To evaluate the accuracy and clinical outcome of a realtime navigation system for the implant placement in insufficient alveolar bone in the mandibular posterior area.

In the study, 23 patients with the loss of mandibular posterior teeth were retrospectively analyzed in department of stomatology, the First Affiliated Hospital of Sun Yat-sen University, from January 2021 to December 2021. Cone-beam computed tomography (CBCT) was performed by wearing registration devices, and the position of the implants was designed. Then implants were placed for each case with the aid of dynamic real-time navigation. The preoperative design scheme and the postoperative CBCT were imported into the dynamic navigation accuracy verification software. The differences of implant accuracy between the designed and the actually placed implants were analyzed, including the mean entry point, apex point and depth deviation as well as overall angular discrepancy. SPSS 23.0 statistical software was used to analyze the data on the accuracy deviation. The measurement data in this study were in accordance with normal distribution and were described by mean ± standard deviation.

In this study, 25 implants were implanted in the mandibular posterior area under the guidance of a computer-aided dynamic navigation system, and good primary stability was obtained. Postoperative CBCT showed the precise implant planning position, avoiding the damage to nearby anatomical structures such as inferior alveolar nerve, and surgical complications. The mean entry point discrepancy of 25 implants was (0.23 ± 0.11) mm, whereas the deviations at the apex point, in the depth and axis were (0.45 ± 0.29) , (0.33 ± 0.32) mm and (1.01° ± 0.65°) , respectively.

Implant placement in the insufficient alveolar bone in the mandibular posterior area can be achieved with high accuracy and predictable clinical outcome under the guidance of a realtime navigation system.