Comparison of the accuracy of implant placement between using sleeve-in-sleeve and integrated sleeve-on-drill drilling systems for static computer-assisted implant surgery: a simulation-based experimental study

Objective: To investigate precision of implant placement with sleeve-in-sleeve and sleeve-on-drill static Computer Assisted Implant Surgery (sCAIS) designs. Materials and Methods: 32 models were digitally planned and fabricated simulating a patient with bilateral missing first premolar. 8 models were assigned in each group: Group A, B and C represented sleeve-in-sleeve design with 2, 4 and 6mm sleeve height respectively. Group D represented integrated sleeve-on-drill design with 4 mm sleeve height. All models were scanned with CBCT and desktop optical scanner. 16 implants were planned and placed using sCAIS for each group. 3D deviation of placed and planned position at implant platform, apex and angular deviation were measured. Data was analyzed using one way ANOVA (P ≤ .05). Pairwise comparisons were tested with Turkey HSD test with adjusted P values. Results: The overall deviation at platform ranged from 0.40± 0.14 mm (group A) to 0.73 ± 1.54 mm (group C), at apex from 0.46± 0.16 mm (group A) to 1.07± 0.37 mm (group C) and the angular deviation ranged from 0.86 ± 0.89 degree (group A) to 3.40 ± 1.29 degree (group C). Group A and B showed significantly less deviation than groups C and D (P < .05). There was no statistically significant difference in all parameters measured between group A and B, as well as between group C and D (P > .05). Conclusions: Both sCAIS designs performed within the current benchmarks of precision. Sleeve-in-sleeve sCAIS design demonstrated higher precision than integrated sleeve-on-drill.