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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT05361226
Other study ID # 2019/DT071-1
Secondary ID
Status Completed
Phase N/A
First received
Last updated
Start date July 9, 2019
Est. completion date October 30, 2020

Study information

Verified date April 2022
Source Mahidol University
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

To compare the static computer-aided implant surgery (s-CAIS) and conventional laboratory-guided implant surgery (c-LIS) in terms of accuracy for single tooth replacement in posterior areas.


Description:

There was still a lack of evidence in randomized clinical studies about the accuracy measurement comparing digital and laboratory workflows with tooth-supported templates for single implant cases in the posterior regions. Therefore, this present study's primary investigation was to perform accuracy measurement comparing digital and laboratory workflows with tooth-supported templates for single implant cases in the posterior regions. The secondary investigation was to find the effect of several factors on the accuracy of implant placement in these areas.


Recruitment information / eligibility

Status Completed
Enrollment 40
Est. completion date October 30, 2020
Est. primary completion date July 30, 2020
Accepts healthy volunteers Accepts Healthy Volunteers
Gender All
Age group 25 Years and older
Eligibility Inclusion Criteria: - Patients had a partially edentulous ridge in the premolar-molar region with existing two-sided interproximal as well as antagonistic contacts - Patients had healthy periodontal status and adequate keratinized gingiva at the edentulous space Exclusion Criteria: - - Patients have any local and systemic diseases considered as contraindications for dental implant treatment.

Study Design


Related Conditions & MeSH terms


Intervention

Other:
Accuracy measurement
Three months following the implant placement, patients were called back to the implant clinic to record the actual implant position with the digital impression technique. Full mouth scans were done by using the intraoral scanner (Trios 3, 3Shape, Copenhagen, Denmark). The surface scans were then exported as an STL file and were imported to coDiagnostiX software. The "Treatment evaluation tool" function tool was used to measure the accuracy of the implant placement which measured the amount of deviation of the placed implant from the planned position. The outcomes were generated into three main parameters.

Locations

Country Name City State
Thailand Faculty of Dentistry, Mahidol University Ratchathewi Bangkok

Sponsors (1)

Lead Sponsor Collaborator
Mahidol University

Country where clinical trial is conducted

Thailand, 

References & Publications (38)

Behneke A, Burwinkel M, Behneke N. Factors influencing transfer accuracy of cone beam CT-derived template-based implant placement. Clin Oral Implants Res. 2012 Apr;23(4):416-23. doi: 10.1111/j.1600-0501.2011.02337.x. Epub 2011 Oct 24. — View Citation

Buser D, Chappuis V, Kuchler U, Bornstein MM, Wittneben JG, Buser R, Cavusoglu Y, Belser UC. Long-term stability of early implant placement with contour augmentation. J Dent Res. 2013 Dec;92(12 Suppl):176S-82S. doi: 10.1177/0022034513504949. Epub 2013 Oct 24. — View Citation

Buser D, Martin W, Belser UC. Optimizing esthetics for implant restorations in the anterior maxilla: anatomic and surgical considerations. Int J Oral Maxillofac Implants. 2004;19 Suppl:43-61. Review. — View Citation

Cassetta M, Di Mambro A, Giansanti M, Stefanelli LV, Cavallini C. The intrinsic error of a stereolithographic surgical template in implant guided surgery. Int J Oral Maxillofac Surg. 2013 Feb;42(2):264-75. doi: 10.1016/j.ijom.2012.06.010. Epub 2012 Jul 11. — View Citation

Cassetta M, Stefanelli LV, Giansanti M, Calasso S. Accuracy of implant placement with a stereolithographic surgical template. Int J Oral Maxillofac Implants. 2012 May-Jun;27(3):655-63. — View Citation

Choi W, Nguyen BC, Doan A, Girod S, Gaudilliere B, Gaudilliere D. Freehand Versus Guided Surgery: Factors Influencing Accuracy of Dental Implant Placement. Implant Dent. 2017 Aug;26(4):500-509. doi: 10.1097/ID.0000000000000620. — View Citation

Cushen SE, Turkyilmaz I. Impact of operator experience on the accuracy of implant placement with stereolithographic surgical templates: an in vitro study. J Prosthet Dent. 2013 Apr;109(4):248-54. doi: 10.1016/S0022-3913(13)60053-0. — View Citation

D'haese J, Ackhurst J, Wismeijer D, De Bruyn H, Tahmaseb A. Current state of the art of computer-guided implant surgery. Periodontol 2000. 2017 Feb;73(1):121-133. doi: 10.1111/prd.12175. Review. — View Citation

Derksen W, Wismeijer D, Flügge T, Hassan B, Tahmaseb A. The accuracy of computer-guided implant surgery with tooth-supported, digitally designed drill guides based on CBCT and intraoral scanning. A prospective cohort study. Clin Oral Implants Res. 2019 Oct;30(10):1005-1015. doi: 10.1111/clr.13514. Epub 2019 Sep 9. — View Citation

Di Giacomo GA, Cury PR, de Araujo NS, Sendyk WR, Sendyk CL. Clinical application of stereolithographic surgical guides for implant placement: preliminary results. J Periodontol. 2005 Apr;76(4):503-7. — View Citation

