Accuracy Comparison of Guided Implant Placement Between Tooth and Mucosal Supported Stereolithographic Models in the Maxillary Arch. (An experimental study)

Objective: Employing stereolithographic surgical guides is highly beneficial for enhancing and analyzing implant position accuracy. This study aimed to differentiate between the accuracy of implant position with two different models employing guided surgery based on the support level (tooth-mucosa). Methods: A total of 80 implants were virtually planned and surgically positioned on twenty maxillary dental arches utilizing two distinct stereolithographic models (40 using tissue and 40 using tooth supported surgical guides). Four virtual implants were planned for each dental arch in the implant planning software. Accuracy measurement was made possible by matching process within the software between virtually planned and actually positioned implants, utilizing radiographic markers in the maxillary arch as matching points. Measuring was carried out at the center of the implant hexagon, apex and angle deviations. Results: The overall difference between tooth- and mucosa-supported surgical models for angular and apical deviations was not statistically significant except for hexagonal deviation, which showed (P <0.001), where the mean distance deviations at the hexagons and apices level showed 1.24 ± 0.38 mm and 1.22 ± 0.51 mm for the guides supported by teeth, and 1.83 ±1.09 mm and 1.24 ±0.69 mm for the guides supported by mucosa. The angular deviation for tooth- and mucosa-supported guides measured 4.38 ± 3.22 and 3.9 ±2.61 degrees, respectively. Conclusions: Based on this study’s results, it is concluded that there is a correlation between implant placement accuracy and the type of surgical guide support. Specifically, surgical guides supported by mucosa showed lower accuracy at the hexagon level compared to those supported by tooth structures. The resiliency of the mucosa may influence implant placement accuracy and subsequent prosthetic plan.