The influence of guide stabilizers and their application sequences on trueness and precision of surgical guides in free end situations: An in vitro analysis

Clin Oral Implants Res. 2024 Mar;35(3):294-304. doi: 10.1111/clr.14226. Epub 2023 Dec 19.

Abstract

Objectives: To evaluate the impact of guide stabilizers and their application sequences on implant placement accuracy of guided implant surgery in multiple teeth loss at free end.

Materials and methods: In this study, 96 implants were placed in the regions of #34, #36, and #37 of 32 identical mandibular models. The influence of using guide stabilizers or not (group A and group B) and various guide stabilizers application sequences (group B: #34 → #36 → #37; group C: #36 → #34 → #37; group D: #37 → #34 → #36) on implant placement trueness and precision was investigated. Data were analyzed using T-tests and one-way ANOVA.

Results: Group B showed significant benefits in enhancing implant placement precision. Compared to group A, it resulted in reducing 3D-deviation at crest and 2D deviation in vestibular-oral direction at both crest and apex. Furthermore, group D demonstrated greater improvement in global implant placement precision by reducing 2D deviation in mesial-distal direction at both crest and apex. Among the three different stabilizer application sequences, group D exhibited the highest level of implant placement precision.

Conclusions: In cases of missing teeth at distal free end, the use of guide stabilizers and their application sequences does not have a significant impact on implant placement trueness. However, they do improve implant placement precision compared to methods that do not utilize guide stabilizers. Specifically, applying a guide stabilizer first at the furthest implant site to change teeth loss classification from free end to edentulous space with posterior support is the most reliable sequence.

Keywords: free end; guide stabilizer; guide surgery; precision; trueness.

MeSH terms

  • Computer-Aided Design
  • Cone-Beam Computed Tomography
  • Dental Implantation, Endosseous / methods
  • Dental Implants*
  • Humans
  • Imaging, Three-Dimensional
  • Mouth, Edentulous*
  • Surgery, Computer-Assisted*
  • Tooth Loss*

Substances

  • Dental Implants