Background: The impact of the jaw bone condition, such as bone quantity and quality in the implant placement
site, affecting the accuracy of implant placement with computer-guided surgery (CGS) remains unclear. Therefore,
this study aimed to evaluate the influence of bone condition, i.e., bone density, bone width, and cortical bone
thickness at the crestal bone on the accuracy of implant placement with CGS.
Methods: A total of 47 tissue-level implants from 25 patients placed in the posterior mandibular area were studied.
Implant placement position was planned on the simulation software, Simplant® Pro 16, by superimposing preoperative computed tomography images with stereolithography data of diagnostic wax-up on the dental cast.
Implant placement surgery was performed using the surgical guide plate to reflect the planned implant position.
The post-surgical dental cast was scanned to determine the position of the placed implant. Linear and vertical
deviations between planned and placed implants were calculated. Deviations at both platform and apical of the
implant were measured in the bucco-lingual and mesio-distal directions. Intra- and inter-observer variabilities were
calculated to ensure measurement reliability. Multiple linear regression analysis was employed to investigate the
effect of the bone condition, such as density, width, and cortical bone thickness at the implant site area, on the
accuracy of implant placement (α = 0.05).
Result: Intra- and inter-observer variabilities of these measurements showed excellent agreement (intra class
correlation coefficient ± 0.90). Bone condition significantly influenced the accuracy of implant placement using CGS(p < 0.05). Both bone density and width were found to be significant predictors.
Conclusions: Low bone density and/or narrow bucco-lingual width near the alveolar bone crest in the implant
placement site might be a risk factor influencing the accuracy of implant placement with CG