Accuracy of Static Computer-assisted Implant Surgery in Distal Free-end Scenarios

NCT ID: NCT06404385

Last Updated: 2025-09-05

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

27 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-09-11

Study Completion Date

2019-12-17

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Technological advances have influenced the approach to implant treatment. One of the fields presently experiencing rapid development is static computer-assisted guided surgery (sCAIS), which allows transfer of the virtual implant planning to the mouth of the patient, based on the use of a surgical guide. In sCAIS there is a deviation between the virtually planned implant position and the actual position of the implant placed during surgery. A recent review analyzed only fully guided implants and recorded a mean coronal horizontal deviation (CHD) of 1.12 mm (standard deviation \[SD\] = 0.08), a mean apical horizontal deviation (AHD) of 1.41 mm (SD = 0.1), a mean vertical deviation (VD) of 0.12 mm (SD = 0.23), and a mean angular deviation (AD) of 3.58º (SD = 0.2).

The aim of the present study was to compare the accuracy of CAD-CAM and conventional guides in candidates for distal free-end implant treatment, and to analyze the effects of possible confounding factors inherent to the patient or the surgical technique employed.A prospective, controlled and blinded quasi-experimental study was carried out involving 27 patients with 76 implants distributed into two groups according to the surgical guide manufacturing approach used: conventional (control group \[CG\]) or CAD-CAM (test group \[TG\]). The implants were planned virtually with the planning software, and the surgical guides were manufactured. Fully guided implant placement was carried out, and the deviations were measured along with other secondary variables as potential confounding factors.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Planning of the implants is made in the ideal prosthetic position based on a previous CAD-CAM (computer aided design - computer aided manufacturing) wax-up. sCAIS facilitates correct prosthetic emergence and therefore contributes to secure optimum esthetic and biological outcomes, affording long-term stability of the soft and hard tissues.

These surgical guides can be manufactured using CAD-CAM or conventional technologies in the laboratory, employing drilling machines or mechanical positioners. In the case of the conventional guide manufactured in the laboratory, the technician creates a radiological guide that is then converted into a surgical guide - the whole process being analogic, except for planning of the implants. At present, and with the development of digital workflows, CAD-CAM procedures are used for both the design and manufacture of the surgical guide, using different processes. This simplifies the workflow, which can reduce the costs of smaller rehabilitations.

Clinical studies on accuracy published in the literature are heterogeneous, with differences in the systems used, the surgical technique, the type of surgical guide support or the type of edentulism involved.These data justify further research in humans, focusing on fully sCAIS, in order to reduce heterogeneity. Furthermore, a review of the literature revealed a lack of clinical publications on the accuracy of CAD-CAM surgical guides compared to conventional guides. Therefore, the aim of the present study was to compare the accuracy of CAD-CAM and conventional guides in candidates for distal free-end implant treatment, and to analyze the effects of possible confounding factors inherent to the patient or the surgical technique employed. Intra- and postoperative complications of the surgical technique were also evaluated, as well as implant success and peri-implant marginal bone loss. Hence, the null hypothesis of the study was the absence of any difference in accuracy between both guides.

A prospective, controlled, examiner- and statistician-blinded, parallel-arm quasi-experimental study was carried out at the University of Valencia (Valencia, Spain). Two groups were established according to the surgical guide design involved: conventional (control group \[CG\]) or CAD-CAM (test group \[TG\]).

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Dental Implant Computer-assisted

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

A prospective, controlled, examiner- and statistician-blinded, parallel-arm quasi-experimental study
Primary Study Purpose

OTHER

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors
single-blind

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Conventional surgical guide

Implants (Straumann®) placed with an analogic laboratory surgical guide

Group Type ACTIVE_COMPARATOR

Static computer-assisted guided surgery with analogic guide

Intervention Type PROCEDURE

coDiagnostix9® planning software

Computer aided design - computer aided manufacturing (CAD-CAM) surgical guide

Implants (Straumann®) placed with static computer-assisted implant surgery

Group Type EXPERIMENTAL

Static computer-assisted guided surgery with CAD-CAM surgical guide

Intervention Type PROCEDURE

coDiagnostix9® planning software

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Static computer-assisted guided surgery with analogic guide

coDiagnostix9® planning software

Intervention Type PROCEDURE

Static computer-assisted guided surgery with CAD-CAM surgical guide

coDiagnostix9® planning software

Intervention Type PROCEDURE

Other Intervention Names

Discover alternative or legacy names that may be used to describe the listed interventions across different sources.

Conventional laboratory surgical guide gonyX® CAD-CAM surgical guide

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Indication of fixed prosthesis over at least two consecutive implants.
* Sufficient residual crest for placing at least two implants 4.1 mm in diameter and 8 mm in length.
* Mature bone and healthy soft tissues.
* Implants placed via fully guided surgery.
* Age \> 18 years.
* Good general health.
* Non-smokers or smokers of \< 10 cigarettes/day (pipe smokers excluded).
* Oral hygiene index \< 3 and bleeding index \< 25%.
* Pre- and post- CBCT scan for analysis of accuracy.
* Periapical radiographs at loading and after one year.

Exclusion Criteria

* Contraindications to implant therapy
* Locations with acute infection.
* Pregnant or nursing women.
* Lack of follow-up.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

University of Valencia

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Berta García Mira

Assistant Professor of Stomatology

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

MIGUEL PEÑARROCHA-DIAGO, Phd, DDS

Role: STUDY_DIRECTOR

University of Valencia

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

University of Valencia. Faculty of Medecine and Dentistry. CLINICA ODONTOLOGICA

Valencia, Valencia, Spain

Site Status

Countries

Review the countries where the study has at least one active or historical site.

