Comparison of Accuracy of Static Surgical Guide Versus Dynamic Navigation System for Implant Placement During Inferior Alveolar Nerve Bypass: An In Vitro Study

Abstract

Background: Precise implant placement is crucial during inferior alveolar nerve (IAN) bypass in the posterior mandible where bone height above the IAN is limited. This in vitro study compared the accuracy of static computer-assisted implant surgery (sCAIS) and dynamic computer-assisted implant surgery (dCAIS) for implant placement during IAN bypass. Methods: Two cone-beam computed tomography (CBCT) mandibular models with deficient bone height (<7 mm) above the IAN canal, classified as clinical scenario I and clinical scenario II, were used as an in vitro setting. Thirty models per clinical scenario were prepared, after which 60 dental implants were placed in the edentulous area of tooth no. 47. Software-based analysis compared planned and actual implant placements by postoperative CBCT. The two models were compared for deviation in distance to the inferior alveolar nerve (DIAN), entry-3D deviation, entry-2D deviation, apex-3D deviation, apex-vertical deviation, and angular deviation by comparative statistical analysis. Results: Both sCAIS and dCAIS showed less deviation from planned implant position in both scenarios. No statistically significant differences were detected except for angular deviation (sCAIS: 1.73° vs. dCAIS: 1.19°, p = 0.004), including clinical scenario I (sCAIS: 1.65° vs. dCAIS: 1.19°, p = 0.033) and II (sCAIS: 1.98° vs. dCAIS: 1.2°, p = 0.033). Conclusions: Both approaches showed minor deviation in both IAN bypass models, while dCAIS showed better angular control, requiring future in vitro and in vivo research in complex clinical environments.