Targeting Perfection

Scientific Evidence

Navident in the clinical scientific literature
Studies published by October 2020

  

1. Stefanelli, L.V., Pranno, N., De Angelis, F. et al. Navigated Antral Bone Expansion (NABE): a prospective study on 35 patients with 4 months of follow-up post implant loading. BMC Oral Health 20, 273 (2020). https://doi.org/10.1186/s12903-020-01268-3

2. Jain SD, Carrico CK, Bermanis I, Rehil S. Intraosseous Anesthesia using Dynamic Navigation Technology. [published online ahead of print, 2020 Sept 10]. J Endod. 2020; doi.org/10.1016/j.joen.2020.09.001

3. Jain SD, Saunders MW, Carrico CK, Jadhav A, Deeb JG, Myers GL. Dynamically Navigated versus Freehand Access Cavity Preparation: A Comparative Study on Substance Loss Using Simulated Calcified Canals. J Endod. 2020 Aug 11:S0099-2399(20)30578-1. doi: 10.1016/j.joen.2020.07.032. Epub ahead of print. PMID: 32795551.

4. Deeb JG, Frantar A, Deeb GR, Carrico CK, Rener-Sitar K. In Vitro Comparison of Time and Accuracy of Implant Placement Using Trephine and Conventional Drilling Techniques Under Dynamic Navigation [published online ahead of print, 2020 Aug 11]. J Oral Implantol. 2020;10.1563/aaid-joi-D-19-00125. doi:10.1563/aaid-joi-D-19-00125

5. Stefanelli, L.V.; Mandelaris, G.A.; Franchina, A.; Pranno, N.; Pagliarulo, M.; Cera, F.; Maltese, F.; Angelis, F.D.; Carlo, S.D. Accuracy of Dynamic Navigation System Workflow for Implant Supported Full Arch Prosthesis: A Case Series. Int. J. Environ. Res. Public Health 2020, 17, 5038.

6. Deeb GR, Tran DQ, Deeb JG. Computer-Aided Planning and Placement in Implant Surgery. Atlas Oral Maxillofac Surg Clin North Am. 2020;28(2):53-58. doi:10.1016/j.cxom.2020.05.001

7. Stefanelli LV, Mandelaris GA, Franchina A, et al. Accuracy Evaluation of 14 Maxillary Full Arch Implant Treatments Performed with Da Vinci Bridge: A Case Series. Materials (Basel). 2020;13(12):E2806. Published 2020 Jun 22. doi:10.3390/ma13122806

8. Gambarini G, Galli M, Morese A, et al. Precision of dynamic navigation to perform endodontic ultraconservative access cavities: a preliminary in vitro analysis [published online ahead of print, 2020 Jun 15]. J Endod. 2020;S0099-2399(20)30385-X. doi:10.1016/j.joen.2020.05.022

9. Gambarini G, Galli M, Morese A, Abduljabbar F, Seracchiani M, Stefanelli LV, Giovarruscio M, Di Nardo D, Testarelli L. Digital Design of Minimally Invasive Endodontic Access Cavity. Appl. Sci. 2020, 10, 3513.

10. Jain SD, Carrico CK, Bermanis I. 3-Dimensional Accuracy of Dynamic Navigation Technology in Locating Calcified Canals. J Endod. 2020;46(6):839-845. doi:10.1016/j.joen.2020.03.014

11. Stefanelli LV, Mandelaris GA, DeGroot BS, Gambarini G, De Angelis F, Di Carlo S. Accuracy of a Novel Trace-Registration Method for Dynamic Navigation Surgery. Int J Periodontics Restorative Dent. 2020 May/Jun;40(3):427-435. doi: 10.11607/prd.4420. PubMed PMID: 32233198.

12. Chen YT, Chiu YW, Peng CY. Preservation of Inferior Alveolar Nerve Using the Dynamic Dental Implant Navigation System. J Oral Maxillofac Surg. 2020 Jan 22. pii: S0278-2391(20)30022-7. doi: 10.1016/j.joms.2020.01.007. [Epub ahead of print] PubMed PMID: 32061618.

13. Aydemir CA, Arisan V. Accuracy of dental implant placement via dynamic navigation or the freehand method: A split-mouth randomized controlled clinical trial. Clin Oral Implants Res. 2020;31(3):255‐263. doi:10.1111/clr.13563

14. Zubizarreta-Macho Á, Muñoz AP, Deglow ER, Agustín-Panadero R, Álvarez JM. Accuracy of Computer-Aided Dynamic Navigation Compared to Computer-Aided Static Procedure for Endodontic Access Cavities: An in Vitro Study. J Clin Med. 2020 Jan 2;9(1). pii: E129. doi: 10.3390/jcm9010129. PubMed PMID: 31906598; PubMed Central PMCID: PMC7019931.

