Fully guided implant surgery using Magnetic Resonance Imaging – An in vitro study on accuracy in human mandibles

• DOI: 10.1111/clr.13622
• Publication Date: 2020-05-27T20:30:11Z
• Authors: Tabea Flügge; Ute Ludwig; Gita Winter; Philipp Amrein; Florian Kernen; Katja Nelson
• Keywords: Dental Implants; Dental Implantation, Endosseous; Kernspintomografie; 610; Mandible; Cone-Beam Computed Tomography; Magnetic Resonance Imaging; Patient Care Planning; computer-aided design; 03 medical and health sciences; Imaging, Three-Dimensional; 0302 clinical medicine; Surgery, Computer-Assisted; virtual implant planning; guided implant surgery; Computer-Aided Design; Humans; magnetic resonance imaging; 600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit

AbstractObjectivesThe objective of this in vitro study was to assess the accuracy of fully guided implant placement following virtual implant planning based on MRI.Material and MethodsSixteen human cadaver hemimandibles with single missing teeth (n = 3), partially edentulous (n = 6) and edentulous situations (n = 7) were imaged using MRI. MRI and optical scans obtained with an intraoral scanner, were imported into an implant planning software. Virtual prosthetic and implant planning were performed regarding hard‐ and soft‐tissue anatomy. Drill guides were manufactured, and fully guided implant placement was performed. Buccal and lingual bone and implant nerve distance were measured by three examiners in preoperative MRI and postoperative CBCT. The implant position was assessed using a software for deviation of implant positions displayed in CBCT and optical scans, respectively.ResultsMRI displayed relevant structures for implant planning such as cortical and cancellous bone, inferior alveolar nerve and neighboring teeth. Implant planning, CAD/CAM of drill guides and guided implant placement were performed. Deviations between planned and actual implant positions in postoperative CBCT and optical scans were 1.34 mm (SD 0.84 mm) and 1.03 mm (SD 0.46 mm) at implant shoulder; 1.41 mm (SD 0.88 mm) and 1.28 mm (SD 0.52 mm) at implant apex, and 4.84° (SD 3.18°) and 4.21° (SD 2.01°). Measurements in preoperative MRI and postoperative CBCT confirmed the compliance with minimum distances of implants to anatomical structures.ConclusionsRelevant anatomical structures for imaging diagnostics in implant dentistry are displayed with MRI. The accuracy of MRI‐based fully guided implant placement in vitro is comparable to the workflow using CBCT.