Evaluation of the Accuracy of Dental Implant Placement on Different Cast Models
Abstract
Introduction: To compare the accuracy of implant placement on mandibular models fabricated from different materials using a single digitally designed surgical guide, and to identify which model provided the highest precision and cost-effectiveness for research and training applications. Materials and Methods: Nine identical mandibular models were fabricated with missing teeth at the right lateral incisor, right first molar, and left first premolar. Three cast models were used: porous polyethylene (MedPor), photopolymer resin (SprintRay), and photopolymer resin (MAZIC® D MODEL). A single CAD/CAM surgical guide was designed in REALGuide 5.3 and printed with SprintRay technology. Using standardized protocols, 27 demo implants (three per model) were placed. Postoperative CBCT scans were digitally superimposed with planned positions to assess angular and linear deviations (coronal, apical, mesial, distal, and labial). The data were analyzed via descriptive statistics, one-way ANOVA, and Tukey’s HSD tests. Results: Analysis revealed a statistically significant deviation at the lateral apical position (ANOVA, p = 0.0011). Porous polyethylene (MedPor) demonstrated greater error than did photopolymer resin (SprintRay) (p = 0.0107) or photopolymer resin (MAZIC® D MODEL) (p = 0.0009), whereas no significant difference was detected between the two resin-based models (p = 0.0775). Although the photopolymer resin (SprintRay) resulted in greater mean deviations at premolar sites, these differences were not statistically significant. Intragroup analysis indicated site-dependent variation within photopolymer resin (MAZIC® D MODEL) (p = 0.0313), whereas porous polyethylene (MedPor) and photopolymer resin (SprintRay) exhibited more consistent error distributions across sites. Conclusion: Photopolymer resin models presented the highest apical accuracy at lateral incisor sites, outperforming porous polyethylene. Resin-based models (SprintRay and MAZIC® D MODEL) proved accurate and cost-effective, whereas porous polyethylene produced larger deviations despite being more than ten times more costly. The two photopolymers also differ in their mechanical properties. Keywords: Apical deviation; Dental implant; Digital implantology; Mandibular model; Surgical guide.
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2. Atay E, Hey J, Beuer F, et al. Evaluation of the accuracy of fully guided implant placement by undergraduate students and postgraduate dentists: a comparative prospective clinical study. Int J Implant Dent. 2024;10:6.
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4. Brånemark PI, Hansson BO, Adell R, et al. Osseointegrated implants in the treatment of the edentulous jaw: experience from a 10-year period. Scand J Plast Reconstr Surg Suppl. 1977;16:1–132.
5. Adell R, Lekholm U, Rockler B, et al. A 15-year study of osseointegrated implants in the treatment of the edentulous jaw. Int J Oral Surg. 1981;10:387–416.
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7. Rasheed M, Mahmood B. Accuracy comparison of guided implant placement between tooth and mucosal supported stereolithographic models in the maxillary arch: an experimental study. Sulaimani Dent J. 2025;12:12–8.
8. Sadowsky SJ. Treatment considerations for maxillary implant overdentures: a systematic review. J Prosthet Dent. 2007;97:340–8.
9. Ku JK, Lee J, Lee HJ, et al. Accuracy of dental implant placement with computer-guided surgery: a retrospective cohort study. BMC Oral Health. 2022;22:8.
10. Papaspyridakos P, Chen CJ, Chuang SK, et al. A systematic review of biologic and technical complications with fixed implant rehabilitations for edentulous patients. Int J Oral Maxillofac Implants. 2012;27:102–10.
11. Romeo E, Storelli S. Systematic review of the survival rate and the biological, technical, and aesthetic complications of fixed dental prostheses with cantilevers on implants reported in longitudinal studies with a mean of 5 years follow-up. Clin Oral Implants Res. 2012;23 Suppl 6:39–49.
12. Wellisz T. Clinical experience with the Medpor porous polyethylene implant. Aesthetic Plast Surg. 1993;17:339–44.
13. Yaremchuk MJ. Facial skeletal reconstruction using porous polyethylene implants. Plast Reconstr Surg. 2003;111:1818–27.
14. Rosenfeld AL, Mandelaris GA, Tardieu PB. Prosthetically directed implant placement using computer software to ensure precise placement and predictable prosthetic outcomes. Part 2: rapid-prototype medical modeling and stereolithographic drilling guides requiring bone exposure. Int J Periodontics Restorative Dent. 2006;26:347–53.
15. Henprasert P, Dawson DV, El-Kerdani T, et al. Comparison of the accuracy of implant position using surgical guides fabricated by additive and subtractive techniques. J Prosthodont. 2020;29:534–41.
16. Gjelvold B, Mahmood DJH, Wennerberg A. Accuracy of surgical guides from 2 different desktop 3D printers for computed tomography-guided surgery. J Prosthet Dent. 2019;121:498–503.
17. Cunha RM, Souza FÁ, Hadad H, et al. Accuracy evaluation of computer-guided implant surgery associated with prototyped surgical guides. J Prosthet Dent. 2021;125:266–72.
