Precision of sleeveless 3D drill guides for insertion of one-piece ceramic implants: a prospective clinical trial

Objective: The insertion of implants through template-guided surgery is an established method. At the present time, the static navigation is based on sleeves integrated into the guides, through which drill bits of the corresponding size are passed. The present clinical trial is designed to test a new sleeveless system to determine the precision of implant insertion for one-piece ceramic implants. Materials and methods: For 12 patients, implant bed preparation and the insertion of the implants were done using a sleeveless implant guide. Twenty implants were inserted in this way and checked for precision. The check was done using a noninvasive method, which permitted comparison of the planning data with the actually realized positions after superimposition. Results: The mean deviations were 0.52 mm (95% CI: 0.37 to 0.67 mm) at the crestal position of the implant, and 0.82 mm (95% CI: 0.56 to 1.08 mm) at the apical tip of the implant. The height deviation was 0.35 mm (95% CI: 0.01 to 0.68 mm). The mean angular deviation was measured as 2.85 degrees (95% CI: 2.18 to 3.51 degrees). Conclusion: The values showed good precision in all the parameters measured. The results were thus in a range equal to or better than the mean precision found in numerous clinical trials described in the literature. In particular, the method showed little deviation, as illustrated by the confidence interval (CI), but also by the clinically critical maximum deviations. Keywords: implant planning, guided surgery, drill guide, sleeve, sleeveless, accuracy, one-piece ceramic implant