Accuracy of static computer-aided implant surgery (S-CAIS) using CAD-CAM surgical templates fabricated from different additive manufacturing technologies

Anshu Bathija; Panos Papaspyridakos; Matthew Finkelman; Yongjeong Kim; Kiho Kang; Andre B De Souza

doi:10.1016/j.prosdent.2023.03.025

Accuracy of static computer-aided implant surgery (S-CAIS) using CAD-CAM surgical templates fabricated from different additive manufacturing technologies

J Prosthet Dent. 2023 Apr 28:S0022-3913(23)00191-9. doi: 10.1016/j.prosdent.2023.03.025. Online ahead of print.

Authors

Anshu Bathija¹, Panos Papaspyridakos², Matthew Finkelman³, Yongjeong Kim⁴, Kiho Kang⁵, Andre B De Souza⁶

Affiliations

¹ Assistant Professor, Department of Prosthodontics, University of New England, Portland, Maine.
² Associate Professor, Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass Adjunct Associate Professor, University of Rochester Eastman Institute for Oral Health, Rochester, NY.
³ Associate Professor, Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston, Mass.
⁴ Associate Professor, Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass.
⁵ Professor, Loma Linda University School of Dentistry, Loma Linda, CA.
⁶ Adjunct Professor, Department of Periodontology, Nova Southeastern University College of Dental Medicine, Davie, Fla. Electronic address: abarbisa@nova.edu.

PMID: 37121851
DOI: 10.1016/j.prosdent.2023.03.025

Abstract

Statement of problem: Different 3D printers are available for guided implant surgery, but studies that evaluate their source of errors and their cost-effectiveness are lacking.

Purpose: The purpose of this in vitro study was to compare the accuracy of different 3-dimensional (3D) printed surgical templates made using different additive manufacturing technologies and to evaluate the effect of implant location on the accuracy of fully guided implant placement.

Material and methods: Fifty partially edentulous maxillary typodonts with edentulous sites in the right second premolar (SP), right lateral incisor (LI), left central incisor (CI), and left first molar (FM) locations were scanned and printed from the standard tessellation language (STL) datasets. The study compared 5 groups for the fabrication of implant surgical templates: Varseo S-Bego (Bego), Polyjet-Stratasys (Poly), Low Force Stereolithography-FormLabs (LFS), P30+-Straumann (P30), and M2-Carbon (M2). After fully guided implant placement, the typodont was scanned, and the 3D implant positions were compared with the master model by superimposing the STL files. Descriptive statistics were calculated for groups and subgroups, and comparisons among the groups and subgroups were conducted via 2-way mixed analysis of variance, Tukey honest significant difference, and post hoc Bonferroni tests (α=.05).

Results: The results were site specific and not consistent within each group. For angle deviation, the within-group analysis for P30 demonstrated significantly lower values for implants positioned at site SP (1.4 ±0.8 degrees) than for sites LI (2.3 ±0.7 degrees; P=.001) and CI (2.3 ±0.8 degrees; P=.007). For 3D offset at base for implant CI, LFS was significantly higher than Bego (P=.002), Poly (P=.035), or M2 (P=.001); P30 was also significantly higher than Bego (P=.014) and M2 (P=.006). LFS had a significantly higher 3D offset at the tip than Bego (P=.001) and M2 (P=.022) for implant CI.

Conclusions: The choice of 3D printer seemed to influence fully guided implant surgery in terms of the final implant position compared with initial implant planning. However, although statistically significant differences were present across groups, all additive manufacturing technologies were within clinically acceptable values.