Accuracy assessment of implant placement in a newly developed dynamic navigation system: A pilot study

The aim of this pilot study was to evaluate the accuracy of a newly developed dynamic navigation system and to compare the accuracy between flapless and open-flap surgery, and between surgeons. The subjects were patients who were scheduled to receive implants of the same size using the newly developed dynamic navigation system. The study’s procedures included cone beam computed tomography (CBCT) filming with fiducials, virtual planning of implant placement and the use of motion tracking technology for calibration and practical implant placement. The accuracy was evaluated using preoperative (virtual implant) and postoperative (actual implant) CBCT images based on angular, apical, coronal and vertical deviations. The differences of deviations between flapless and open-flap surgery, and between two surgeons, were statistically compared. In total, 66 implants were placed in 39 patients. The median and interquartile range of angular, apical, coronal and vertical deviations were 3.07° (2.52–3.54°), 0.96 mm (0.75–1.42 mm), 0.76 mm (0.57–1.37 mm) and 0.71 mm (0.61–0.88 mm), respectively. These deviations were similar to those found in previous studies. Flapless surgery resulted in a more accurate placement with respect to apical and coronal deviations, and the differences between the two surgeons were limited. The newly developed dynamic navigation system is considered to be eligible for clinical use.