Abstract：
OBJECTIVE: To assess navigation accuracy for complete-arch implant placement with immediate loading of digitally prefabricated provisional.
METHODS: Consecutive edentulous and terminal dentition patients requiring at least one complete-arch FDP were treated between December 2020 and January 2022. Accuracy was evaluated by superimposing pre-operative and post-operative cone beam computed tomography (CBCT), recording linear (mm) and angular (degrees) deviations. T-tests were performed to investigate the potential effect of the registration algorithm (fiducial-based vs. fiducial-free), type of references for the fiducial-free algorithm (teeth vs. bone screws), site characteristic (healed vs. post-extractive), implant angulation (axial vs. tilted), type of arch (maxilla vs. mandible) on the accuracy with p-value <0.05.
RESULTS: Twenty-five patients, 36 complete-arches, and 161 implants were placed. The overall mean angular deviation was 2.19° (SD 1.26°). The global platform and apex mean deviations were 1.17 mm (SD 0.57 mm), and 1.30 mm (SD 0.62 mm). Meaningful global platform (p = 0.0009) and apical (p = 0.0109) deviations were experienced only between healed and post-extraction sites. None of the analyzed variables significantly influenced angular deviation. Minor single-axis deviations were reported for the type of jaw (y-axis at implant platform and apex), registration algorithm (y-axis platform and z-axis deviations), and type of references for the fiducial-free algorithm. No statistically significant differences were found in relation to implant angulation.
CONCLUSIONS: Within the study limitations navigation was reliable for complete-arch implant placement with immediate loading digitally pre-fabricated FDP. AI-driven surface anatomy identification and calibration protocol made fiducial-free registration as accurate as fiducial-based, teeth and bone screws equal as references. Implant site characteristics were the only statistically significant variable with healed sites reporting higher accuracy compared to post-extractive. Live-tracked navigation surgery enhanced operator performance and accuracy regardless of implant angulation and type of jaw. A mean safety room of about 1 mm and 2° should be considered.
METHODS: Consecutive edentulous and terminal dentition patients requiring at least one complete-arch FDP were treated between December 2020 and January 2022. Accuracy was evaluated by superimposing pre-operative and post-operative cone beam computed tomography (CBCT), recording linear (mm) and angular (degrees) deviations. T-tests were performed to investigate the potential effect of the registration algorithm (fiducial-based vs. fiducial-free), type of references for the fiducial-free algorithm (teeth vs. bone screws), site characteristic (healed vs. post-extractive), implant angulation (axial vs. tilted), type of arch (maxilla vs. mandible) on the accuracy with p-value <0.05.
RESULTS: Twenty-five patients, 36 complete-arches, and 161 implants were placed. The overall mean angular deviation was 2.19° (SD 1.26°). The global platform and apex mean deviations were 1.17 mm (SD 0.57 mm), and 1.30 mm (SD 0.62 mm). Meaningful global platform (p = 0.0009) and apical (p = 0.0109) deviations were experienced only between healed and post-extraction sites. None of the analyzed variables significantly influenced angular deviation. Minor single-axis deviations were reported for the type of jaw (y-axis at implant platform and apex), registration algorithm (y-axis platform and z-axis deviations), and type of references for the fiducial-free algorithm. No statistically significant differences were found in relation to implant angulation.
CONCLUSIONS: Within the study limitations navigation was reliable for complete-arch implant placement with immediate loading digitally pre-fabricated FDP. AI-driven surface anatomy identification and calibration protocol made fiducial-free registration as accurate as fiducial-based, teeth and bone screws equal as references. Implant site characteristics were the only statistically significant variable with healed sites reporting higher accuracy compared to post-extractive. Live-tracked navigation surgery enhanced operator performance and accuracy regardless of implant angulation and type of jaw. A mean safety room of about 1 mm and 2° should be considered.
摘要：
目的：评估全牙弓植入物放置的导航精度，并立即加载数字预制临时植入物。
方法：在2020年12月至2022年1月期间，对需要至少一次完整足弓FDP的连续无牙颌和晚期牙列患者进行了治疗。通过叠加术前和术后锥形束计算机断层扫描（CBCT）来评估准确性，记录线性（毫米）和角度（度）偏差。进行了T检验以研究配准算法的潜在影响(基于基准的与无基准)，无基准算法的参考类型(牙齿与骨螺钉)，部位特征(愈合与提取后)，植入物角度(轴向与倾斜)，弓型(上颌骨vs.下颌骨）的精度与p值<0.05。
结果：25名患者，36个完整的拱门，并放置了161个植入物。总体平均角度偏差为2.19°(SD1.26°)。全球平台和顶点平均偏差为1.17mm（SD0.57mm），和1.30毫米（SD0.62毫米）。仅在愈合部位和提取后部位之间经历了有意义的全球平台（p=0.0009）和根尖（p=0.0109）偏差。所分析的变量都没有显著影响角度偏差。据报道，颌骨类型的单轴偏差较小（植入物平台和顶点处的y轴），配准算法（y轴平台和z轴偏差），以及无基准算法的参考类型。在植入物角度方面没有发现统计学上的显着差异。
结论：在研究的局限性中，导航对于完全牙弓植入物的放置是可靠的，并立即加载数字预制FDP。AI驱动的表面解剖结构识别和校准协议使无基准配准与基于基准的一样准确，牙齿和骨螺钉等于参考。植入物部位特征是唯一具有统计学意义的变量，与摘除后相比，愈合部位报告的准确性更高。实时跟踪导航手术可增强操作员的性能和准确性，而无需考虑植入物的角度和颌骨类型。应考虑约1mm和2°的平均安全空间。
方法：在2020年12月至2022年1月期间，对需要至少一次完整足弓FDP的连续无牙颌和晚期牙列患者进行了治疗。通过叠加术前和术后锥形束计算机断层扫描（CBCT）来评估准确性，记录线性（毫米）和角度（度）偏差。进行了T检验以研究配准算法的潜在影响(基于基准的与无基准)，无基准算法的参考类型(牙齿与骨螺钉)，部位特征(愈合与提取后)，植入物角度(轴向与倾斜)，弓型(上颌骨vs.下颌骨）的精度与p值<0.05。
结果：25名患者，36个完整的拱门，并放置了161个植入物。总体平均角度偏差为2.19°(SD1.26°)。全球平台和顶点平均偏差为1.17mm（SD0.57mm），和1.30毫米（SD0.62毫米）。仅在愈合部位和提取后部位之间经历了有意义的全球平台（p=0.0009）和根尖（p=0.0109）偏差。所分析的变量都没有显著影响角度偏差。据报道，颌骨类型的单轴偏差较小（植入物平台和顶点处的y轴），配准算法（y轴平台和z轴偏差），以及无基准算法的参考类型。在植入物角度方面没有发现统计学上的显着差异。
结论：在研究的局限性中，导航对于完全牙弓植入物的放置是可靠的，并立即加载数字预制FDP。AI驱动的表面解剖结构识别和校准协议使无基准配准与基于基准的一样准确，牙齿和骨螺钉等于参考。植入物部位特征是唯一具有统计学意义的变量，与摘除后相比，愈合部位报告的准确性更高。实时跟踪导航手术可增强操作员的性能和准确性，而无需考虑植入物的角度和颌骨类型。应考虑约1mm和2°的平均安全空间。