Spain

References

Explore related publications, articles, or registry entries linked to this study.

Balaguer-Marti JC, Canet-Lopez A, Penarrocha-Diago M, Romeo-Rubio M, Penarrocha-Diago M, Garcia-Mira B. Influence of Splint Support on the Precision of Static Totally Guided Dental Implant Surgery: A Systematic Review and Network Meta-analysis. Int J Oral Maxillofac Implants. 2023 Jan-Feb;38(1):157-168. doi: 10.11607/jomi.9796.

Reference Type BACKGROUND
PMID: 37099571 (View on PubMed)

Bover-Ramos F, Vina-Almunia J, Cervera-Ballester J, Penarrocha-Diago M, Garcia-Mira B. Accuracy of Implant Placement with Computer-Guided Surgery: A Systematic Review and Meta-Analysis Comparing Cadaver, Clinical, and In Vitro Studies. Int J Oral Maxillofac Implants. 2018 January/February;33(1):101-115. doi: 10.11607/jomi.5556. Epub 2017 Jun 20.

Reference Type BACKGROUND
PMID: 28632253 (View on PubMed)

Chen X, Yang Z, Wang Y, Fu G. Fixation Pins Increase the Accuracy of Implant Surgery in Free-End Models: An In Vitro Study. J Oral Maxillofac Surg. 2023 May;81(5):593-601. doi: 10.1016/j.joms.2022.12.017. Epub 2023 Jan 28.

Reference Type BACKGROUND
PMID: 36716792 (View on PubMed)

El Kholy K, Lazarin R, Janner SFM, Faerber K, Buser R, Buser D. Influence of surgical guide support and implant site location on accuracy of static Computer-Assisted Implant Surgery. Clin Oral Implants Res. 2019 Nov;30(11):1067-1075. doi: 10.1111/clr.13520. Epub 2019 Aug 20.

Reference Type BACKGROUND
PMID: 31381178 (View on PubMed)

El Kholy K, Janner SFM, Schimmel M, Buser D. The influence of guided sleeve height, drilling distance, and drilling key length on the accuracy of static Computer-Assisted Implant Surgery. Clin Implant Dent Relat Res. 2019 Feb;21(1):101-107. doi: 10.1111/cid.12705. Epub 2018 Dec 27.

Reference Type BACKGROUND
PMID: 30589502 (View on PubMed)

Kessler A, Le V, Folwaczny M. Influence of the tooth position, guided sleeve height, supporting length, manufacturing methods, and resin E-modulus on the in vitro accuracy of surgical implant guides in a free-end situation. Clin Oral Implants Res. 2021 Sep;32(9):1097-1104. doi: 10.1111/clr.13804. Epub 2021 Jul 17.

Reference Type BACKGROUND
PMID: 34218450 (View on PubMed)

Khorsandi D, Fahimipour A, Abasian P, Saber SS, Seyedi M, Ghanavati S, Ahmad A, De Stephanis AA, Taghavinezhaddilami F, Leonova A, Mohammadinejad R, Shabani M, Mazzolai B, Mattoli V, Tay FR, Makvandi P. 3D and 4D printing in dentistry and maxillofacial surgery: Printing techniques, materials, and applications. Acta Biomater. 2021 Mar 1;122:26-49. doi: 10.1016/j.actbio.2020.12.044. Epub 2020 Dec 26.

Reference Type BACKGROUND
PMID: 33359299 (View on PubMed)

Le V, Kessler A, Folwaczny M. Influence of DLP and SLA printer technology on the accuracy of surgical guides for implant dentistry in free-end situations. Int J Comput Dent. 2023 Sep 26;26(3):217-226. doi: 10.3290/j.ijcd.b3774115.

Reference Type BACKGROUND
PMID: 36625374 (View on PubMed)

Matta RE, Bergauer B, Adler W, Wichmann M, Nickenig HJ. The impact of the fabrication method on the three-dimensional accuracy of an implant surgery template. J Craniomaxillofac Surg. 2017 Jun;45(6):804-808. doi: 10.1016/j.jcms.2017.02.015. Epub 2017 Feb 20.

Reference Type BACKGROUND
PMID: 28363503 (View on PubMed)

Putra RH, Yoda N, Astuti ER, Sasaki K. The accuracy of implant placement with computer-guided surgery in partially edentulous patients and possible influencing factors: A systematic review and meta-analysis. J Prosthodont Res. 2022 Jan 11;66(1):29-39. doi: 10.2186/jpr.JPR_D_20_00184. Epub 2021 Jan 26.

Reference Type BACKGROUND
PMID: 33504723 (View on PubMed)

Berta GM, Luigi C, Miguel PD, Carlos BJ. Prospective Clinical Study on the Accuracy of Static Computer-Assisted Implant Surgery in Patients With Distal Free-End Implants. Conventional Versus CAD-CAM Surgical Guides. Clin Oral Implants Res. 2025 Mar;36(3):314-324. doi: 10.1111/clr.14384. Epub 2024 Nov 23.

Reference Type DERIVED
PMID: 39578942 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

H20190402125847

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

SURGICAL GUIDES EFFECTIVENESS
NCT06737289 RECRUITING NA
Accuracy of Half-guided Implant Placement
NCT04854239 COMPLETED PHASE4