El Kholy K, Janner SFM, Schimmel M, Buser D. The influence of guided sleeve height, drilling distance, and drilling key length on the accuracy of static Computer-Assisted Implant Surgery. Clin Implant Dent Relat Res. 2019 Feb;21(1):101-107. doi: 10.1111/cid.12705. Epub 2018 Dec 27. — View Citation

El Kholy K, Lazarin R, Janner SFM, Faerber K, Buser R, Buser D. Influence of surgical guide support and implant site location on accuracy of static Computer-Assisted Implant Surgery. Clin Oral Implants Res. 2019 Nov;30(11):1067-1075. doi: 10.1111/clr.13520. Epub 2019 Aug 20. — View Citation

Ersoy AE, Turkyilmaz I, Ozan O, McGlumphy EA. Reliability of implant placement with stereolithographic surgical guides generated from computed tomography: clinical data from 94 implants. J Periodontol. 2008 Aug;79(8):1339-45. doi: 10.1902/jop.2008.080059 . — View Citation

Farley NE, Kennedy K, McGlumphy EA, Clelland NL. Split-mouth comparison of the accuracy of computer-generated and conventional surgical guides. Int J Oral Maxillofac Implants. 2013 Mar-Apr;28(2):563-72. doi: 10.11607/jomi.3025. — View Citation

Gallardo YNR, da Silva-Olivio IR, Gonzaga L, Sesma N, Martin W. A Systematic Review of Clinical Outcomes on Patients Rehabilitated with Complete-Arch Fixed Implant-Supported Prostheses According to the Time of Loading. J Prosthodont. 2019 Dec;28(9):958-968. doi: 10.1111/jopr.13104. Epub 2019 Oct 18. Review. — View Citation

Geng W, Liu C, Su Y, Li J, Zhou Y. Accuracy of different types of computer-aided design/computer-aided manufacturing surgical guides for dental implant placement. Int J Clin Exp Med. 2015 Jun 15;8(6):8442-9. eCollection 2015. — View Citation

Hultin M, Svensson KG, Trulsson M. Clinical advantages of computer-guided implant placement: a systematic review. Clin Oral Implants Res. 2012 Oct;23 Suppl 6:124-35. doi: 10.1111/j.1600-0501.2012.02545.x. Review. — View Citation

Jung RE, Schneider D, Ganeles J, Wismeijer D, Zwahlen M, Hämmerle CH, Tahmaseb A. Computer technology applications in surgical implant dentistry: a systematic review. Int J Oral Maxillofac Implants. 2009;24 Suppl:92-109. Review. — View Citation

Kunavisarut C, Santivitoonvong A, Chaikantha S, Pornprasertsuk-Damrongsri S, Joda T. Patient-reported outcome measures comparing static computer-aided implant surgery and conventional implant surgery for single-tooth replacement: A randomized controlled trial. Clin Oral Implants Res. 2022 Mar;33(3):278-290. doi: 10.1111/clr.13886. Epub 2022 Jan 2. — View Citation

Nokar S, Moslehifard E, Bahman T, Bayanzadeh M, Nasirpouri F, Nokar A. Accuracy of implant placement using a CAD/CAM surgical guide: an in vitro study. Int J Oral Maxillofac Implants. 2011 May-Jun;26(3):520-6. — View Citation

Ozan O, Orhan K, Turkyilmaz I. Correlation between bone density and angular deviation of implants placed using CT-generated surgical guides. J Craniofac Surg. 2011 Sep;22(5):1755-61. doi: 10.1097/SCS.0b013e31822e6305. — View Citation

Park JY, Song YW, Park SH, Kim JH, Park JM, Lee JS. Clinical factors influencing implant positioning by guided surgery using a nonmetal sleeve template in the partially edentulous ridge: Multiple regression analysis of a prospective cohort. Clin Oral Implants Res. 2020 Dec;31(12):1187-1198. doi: 10.1111/clr.13664. Epub 2020 Sep 22. — View Citation

Pettersson A, Kero T, Gillot L, Cannas B, Fäldt J, Söderberg R, Näsström K. Accuracy of CAD/CAM-guided surgical template implant surgery on human cadavers: Part I. J Prosthet Dent. 2010 Jun;103(6):334-42. doi: 10.1016/S0022-3913(10)60072-8. — View Citation

Pozzi A, Polizzi G, Moy PK. Guided surgery with tooth-supported templates for single missing teeth: A critical review. Eur J Oral Implantol. 2016;9 Suppl 1:S135-53. Review. — View Citation

Rungcharassaeng K, Caruso JM, Kan JY, Schutyser F, Boumans T. Accuracy of computer-guided surgery: A comparison of operator experience. J Prosthet Dent. 2015 Sep;114(3):407-13. doi: 10.1016/j.prosdent.2015.04.004. Epub 2015 Jun 25. — View Citation

Sarment DP, Sukovic P, Clinthorne N. Accuracy of implant placement with a stereolithographic surgical guide. Int J Oral Maxillofac Implants. 2003 Jul-Aug;18(4):571-7. — View Citation

