Accuracy of keyless vs drill-key implant systems for static computer-assisted implant surgery using two guide-hole designs compared to freehand implant placement: an in vitro study.

Raabe, Clemens; Schuetz, Tabea S; Chappuis, Vivianne; Yilmaz, Burak; Abou-Ayash, Samir; Couso-Queiruga, Emilio (2023). Accuracy of keyless vs drill-key implant systems for static computer-assisted implant surgery using two guide-hole designs compared to freehand implant placement: an in vitro study. International journal of implant dentistry, 9(1), p. 4. Springer 10.1186/s40729-023-00470-6

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PURPOSE

This in vitro study aimed at comparing the accuracy of freehand implant placement with static computer-assisted implant surgery (sCAIS), utilizing a keyless and a drill-key implant system and two guide-hole designs.

METHODS

A total of 108 implants were placed in 18 partially edentulous maxillary models simulating two different alveolar ridge morphologies. 3D digital deviations between pre-planned and post-operative implant positions were obtained. Guide material reduction was assessed in the keyless implant system for the manufacturer's sleeve and sleeveless guide-hole designs.

RESULTS

sCAIS using a sleeveless guide-hole design demonstrated smaller mean angular, crestal and apical deviations compared to sCAIS utilizing a manufacturer's sleeve and the freehand group (2.6 ± 1.6°, vs 3.3 ± 1.9°, vs 4.0 ± 1.9°; 0.5 ± 0.3 mm, vs 0.6 ± 0.3 mm, vs 0.8 ± 0.3 mm; and 1.0 ± 0.5 mm, vs 1.2 ± 0.7 mm, vs 1.5 ± 0.6 mm). Smaller angular and apical mean deviations were observed in the keyless implant system as compared with the drill-key implant system (3.1 ± 1.7°, vs 3.5 ± 1.9°, p = 0.03; and 1.2 ± 0.6 mm, vs 1.4 ± 0.7 mm, p = 0.045). Overall, smaller angular, crestal, and apical deviations (p < 0.0001) were observed in healed alveolar ridges (2.4 ± 1.7°, 0.5 ± 0.3 mm, and 0.9 ± 0.5 mm) than in extraction sockets (4.2 ± 1.6°, 0.8 ± 0.3 mm, and 1.6 ± 0.5 mm). Higher mean volumetric material reduction was observed in sleeveless than in manufacturer's sleeve guide-holes (- 0.10 ± 0.15 mm3, vs - 0.03 ± 0.03 mm3, p = 0.006).

CONCLUSIONS

Higher final implant positional accuracy was observed in sCAIS for the keyless implant system, with a sleeveless guide-hole design, and in healed ridges. Sleeveless guide holes resulted in higher volumetric material reduction compared with the manufacturer's sleeve.

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6 Citations in Scopus

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