Prospective analysis of site-specific accuracy and error sources in dynamically navigated implant surgery.

PURPOSE: This prospective study aimed to analyze the site-specific accuracy of dynamic navigation surgery and quantify the contributory factors of various error sources in implant placement. MATERIALS AND METHODS: Sixty-seven dental implants were placed in 45 patients selected consecutively. The accuracy was evaluated by comparing planned versus actual implant positions, measuring coronal, apical, and angular deviations. Most importantly, the discrepancies in interimplant distances were analyzed for the influence of system and operational errors on the overall inaccuracy. RESULTS: The mean coronal, apical, and angular deviations were 0.98 ± 0.36, 1.23 ± 0.51, and 3.72 ± 3.23 mm, respectively. Beyond validating its overall precision, the findings offered two key advancements: First, the maxillary group demonstrated a significantly lower angle deviation (2.97° ± 1.49°) than the mandibular group (4.50° ± 4.24°, p < 0.05); the apical deviation in the anterior and posterior teeth was 1.01 ± 0.44 versus 1.30 ± 0.51 mm (p < 0.05); and the coronal deviation in the left and right jaws was 0.85 ± 0.34 versus 1.13 ± 0.33 mm (p < 0.05). Most importantly, the interimplant distance deviations were remarkably smaller (the coronal: 0.65 ± 0.53 mm and apical: 0.52 ± 0.30 mm) than global deviations (1.11 ± 0.37 and 1.26 ± 0.54 mm, respectively). CONCLUSIONS: An anatomical implant site significantly influenced the accuracy of dynamic navigation. The analysis of interimplant distances demonstrated that the overall error was predominantly attributable to registration error, whereas the system and the operational errors had a relatively small negative impact.