Influence of implant diameter on accuracy of static implant guided surgery: An in vitro study

Statement of problem: Static guided implant surgery may be the most accurate method of implant placement to date. However, within the same guided implant system, whether accuracy is affected when placing a larger diameter implant that requires more drills than a smaller diameter implant is unclear. Purpose: The purpose of this in vitro study was to evaluate the influence of implant diameter on the angulation and 3-dimensional (3D) deviations of posterior single implant placement using static guided surgery. Material and methods: A polyurethane dental cast was made with an edentulous site at the maxillary right first molar position. Identical implant planning for each of 3 dental implant diameters 3.3, 4.1, and 4.8 mm (Straumann BLT) were made, and surgical guides for each implant diameters were fabricated by stereolithography. Fifteen implants of each diameter (N=45) were placed in simulated casts. A scan body was placed and the cast was scanned using an intraoral scanner. The positional discrepancies of implant placement, including angulation as well as 3D implant cervical and apex area deviations, were compared with the planned position. Linear ANOVA single factor analysis (ɑ=.05) was used, and box plots were made. Results: The ranges of angulation deviations for 3.3-, 4.1-, and 4.8-mm implants were 3.6 degrees to 6.0 degrees, 3.7 degrees to 7.7 degrees, and 3.1 degrees to 6.7 degrees, respectively. The ranges of 3D implant entry deviations of 3.3-, 4.1-, and 4.8-mm implants were 0.96 to 1.4, 0.85 to 1.72, and 0.89 to 1.78 mm, respectively. The ranges of 3D implant apex of 3.3-, 4.1-, and 4.8-mm implants were 0.63 to 1.21, 0.64 to 1.48, and 0.48 to 1.27 mm, respectively. No statistically significant differences were found in any of the 3 measurements: P=.67 for deviation in angulation; P=.27 for 3D implant deviation of entry; and P=.3 for 3D implant deviation of the apex. Conclusions: Implant diameters had no significant effect on placement deviations when a single posterior static guided surgery was used.