890 |
Bucco-lingual | 1.25 (0.75) | 1.12–1.39 | 0.01–3.10 | 1.36 (0.66) | 1.19–1.53 | 0.20–2.79 | 1.15 (0.83) | 0.93–1.36 | 0.01–3.10 | 0.126 |
Apico-coronal | 0.58 (0.50) | 0.49–0.67 | 0.00–2.35 | 0.50 (0.43) | 0.39–0.61 | 0.00–2.19 | 0.66 (0.55) | 0.52–0.81 | 0.00–2.35 | 0.068 |
Angular deviation (°) | 2.88 (2.03) | 2.51–3.25 | 0.20–12.70 | 2.87 (2.22) | 2.30–3.44 | 0.20–12.70 | 2.89 (1.83) | 2.41–3.36 | 0.40–10.40 | 0.964 |
Process Chain A n = 15 Models/30 Implants | Process Chain B_1 n = 15 Models/30 Implants | Process Chain B_2 n = 15 Models/30 Implants | Process Chain C n = 15 Models/30 Implants | p-Value | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Mean (SD) | 95% CI | Min–Max | Mean (SD) | 95% CI | Min–Max | Mean (SD) | 95% CI | Min–Max | Mean (SD) | 95% CI | Min–Max | ||
Deviation at implant shoulder (mm) | |||||||||||||
3D | 1.40 (0.65) | 1.16–1.64 | 0.41–3.75 | 1.85 (0.52) | 1.66–2.04 | 0.53–2.99 | 1.48 (0.92) | 1.14–1.83 | 0.20–4.02 | 1.39 (0.59) | 1.17–1.61 | 0.50–3.14 | 0.034 |
Mesio-distal | 0.80 (0.63) | 0.55–1.04 | 0.06–3.06 | 0.64 (0.50) | 0.45–0.83 | 0.04–1.70 | 0.68 (0.66) | 0.44–0.93 | 0.02–2.37 | 0.67 (0.56) | 0.46–0.88 | 0.04–2.63 | 0.763 |
Bucco-lingual | 0.60 (0.48) | 0.42–0.78 | 0.06–1.91 | 1.47 (0.65) | 1.47–1.72 | 0.14–2.6 | 0.91 (0.75) | 0.63–1.19 | 0.00–2.81 | 0.95 (0.53) | 0.76–1.15 | 0.00–1.81 | <0.005 |
Apico-coronal | 0.67 (0.53) | 0.47–0.87 | 0.00–2.10 | 0.56 (0.38) | 0.41–0.70) | 0.01–1.29 | 0.60 (0.65) | 0.36–0.84 | 0.01–2.34 | 0.45 (0.37) | 0.31–0.59 | 0.02–1.65 | 0.303 |
Deviation at implant apex (mm) | |||||||||||||
3D | 1.54 (0.72) | 1.27–1.81 | 0.75–3.56 | 2.13 (0.62) | 1.90–2.09 | 0.69–3.49 | 1.80 (1.06) | 1.41–2.20 | 0.29–4.05 | 1.68 (0.65) | 1.44–1.92 | 0.63–3.68 | 0.029 |
Mesio-distal | 0.80 (0.66) | 0.55–1.05 | 0.04–2.87 | 0.67 (0.51) | 0.48–0.86 | 0.04–1.80 | 0.83 (0.88) | 0.50–1.16 | 0.04–3.73 | 0.93 (0.70) | 0.66–1.19 | 0.01–3.26 | 0.553 |
Bucco-lingual | 0.86 (0.59) | 0.64–1.08 | 0.01–2.41 | 1.82 (0.68) | 1.57–2.07 | 0.08–3.10 | 1.23 (0.79) | 0.93–1.20 | 0.12–2.93 | 1.10 (0.60) | 0.88–1.32 | 0.18–2.31 | <0.005 |
Apico-coronal | 0.69 (0.53) | 0.49–0.89 | 0.00–2.12 | 0.57 (0.39) | 0.42–0.71 | 0.01–1.35 | 0.62 (0.65) | 0.38–0.86 | 0.01–2.35 | 0.45 (0.37) | 0.31–0.59 | 0.00–1.62 | 0.303 |
Angular deviation (°) | 2.77 (1.06) | 2.37–3.16 | 0.90–5.50 | 2.70 (2.61) | 1.73–3.68 | 0.40–12.70 | 3.43 (2.44) | 2.52–3.13 | 0.50–12.6 | 2.62 (1.60) | 2.02–3.22 | 0.20–7.70 | 0.394 |
A-B_1 | A-B_2 | A-C | B_1-B_2 | B_1-C | B_2-C | |
---|---|---|---|---|---|---|
Deviation at implant shoulder (mm) | ||||||
3D | 0.001 * | 0.722 | 0.873 | 0.003 * | 0.002 * | 0.844 |
Mesio-distal | 0.747 | 0.887 | 0.849 | 0.992 | 0.997 | 1.000 |
Bucco-lingual | <0.001 * | 0.220 | 0.125 | 0.003 * | 0.007 * | 0.992 |
Apico-coronal | 0.800 | 0.937 | 0.303 | 0.988 | 0.835 | 0.648 |
Deviation at implant apex (mm) | ||||||
3D | 0.022 * | 0.573 | 0.905 | 0.366 | 0.119 | 0.929 |
Mesio-distal | 0.884 | 0.998 | 0.897 | 0.805 | 0.481 | 0.951 |
Bucco-lingual | <0.001 * | 0.147 | 0.502 | 0.005 * | <0.001 * | 0.881 |
Apico-coronal | 0.796 | 0.958 | 0.255 | 0.976 | 0.787 | 0.536 |
Angular deviation (degree) | 0.999 | 0.590 | 0.992 | 0.513 | 0.998 | 0.413 |
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Schnutenhaus, S.; Knipper, A.; Wetzel, M.; Edelmann, C.; Luthardt, R. Accuracy of Computer-Assisted Dynamic Navigation as a Function of Different Intraoral Reference Systems: An In Vitro Study. Int. J. Environ. Res. Public Health 2021, 18, 3244. https://doi.org/10.3390/ijerph18063244
Schnutenhaus S, Knipper A, Wetzel M, Edelmann C, Luthardt R. Accuracy of Computer-Assisted Dynamic Navigation as a Function of Different Intraoral Reference Systems: An In Vitro Study. International Journal of Environmental Research and Public Health. 2021; 18(6):3244. https://doi.org/10.3390/ijerph18063244
Chicago/Turabian StyleSchnutenhaus, Sigmar, Anne Knipper, Martin Wetzel, Cornelia Edelmann, and Ralph Luthardt. 2021. "Accuracy of Computer-Assisted Dynamic Navigation as a Function of Different Intraoral Reference Systems: An In Vitro Study" International Journal of Environmental Research and Public Health 18, no. 6: 3244. https://doi.org/10.3390/ijerph18063244