18. Marlière DAA, Demètrio MS, Picinini LS, et al. Accuracy of computer-guided surgery for dental implant placement in fully edentulous patients: a systematic review. Eur J Dent. 2018;12:153–60.
19. Ramasamy M, Raja R, Subramonian K, et al. Implant surgical guides: from the past to the present. J Pharm Bioallied Sci. 2013;5 Suppl 1:S98–102.
20. Bover-Ramos F, Viña-Almunia J, Cervera-Ballester J, et al. Accuracy of implant placement with computer-guided surgery: a systematic review and meta-analysis comparing cadaver, clinical, and in vitro studies. Int J Oral Maxillofac Implants. 2018;33:101–15.
21. Tahmaseb A, Wu V, Wismeijer D, et al. The accuracy of static computer-aided implant surgery: a systematic review and meta-analysis. Clin Oral Implants Res. 2018;29 Suppl 16:416–35.
22. Schneider D, Marquardt P, Zwahlen M, et al. A systematic review on the accuracy and the clinical outcome of computer-guided template-based implant dentistry. Clin Oral Implants Res. 2009;20 Suppl 4:73–86.
23. Soares MM, Harari ND, Cardoso ES, et al. An in vitro model to evaluate the accuracy of guided surgery systems. Int J Oral Maxillofac Implants. 2012;27:824–31.
24. Marquez Bautista N, Meniz-García C, López-Carriches C, et al. Accuracy of different systems of guided implant surgery and methods for quantification: a systematic review. Appl Sci. 2024;14:11479.
2. Atay E, Hey J, Beuer F, et al. Evaluation of the accuracy of fully guided implant placement by undergraduate students and postgraduate dentists: a comparative prospective clinical study. Int J Implant Dent. 2024;10:6.
3. Mahmood M, Mahmood B. Clinical, physiological, and psychological evaluation of implant-related full mouth rehabilitation. Sulaimani Dent J. 2023;10:44–51.
4. Brånemark PI, Hansson BO, Adell R, et al. Osseointegrated implants in the treatment of the edentulous jaw: experience from a 10-year period. Scand J Plast Reconstr Surg Suppl. 1977;16:1–132.
5. Adell R, Lekholm U, Rockler B, et al. A 15-year study of osseointegrated implants in the treatment of the edentulous jaw. Int J Oral Surg. 1981;10:387–416.
6. Huang L, Liu L, Yang S, et al. Evaluation of the accuracy of implant placement using implant positional guide versus freehand: a prospective clinical study. Int J Implant Dent. 2023;9:45.
7. Rasheed M, Mahmood B. Accuracy comparison of guided implant placement between tooth and mucosal supported stereolithographic models in the maxillary arch: an experimental study. Sulaimani Dent J. 2025;12:12–8.
8. Sadowsky SJ. Treatment considerations for maxillary implant overdentures: a systematic review. J Prosthet Dent. 2007;97:340–8.
9. Ku JK, Lee J, Lee HJ, et al. Accuracy of dental implant placement with computer-guided surgery: a retrospective cohort study. BMC Oral Health. 2022;22:8.
10. Papaspyridakos P, Chen CJ, Chuang SK, et al. A systematic review of biologic and technical complications with fixed implant rehabilitations for edentulous patients. Int J Oral Maxillofac Implants. 2012;27:102–10.
11. Romeo E, Storelli S. Systematic review of the survival rate and the biological, technical, and aesthetic complications of fixed dental prostheses with cantilevers on implants reported in longitudinal studies with a mean of 5 years follow-up. Clin Oral Implants Res. 2012;23 Suppl 6:39–49.
12. Wellisz T. Clinical experience with the Medpor porous polyethylene implant. Aesthetic Plast Surg. 1993;17:339–44.
13. Yaremchuk MJ. Facial skeletal reconstruction using porous polyethylene implants. Plast Reconstr Surg. 2003;111:1818–27.
14. Rosenfeld AL, Mandelaris GA, Tardieu PB. Prosthetically directed implant placement using computer software to ensure precise placement and predictable prosthetic outcomes. Part 2: rapid-prototype medical modeling and stereolithographic drilling guides requiring bone exposure. Int J Periodontics Restorative Dent. 2006;26:347–53.
15. Henprasert P, Dawson DV, El-Kerdani T, et al. Comparison of the accuracy of implant position using surgical guides fabricated by additive and subtractive techniques. J Prosthodont. 2020;29:534–41.
16. Gjelvold B, Mahmood DJH, Wennerberg A. Accuracy of surgical guides from 2 different desktop 3D printers for computed tomography-guided surgery. J Prosthet Dent. 2019;121:498–503.
17. Cunha RM, Souza FÁ, Hadad H, et al. Accuracy evaluation of computer-guided implant surgery associated with prototyped surgical guides. J Prosthet Dent. 2021;125:266–72.
18. Marlière DAA, