Genauigkeitsanalyse zur navigationsgestützten Planung und Insertion von dentalen Implantaten in Unterkieferkunststoffmodellen

The surgical insertion of dental implants requires careful preoperative diagnostics. Particularly, in morphologically difficult situations a CT scan is most useful for the true to scale three-dimensional imaging of the alveolar process and the implant planning. Using a navigation system we are enabled to transfer the preoperative planning and simulation accurately into the operating situs. In this study we examined the suitability and accuracy of the at present commercially available navigation system STN (Surgical Tool Navigator, Carl Zeiss, Oberkochen, Germany) and the software STP 4 (Leibinger, Freiburg, Germany) for the use in dental implant surgery. CT data sets adjusted to 1.5/1.5/1.0 of 20 lower jaw phantom models were made. Under guidance of the navigation system, 100 implants altogether were inserted into 20 lower jaws. By means of image fusion the preoperative and postoperative CT scans could be compared and thus the deviation between the preceded planning and the result after operation measured in different axial layers.When using 5 fiducial marker we achieved a by the system calculated localization accuracy of 0.79 +/0.25 mm. The precise accuracy, i.e. the deviation of the operation result from the preceded planning, amounts to 0.68 +/0.63 mm in our investigation.With the described system configuration it was possible to achieve a sufficient accuracy for this specific indication. By extending the software by specific planning tools it could be adapted and improved.