Angular accuracy in pterygoid implant placement: Evaluating digitally guided surgical systems in the atrophic maxilla

Abstract

Introduction: The rehabilitation of atrophic maxillae presents significant challenges in the posterior maxilla where conventional implant placement cannot be placed due to limited bone volume. Pterygoid implants placed in the dense cortical bone of the pterygoid region offered a reliable alternative. This study evaluates the precision of digitally guided pterygoid implant placement by comparing preplanned virtual implant positions with postoperative outcomes using computer aided design (CAD) software.

Methods: A total of 20 patients with free ended atrophic posterior maxillae underwent implant placement using customized 3D-printed surgical guides designed through CAD software on preoperative CBCT data. Angular deviations between planned and placed implants were evaluated by merging the merged preoperative and postoperative CBCT scans in DICOM files in a CAD software. Descriptive statistical analysis was conducted to determine mean, range, and standard deviation of angular deviations.

Results: Angular deviations ranged from 1.0° to 12.8° with a mean deviation of 4.8° ± 3.1°. These values align with previously reported ranges for guided implant surgery but for shorter implant lengths, confirming the effectiveness of digitally guided systems in achieving precise implant placement.

Conclusion: Digitally guided surgery improves the accuracy of pterygoid implant placement, minimizing angular deviations and optimizing clinical outcomes. However, variability necessitates more refinement of protocols.