Optimizing Dental Implant Success: Biomechanical Insights, Computer-Guided Precision and The Role of Open Guide Systems in Achieving Cost-Effective and Accessible Treatment.

OBJECTIVE

This study aimed to compare the positional and angular accuracy of digitally planned implant placements with an open-guide system, using a vision measuring machine (VMM).

METHODOLOGY: This in vitro experimental study, conducted at King Saud University (May to September 2024), involved placing 24 endosseous implants into eight replaceable bone blocks. Three implants were placed in each bone block (Nissin™ Dental, Japan), measuring approximately 50 mm (L) × 25 mm (W) × 20 mm (H). A jaw model simulating a partially edentulous mandible was used. Preoperative CBCT scans and virtual surgical planning software guided the fabrication of stereolithographic surgical templates. Post-placement, implant accuracy was assessed using the VMM.

RESULTS

The open-guide system (Group-B) demonstrated significantly improved linear (e.g., L I- II: 1.09 mm, p = 0.001) and angular accuracy (e.g., P III deviation from 90º: 9.59º, p = 0.000) compared to digital planning alone (Group-A). Vertical accuracy, however, was inconsistent, with some deviations reaching significance (e.g., V DI: p = 0.000), while others did not (e.g., V DII: p = 0.552).

CONCLUSION

The stereolithographic open-guide system enhances linear and angular precision in implant placement, particularly in multi-implant cases. However, vertical accuracy remains less predictable, warranting further refinement for improved surgical outcomes.