Schneider D, Marquardt P, Zwahlen M, Jung RE. A systematic review on the accuracy and the clinical outcome of computer-guided template-based implant dentistry. Clin Oral Implants Res. 2009 Sep;20 Suppl 4:73-86. doi: 10.1111/j.1600-0501.2009.01788.x. Review. — View Citation

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Smitkarn P, Subbalekha K, Mattheos N, Pimkhaokham A. The accuracy of single-tooth implants placed using fully digital-guided surgery and freehand implant surgery. J Clin Periodontol. 2019 Sep;46(9):949-957. doi: 10.1111/jcpe.13160. Epub 2019 Jul 19. — View Citation

Sugiura T, Yamamoto K, Horita S, Murakami K, Tsutsumi S, Kirita T. The effects of bone density and crestal cortical bone thickness on micromotion and peri-implant bone strain distribution in an immediately loaded implant: a nonlinear finite element analysis. J Periodontal Implant Sci. 2016 Jun;46(3):152-65. doi: 10.5051/jpis.2016.46.3.152. Epub 2016 Jun 28. — View Citation

Tahmaseb A, Wismeijer D, Coucke W, Derksen W. Computer technology applications in surgical implant dentistry: a systematic review. Int J Oral Maxillofac Implants. 2014;29 Suppl:25-42. doi: 10.11607/jomi.2014suppl.g1.2. Review. — View Citation

Tahmaseb A, Wu V, Wismeijer D, Coucke W, Evans C. The accuracy of static computer-aided implant surgery: A systematic review and meta-analysis. Clin Oral Implants Res. 2018 Oct;29 Suppl 16:416-435. doi: 10.1111/clr.13346. — View Citation

Tarnow DP, Cho SC, Wallace SS. The effect of inter-implant distance on the height of inter-implant bone crest. J Periodontol. 2000 Apr;71(4):546-9. — View Citation

Tolstunov L. Classification of the alveolar ridge width: implant-driven treatment considerations for the horizontally deficient alveolar ridges. J Oral Implantol. 2014 Jul;40 Spec No:365-70. doi: 10.1563/aaid-joi-D-14-00023. Epub 2014 Feb 27. — View Citation

Van Assche N, Vercruyssen M, Coucke W, Teughels W, Jacobs R, Quirynen M. Accuracy of computer-aided implant placement. Clin Oral Implants Res. 2012 Oct;23 Suppl 6:112-23. doi: 10.1111/j.1600-0501.2012.02552.x. Review. — View Citation

Vieira DM, Sotto-Maior BS, Barros CA, Reis ES, Francischone CE. Clinical accuracy of flapless computer-guided surgery for implant placement in edentulous arches. Int J Oral Maxillofac Implants. 2013 Sep-Oct;28(5):1347-51. doi: 10.11607/jomi.3156. — View Citation

Younes F, Eghbali A, De Bruyckere T, Cleymaet R, Cosyn J. A randomized controlled trial on the efficiency of free-handed, pilot-drill guided and fully guided implant surgery in partially edentulous patients. Clin Oral Implants Res. 2019 Feb;30(2):131-138. doi: 10.1111/clr.13399. Epub 2019 Jan 7. — View Citation

Zhao XZ, Xu WH, Tang ZH, Wu MJ, Zhu J, Chen S. Accuracy of computer-guided implant surgery by a CAD/CAM and laser scanning technique. Chin J Dent Res. 2014;17(1):31-6. — View Citation

* Note: There are 38 references in allClick here to view all references

Outcome

Type Measure Description Time frame Safety issue
Primary The accuracy of implant placement Patients were called back to record the actual implant position with the the intraoral scanner (Trios 3, 3Shape, Copenhagen, Denmark). The surface scans were then exported as an STL file and were imported to coDiagnostiX software. Those postoperative surface scans were merged with the preoperative surface scan in each group protocols. The "Treatment evaluation tool" function tool was used to measure the accuracy of the implant placement which measured the amount of deviation of the placed implant from the planned position. The outcomes were generated into three main parameters which were Angular deviation, Coronal global deviation and Apical global deviation.
Angular deviation = the amount of angle(°), in which the actually placed implant deviated from the virtually planned implant in 3D.
Coronal/ Apical global deviation = the amount of distance(mm), in which the actually placed implant deviated from the virtually planned implant at the coronal/ apical position in 3D.
Three months after implant placement
Secondary Factors influencing the accuracy of implant placement Various factors influencing the accuracy of implant placement were also analyzed including the type of arch (Maxilla vs. Mandible), side of the arch (Left vs. Right), implant location (Premolar vs. Molar), implant diameter (WN vs. RN), implant length (8 vs. 10 mm), ridge morphology (Broad (=8mm) vs. Narrow (?8mm), cortical bone thickness and cortical interference. The thickness of the cortical bone was evaluated at the center of the implant after the planned implant position was completely set in the coDiagnostiX program. If any parts of the planned implant involving against any cortical bone walls, it would count as having a cortical interference. Three months after implant placement
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