Comparison of Static and Dynamic Computerassisted Guidance Methods in Implantology

The planning of dental implant position and its transfer to the operation site can be considered as one of the most important factors for the long-term success of implant-supported prosthetic und epithetic restorations. This study compares computer-assisted fabricated surgical templates as the static method with intraoperative image guided navigation as the dynamic method for transfer of threedimensional pre-operative planning. For the static method, the systems Med3D, coDiagnostix/ gonyX, and SimPlant were used. For the dynamic method, the systems RoboDent und VectorVision2 were applied. A total of 746 implants were inserted between August 1999 and December 2005 in 206 patients. The static approach was used most frequently, accounting for 611 fixtures in 168 patients. The failure ratios within the first 6 months were 1.31% in the statically controlled insertion group compared to 2.96% in the dynamically controlled insertion group. Complications related to an incorrect position of the implants have not been observed so far in either group. All computer-assisted methods included in this study were successfully applied in a clinical setting after a certain start-up period. The indications for application of computer-assisted methods in implantology are currently given in difficult anatomical situations. Due to uncomplicated handling and low resource demands, the static template technique can be recommended as the method of choice for the majority of all cases falling into this category. Keywords: dental implants, computer tomography, digital volume tomography, surgical templates, intra-operative navigation, imaging methods, implant planning, implant insertion