ObjectivesTo compare the accuracy of CAD‐CAM and conventional guides in the static computer‐assisted implant surgery (sCAIS) placement of distal free‐end implants.Material and MethodsA prospective, controlled, and blinded quasi‐experimental study was done involving 27 patients (76 implants) distributed into two groups according to the surgical guide manufacturing approach used: conventional (control group [CG]) or CAD‐CAM (test group [TG]). The implants were planned in the software and the surgical guides were manufactured. Fully guided implant placement was carried out and the deviations were measured along with secondary variables as potential confounding factors. Descriptive analyses were performed on mean, standard deviation (SD), and interquartile range (IQR). In the comparative/inferential analysis hypothesis, contrasts were made of the quantitative and qualitative variables and multiple linear models were generated to adjust for the different confounding variables recorded.ResultsCoronal horizontal deviation (CHD) was significantly greater in CG (1.52 mm) versus TG (1.04 mm) (p = 0.004). Apical horizontal deviation (AHD) in turn was 1.67 versus 1.46 mm, respectively; angular deviation was 2.87 versus 3.64; and vertical deviation was −0.1 versus −0.05 mm, with no significant differences between the groups (p > 0.05). A greater sleeve height, positioning in premolars versus molars, and the use of shorter implants, were associated with greater accuracy in relation to CHD and/or AHD (p < 0.05). The implant success rate at 1 year was 92.1%, 90.7% in TG, and 100% in CG, being statistically significant (p = 0.026) at the implant level, but not significant at the patient level.ConclusionsThe CAD‐CAM surgical guides proved to be more accurate than the conventional guides in the sCAIS placement of distal free‐end implants, with statistically significant differences being observed in terms of CHD. All implant failures occurred in TG (6 implants/3 patients).Trial RegistrationClinicalTrials.gov identifier: NCT06404385

中文翻译：

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远端自由端种植体患者静态计算机辅助种植体手术准确性的前瞻性临床研究。传统手术导板与 CAD-CAM 手术导板


目的比较 CAD-CAM 和传统导板在远端自由端种植体静态计算机辅助种植体手术 （sCAIS） 放置中的准确性。材料和方法进行了一项前瞻性、对照和盲法的准实验研究，涉及 27 名患者（76 个植入物），根据所使用的手术导板制造方法分为两组：常规（对照组 [CG]）或 CAD-CAM（测试组 [TG]）。在软件中规划植入物并制造手术导板。进行完全引导的种植体植入，并测量偏差以及作为潜在混杂因素的次要变量。对平均值、标准差 （SD） 和四分位距 （IQR） 进行描述性分析。在比较/推理分析假设中，对定量和定性变量进行了对比，并生成了多个线性模型以调整记录的不同混杂变量。结果CG （1.52 mm） 的冠状水平偏差 （CHD） 显著大于 TG （1.04 mm） （p = 0.004）。根尖水平偏差 （AHD） 分别为 1.67 和 1.46 mm;角度偏差为 2.87 对 3.64;垂直偏差为 -0.1 与 -0.05 mm，组间无显著差异 （p > 0.05）。与磨牙相比，更大的袖套高度、在前磨牙中的位置以及使用较短的种植体与相对于 CHD 和/或 AHD 的准确性更高相关 （p < 0.05）。1 年时植入成功率为 92.1%，TG 为 90.7%，CG 为 100%，在种植体水平具有统计学意义 （p = 0.026），但在患者水平不显著。结论 CAD-CAM 手术导板在远端自由端种植体的 sCAIS 放置中被证明比传统导板更准确，在 CHD 方面观察到统计学上的显著差异。所有种植体失败均发生在 TG （6 个种植体/3 名患者）。试验注册临床试验。gov 标识符：NCT06404385