Comparative Evaluation of the Accuracy and Occlusal Equilibrium of Dynamically Navigated Implants in Immediate Extraction Sockets with Freehand Immediate Implant Placement: A Randomized Clinical Trial
Citation Information :
Selvaganesh S, Nesappan T, Cinderella R. Comparative Evaluation of the Accuracy and Occlusal Equilibrium of Dynamically Navigated Implants in Immediate Extraction Sockets with Freehand Immediate Implant Placement: A Randomized Clinical Trial. Int J Prosthodont Restor Dent 2025; 15 (1):41-50.
Purpose: To compare and evaluate the accuracy and occlusal equilibrium of dynamically navigated implants in immediate extraction sockets with freehand immediate implant placement.
Materials and methods: Patients requiring immediate implant placement were allocated into two groups: group I (immediate implants placed under dynamic navigation) and group II (immediate implants placed using freehand). A total of 30 implants were placed (n = 15) in each group. The placements of the immediate implants were carried out under dynamic guidance using Navident software. The deviations in placement were assessed by matching the planning data with the post-placement cone-beam computed tomography (CBCT) image. The linear and angular deviations were the primary outcome variables. Other outcome measures were occlusal equilibrium, operative complications, and prosthetic loading complications. Shapiro–Wilk's test was done to assess the normality of the data, and a t-test was used to assess the accuracy between the techniques. Other outcome parameters were represented in percentages.
Results: The accuracy of planned and placement sites at the entry point was statistically significant (p = 0.05). The dynamic navigation group demonstrated superior accuracy, with a mean deviation of 0.92 ± 0.93 mm, compared to the freehand implant placement group (3.06 ± 1.3 mm). There was no statistically significant difference in the linear (dynamic navigation: 1.18 ± 0.92 mm; freehand: 2.6 ± 1.3 mm) and angular deviations (dynamic navigation: 1.5 ± 1.5°; freehand: 4.4 ± 4.1°). The most common surgical complication encountered was recalibration, occurring in 40% of cases. However, occlusal equilibrium analysis revealed no necessary adjustments to the crowns for implants placed using dynamic navigation.
Conclusion: Within the limitations of the study, it can be concluded that dynamic navigation can serve as an alternative to freehand placement. It enhances implant placement accuracy, particularly in challenging immediate extraction sites where achieving the correct prosthetic position can be difficult. Immediate implant placements under dynamic navigation help in increasing the accuracy and reducing the offset forces.
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