Relevance of the Operator’s Experience in Conditioning the Static Computer-Assisted Implantology: A Comparative In Vitro Study with Three Different Evaluation Methods

Gerardo Pellegrino 1,* , Giuseppe Lizio 1 , Filippo D’Errico 1, Agnese Ferri 1, Annalisa Mazzoni 1, Federico Del Bianco 1, Luigi Vito Stefanelli 2 and Pietro Felice 1

Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, 40100 Bologna, Italy
2 Department of Oral and Maxillo-Facial Sciences, Sapienza, University of Rome, 00100 Rome, Italy Correspondence should be addressed to Gerardo Pellegrino: gerardo.pellegrino2@unibo.it Received 28 July 2022; Accepted 20 September 2022; Published 23 September 2022 Academic Editor: Bruno Chrcanovic
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Abstract

The present study aimed to evaluate the influence of manual expertise on static computeraided implantology (s-CAI) in terms of accuracy and operative timings. After the cone-beam CT (CBCT) scanning of eleven mandibular models, a full-arch rehabilitation was planned, and two different skilled operators performed s-CAI. The distances between the virtual and actual implant positions were calculated considering the three spatial vectorial axes and the three-dimensional Euclidean value for the entry (E) and apical (A) points, along with the axis orientation differences (Ax). These values emerged from the overlapping of the pre-op CBCT to post-op CBCT data (method 1), from scanning the data from the laboratory scanner (method 2), and from the intra-oral scanner (method 3) and were correlated with the operators’ expertise and operative timings. The mean values for accuracy from the three methods were: E = 0.57 (0.8, 0.45, 0.47) mm, A = 0.6 (0.8, 0.48, 0.49) mm, and Ax 1.04 (1.05,1.03,1.05) for the expert operator; and E = 0.8 (0.9, 0.87, 0.77), A = 0.95 (1.02, 0.95, 0.89), and Ax =1.64 (1.78, 1.58, 1.58) for the novice. The mean value of the operative timings was statistically inferior for the expert operator (p < 0.05), with an improved accuracy over time for both operators. A significant difference (p < 0.05) emerged between method 1 and methods 2 and 3 for seven of the nine variables, without differences between the evaluations from the two scanners. The support from digital surgical guides does not eliminate the importance of manual expertise for the reliability and the shortening of the surgical procedure, and it requires a learning pathway over time.

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