Is accurate dental implant placement feasible using a novel dynamic computer-assisted surgery system without patient optical markers or registration? A preliminary retrospective cohort study

Abstract

Objectives: To evaluate the accuracy and surgery time of dental implant placement using a novel dynamic computer-assisted implant surgery (dCAIS) system that eliminates the need for patient registration and optical tracking markers. The secondary objective was to compare these outcomes with those obtained using a conventional dCAIS system. Materials and Methods: A preliminary retrospective cohort study was conducted involving 33 participants (33 implants). Eleven implants were placed using the novel dCAIS system that determines patient positioning based on anterior tooth anatomy (Prototype group), while 22 implants were placed using a conventional dCAIS system requiring standard registration and an optical tracking marker (Control group). Pre- and postoperative cone-beam computed tomography (CBCT) scans were superimposed to assess implant placement accuracy. Descriptive and bivariate analyses were performed to compare accuracy and surgery time between the two groups. Results: Mean angular deviations were similar between groups (p = 0.924): 1.95° (SD 1.38) in the prototype group and 2.38° (SD 2.30) in the control group. No significant differences were observed in platform global deviation (mean difference [MD]: −0.33 mm; 95% CI: −0.75 to 0.09), apex global deviation (MD: −0.43 mm; 95% CI: −0.94 to 0.08), or apex depth deviation (MD: 0.28 mm; 95% CI: −0.30 to 0.86). Surgical procedures were significantly faster in the prototype group (p = 0.002; MD: 3.0 min; 95% CI: 0.56–5.45). Conclusions: The findings of this preliminary study seem to suggest that the tested prototype dCAIS system may be feasible to accurately place implants without conventional registration or optical tracking, potentially reducing surgical time. However, these findings should be interpreted with caution due to the study limitations.