15. Mediavilla Guzmán A, Riad Deglow E, Zubizarreta-Macho Á, Agustín-Panadero R, Hernández Montero S. Accuracy of Computer-Aided Dynamic Navigation Compared to Computer-Aided Static Navigation for Dental Implant Placement: An In Vitro Study. J Clin Med. 2019 Dec 2;8(12). pii: E2123. doi: 10.3390/jcm8122123. PubMed PMID: 31810351; PubMed Central PMCID: PMC6947513.

16. Chen JT. A Novel Application of Dynamic Navigation System in Socket Shield Technique. J Oral Implantol. 2019 Oct;45(5):409-415. doi:10.1563/aaid-joi-D-19-00072. Epub 2019 Aug 7. PubMed PMID: 31389753

17. Gambarini G, Galli M, Stefanelli LV, Di Nardo D, Morese A, Seracchiani M, De Angelis F, Di Carlo S, Testarelli L. Endodontic Microsurgery Using Dynamic Navigation System: A Case Report. DOI: https://doi.org/10.1016/j.joen.2019.07.010

18. Golob Deeb J, Bencharit S, Carrico CK, Lukic M, Hawkins D, Rener-Sitar K, Deeb GR. Exploring training dental implant placement using computer-guided implant navigation system for predoctoral students: a pilot study. Eur J Dent Educ. 2019 May 29. doi: 10.1111/eje.12447. [Epub ahead of print] PubMed PMID: 31141291.

19. Chong BS, Dhesi M, Makdissi J. Computer-aided dynamic navigation: a novel method for guided endodontics. Quintessence Int. 2019;50(3):196-202. doi: 10.3290/j.qi.a41921. PubMed PMID: 30773571.

20. Stefanelli LV, DeGroot BS, Lipton DI, Mandelaris GA. Accuracy of a Dynamic Dental Implant Navigation System in a Private Practice. Int J Oral Maxillofac Implants. 2019 January/February;34(1):205–213. doi: 10.11607/jomi.6966. Epub 2018 Dec 5. PubMed PMID: 30521660.

21. Jorba-García A, Figueiredo R, González-Barnadas A, Camps-Font O, Valmaseda-Castellón E. Accuracy and the role of experience in dynamic computer guided dental implant surgery: An in-vitro study. Med Oral Patol Oral Cir Bucal. 2019 Jan 1;24(1):e76-e83. doi: 10.4317/medoral.22785. PubMed PMID: 30573712; PubMed Central PMCID: PMC6344002.

22. Mandelaris GA, Stefanelli LV, DeGroot BS. Dynamic Navigation for Surgical Implant Placement: Overview of Technology, Key Concepts, and a Case Report. Compend Contin Educ Dent. 2018 Oct;39(9):614-621; quiz 622. Review. PubMed PMID: 30299111.

23. Taniguchi Y, Tsuzuki T, Kakura K, Yoneda M, Isshi K, et al. (2018) Research Concerning Abutment Placement Training using a Navigation System. Dentistry 8: 517. doi:10.4172/2161-1122.1000517.

24. Jokstad A, Winnett B, Fava J, Powell D, Somogyi-Ganss E. Investigational Clinical Trial of a Prototype Optoelectronic Computer-Aided Navigation Device for Dental Implant Surgery. Int J Oral Maxillofac Implants. 2018 May/Jun;33(3):679-692. doi: 10.11607/jomi.6351. PubMed PMID: 29763504.

25. D’haese J, Ackhurst J, Wismeijer D, De Bruyn H, Tahmaseb A. Current state of the art of computer-guided implant surgery. Periodontol 2000. 2017 Feb;73(1):121-133. doi: 10.1111/prd.12175. Review. PubMed PMID: 28000275.

26. Somogyi-Ganss E, Holmes HI, Jokstad A. Accuracy of a novel prototype dynamic computer-assisted surgery system. Clin Oral Implants Res. 2015 Aug;26(8):882-890. doi: 10.1111/clr.12414. Epub 2014 May 19. PubMed PMID: 24837492.

