Purpose: To evaluate the accuracy of a newly developed open-source system for three-dimensional dental implant planning and fully guided dental implant placement.
Materials and methods: Forty-eight implant positions were planned for eight partially edentulous anatomical patient equivalent models with an open-source implant planning system on the basis of cone beam computed tomography (CBCT) scans. The virtual software planning leads to an output of four different coordinates for each implant position; with these, surgical guides were manufactured using a coordinate-transfer apparatus. During the surgical simulation, drills and implants were fully guided as they were inserted by means of the harmonized components of the vendor's sleeve-in-sleeve system. After follow-up CBCT investigation and reference marker-based software registration, linear horizontal, vertical, and maximal 3D deviations, as well as angular deviations, between the virtual planning data and the surgical results were calculated.
Results: The mean three-dimensional deviation values for the final implant positions were 671 μm (95% confidence interval [CI] 452 to 891 μm) at the implant base and 808 μm (95% CI 646 to 971 μm) at the implant tip. Mean vertical deviations were 273 μm (95% CI 200 to 345 μm). Mean angular deviations of 1.9 degrees (95% CI 1.4 to 2.4 degrees) were measured.
Conclusions: The open-source implant planning system described in this study demonstrated a level of accuracy that is equal or superior to most descriptions of the literature on computer-aided implant dentistry, allows for predictable implant positioning, and has the potential to reduce postoperative impairment versus conventional implant insertion.