Using material extrusion 3D printing for static computer-assisted implant surgery: An in vitro accuracy study

Gamba, DiegoDiaz; Talmazov, Georgi; Bagratuni, Malte; Rothlauf, Severin; Bohner, Lauren; Schmidt, Franziska; Sesma, Newton; Pieralli, Stefano

Abstract

Objective: This study evaluated the accuracy of static computer-assisted implant surgery (sCAIS) using commercial implant planning software (Blue Sky Plan 4) combined with material extrusion (ME) and digital light processing (DLP) 3D printing technologies. Methods: A mandibular typodont model with three missing teeth was used in the virtual implant planning software. Surgical guides were designed in a splint-type configuration and fabricated using ME and DLP. A total of 40 implants were placed following a fully-guided protocol. Accuracy was assessed by measuring coronal, apical, and angular deviations, and depths using digital superimposition and 3D analysis. Statistical analysis was applied to assess the influence of 3D printing technology and implant site. The significance level was set at alpha=0.05. Results: No statistically significant differences existed between ME and DLP technologies for angular, coronal, or apical deviations and depths (p > 0.05). However, the implant site significantly influenced accuracy, with statistical differences found for coronal (p < 0.01) and apical (p < 0.01) deviations. No significant interaction occurred between the fabrication method and the implant site. Conclusion: The utilization of ME 3D printing is an accurate and cost-effective solution for sCAIS manufacturing. Despite some variability, it simplifies the workflow and increases patient access to guided implant treatments. Clinical significance: Material extrusion (ME) 3D printing offers a clinically acceptable and accurate alternative to resin-based technologies for fabricating surgical guides. By eliminating complex chemical post-processing and reducing equipment costs, the ME workflow provides a simplified, cost-effective solution that can improve patient access to static computer-assisted implant surgery (sCAIS).