Featured scientific studies

Latest scientific studies

Dynamically Navigated versus Freehand Access Cavity Preparation – A Comparative Study on Substance Loss using Simulated Calcified Canals

Accuracy Evaluation of 14 Maxillary Full Arch Implant Treatments Performed with Da Vinci Bridge: A Case Series

Dynamic Navigation for Surgical Implant Placement Overview of Technology, Key Concepts, and a Case Report

Research Concerning Abutment Placement Training using a Navigation System

Advantages of Navigated dental implant surgery – quotes from scientific medical publications

  1. Reduces errors. With Navident, implants are typically placed 3 times more accurately than freehand, providing increased safety and improved esthetics
  • Image-guided insertion of dental implants is significantly more accurate than manual insertion.11
  • There are situations where highly accurate implantation is mandatory: when there is relatively little amount of bone available, so that malpositioning of the implant would result in perforation of the cortical bone, the mandibular nerve or the schneiderian membrane, systems for guidance of the implantologist can give additional safety.11
  • Computer-navigated surgery may optimize several treatment processes, and with appropriate training, experience, and pre-surgical planning, could be useful in situations where there is complex anatomy and where minimally invasive surgery is desirable. 2
  • Computerized planning might even allow for the provision of implant therapy where complex anatomical limitations had previously precluded treatment. 2
  • For improved accuracy, implants should be inserted in a fully guided manner (versus guided implant bed preparation alone) whenever possible. 1
  • The prototype dynamic CAS system was comparably accurate to static CAS systems.9
  • Dynamic intraoperative navigation systems that reproduce the virtual implant position in real-time and allow intraoperative changes in implant position had a mean error at entry point of 0.62 mm with a maximum error of 3.4 mm. The same systems demonstrated a mean error of 0.68 mm at the apex with a maximum error of 3.5 mm. Nonetheless, it is interesting that they are more accurate than CAD/CAM surgical guides. This is because of the fact that if an error is encountered during the drilling process using a dynamic guide, the clinician can recognize the issue in real-time and make adjustments as needed. By contrast, when using a CAD/CAM guide, clinicians, particularly those with less experience, may not recognize an inaccuracy in osteotomy position, inclination, or depth.6
  • In areas of complex anatomy, computer-aided navigational surgery is definitely superior to conventional implant surgery in treatment planning and avoiding iatrogenic injuries.12
  • The use of computer-aided navigation technology can contribute to considerable quality improvement. Preoperative planning is exactly realized and intraoperative safety is increased, because damage to nerves or neighboring teeth can be avoided.13
  • The accurate reporting of the exact position of the drilling bur should minimize the potential risk of damage to critical anatomic structures. The accurate intraoperative navigation allows the surgeon to precisely transfer the presurgical plan to the patient.14
  • The benefit of the navigation technology relies on the ability to control depths, position and angle of the implant. The bone density can be evaluated within the CT-data intra-operatively to avoid an implant malpositioning in such a way that primary stability is not given. Navigation technology provides the ability to accurately pre-plan implant treatment.15
  1. Reduces or eliminates the need for bone augmentation in marginal cases, saving time, cost, pain and hassles.
  • By visualizing bone volume preoperatively, it may be possible to place implants more precisely in the available bone, with a consequent reduction in any grafting requirements. 2
  • Bone augmentation procedures may be avoided or reduced by optimizing implant positioning in accessible bone (Fortin et al. 2009).4
  • Navigation systems provide ability to re-localize the position of implant bodies; excisions to expose the implant after the healing period can then be performed minimally invasively.15
  1. Enables flapless drilling, which reduces chair time, patient trauma, pain, and recovery time.
  • Computerized planning also helps avoid anatomical complications and can be used with flapless surgery, which can lead to reduced morbidity. 2
  • Guided surgery may be utilized with a flapless or raised flap approach. 1
  • A clinical advantage with flapless guided surgery is that the technique is likely to decrease pain and discomfort in the immediate postoperative period.4
  • One of the advantages of guided implant surgery is reduced complications associated with implant placement in flapless procedures versus non-guided procedures.7
  • A minimally invasive trans-gingival approach using navigational guidance on the basis of preoperative image data is possible. This is helpful in high-risk patients, such as cardiovascular patients with anticoagulation medication. Finally, navigation systems may reduce the operating time.15
  1. Enables immediate loading of temporary restorations prepared in advance of the implantation, reducing chair time and patient discomfort.
  • Guided surgery may be used with different loading protocols, in partially and fully edentulous indications. 1
  • They can also be used for the optimization of implant placement in critical esthetic cases and for immediate loading with preformed restorations.
  1. Maximizes planning flexibility. The plan can be modified at any time, even during operation.
  • Optical tracking systems seem to be more accurate and have more flexibility during surgery but require more training for the staff. 5
  • Unlike static guides, changes to implant position can be made during operation, and still maintain fully navigated implant insertion.8
  1. Reduces dentist anxiety
  • With navigational technology, implant surgery need not be “blind”. With real-time direct virtual vision, both surgeons and patients are reassured of surgical safety. This increases the confidence and reduces surgical stress in both the patient and the clinician.12
  1. Improves prosthetic outcome
  • The subsequent improved accuracy of implant placement should improve the prosthetic outcome and could also facilitate prefabrication of the prosthesis. 2
  1. Improves implant survival rates
  • Increased surgical precision may lead to improvements in implant survival rates.2
  • High implant survival rates after only 12 months of observation in different indications and a reasonable level of accuracy.3
  • The limited scientific evidence available suggests that guided placement has at least as good implant survival as conventional protocols. 4
  1. Price – Specific advantage of Navident
  • Dynamic navigation systems have largely been abandoned mainly due to cost of implementation. Nonetheless, it is interesting that they are more accurate than CAD/CAM surgical guides.10
  1. Other
  • In time, these systems might have the potential as teaching tools.2

