3D Evaluation of Free-handed-Countersink Guided and Fully Guided Implant Surgery in Partially Edentulous Patients

This clinical trial with a quasi-experimental design investigates the accuracy of dental implant placement using three different surgical approaches: free-handed countersink guided, fully-guided, and traditional freehand techniques in partially edentulous patients. Dental implant therapy not only requires successful osseointegration but also a precise three-dimensional placement to ensure functional and esthetic outcomes. Accurate implant positioning is vital to prevent complications and ensure long-term stability. The evolution of digital technology has led to the development of computer-assisted implant surgery, enhancing surgical precision and minimizing the chances of deviation from planned positions. In this study, implants were placed in the same patients on both sides of the jaw using two techniques for comparison - one side received a free-handed countersink guided implant, while the other used a fully-guided surgical guide. Patients included in this research were partially dentate adults with adequate oral health, bone volume, and no systemic conditions or habits that could interfere with healing. Pre-operative and post-operative cone-beam computed tomography (CBCT) scans were used to evaluate the positional accuracy of the implants. The three-dimensional evaluation method utilized Blue Sky Plan 4 and 3D Slicer software to superimpose and analyze implant placements. Parameters such as angular deviation, crestal global deviation, apical global deviation, vertical linear deviation, lateral linear deviation, apical vertical deviation, apical lateral deviation, and distances from anatomical structures like the inferior alveolar nerve and the maxillary sinus were measured to assess placement accuracy. Measurements were taken using automatic image registration and STL superimposition of planned versus actual implant locations. Data collected was analyzed using SPSS software. Both descriptive and inferential statistical analyses were conducted. The results aime