References

  1. Consensus Statements and Recommended Clinical Procedures Regarding Contemporary Surgical and Radiographic Techniques in Implant Dentistry. Bornstein MM, Al Nawas B, Kuchler U, Tahmaseb A. Int J Oral Maxillofac Implants. 2013 Aug 15. doi: 10.11607/jomi.2013.g1
  2. Consensus statements and recommended clinical procedures regarding computer-assisted implant dentistry. Hämmerle CH1, Stone P, Jung RE, Kapos T, Brodala N. Int J Oral Maxillofac Implants. 2009;24 Suppl:126-31.
  3. Computer technology applications in surgical implant dentistry: a systematic review. Jung RE, Schneider D, Ganeles J, Wismeijer D, Zwahlen M, Hämmerle CH, Tahmaseb A. Int J Oral Maxillofac Implants. 2009;24 Suppl:92-109.
  4. Clinical advantages of computer-guided implant placement: a systematic review. Hultin M, Svensson KG, Trulsson M. Clin Oral Implants Res. 2012 Oct;23 Suppl 6:124-35
  5. Computer-aided manufacturing technologies for guided implant placement. Neugebauer J, Stachulla G, Ritter L, Dreiseidler T, Mischkowski RA, Keeve E, Zöller JE. Expert Rev Med Devices. 2010 Jan;7(1):113-29. doi: 10.1586/erd.09.61. Review.
  6. Glossary of Oral and Maxillofacial Implants. Laney WR, ed in chief. Chicago, IL: Quintessence Publishing Co, Ltd; 2007. (in 2013 Assessing Image-Guided Implant Surgery in Today’s Clinical Practice)
  7. Flapless surgery and its effect on dental implant outcomes. Brodala N. Int J Oral Maxillofac Implants. 2009;24(suppl):118-125. (in 2013 Assessing Image-Guided Implant Surgery in Today’s Clinical Practice)
  8. Accuracy of implantation using the RoboDent navigation system: a prospective, multicentric, clinical observation. Doctoral Thesis of Juliane Ernst, Department of Medicine – Charité – University Medicine Berlin, June 2008
  9. Somogyi-Ganss E, Holmes HI, Jokstad A. Accuracy of a novel prototype dynamic computer-assisted surgery system. Clin. Oral Impl. 2014 May 19. doi: 10.1111/clr.12414
  10. Norkin FJ, Ganeles J, Zfaz S, Modares A. Assessing image-guided implant surgery in today’s clinical practice. Compend Contin Educ Dent. 2013 Nov-Dec;34(10):747-50; quiz 751
  11. Accuracy of image-guided implantology. Brief J, Edinger D, Hassfeld S, Eggers G. Clin Oral Implants Res. 2005 Aug;16(4):495-501.
  12. Computer-assisted navigational surgery enhances safety in dental implantology. Ng FC, Ho KH, Wexler A. Ann Acad Med Singapore. 2005 Jun;34(5):383-8.
  13. Computer-aided navigation in dental implantology: 7 years of clinical experience. Ewers R Schicho K, Truppe M, Seemann R, Reichwein A, Figl M, Wagner A. J Oral Maxillofac Surg. 2004 Mar;62(3):329-34.
  14. Navigation surgery for dental implants: assessment of accuracy of the image guided implantology system. Casap N, Wexler A, Persky N, Schneider A, Lustmann J. J Oral Maxillofac Surg. 2004 Sep;62(9 Suppl 2):116-9.
  15. Accuracy of navigation-guided socket drilling before implant installation compared to the conventional free-hand method in a synthetic edentulous lower jaw model. Hoffmann J, Westendorff C, Gomez-Roman G, Reinert S. Clin Oral Implants Res. 2005 Oct;16(5):609-14.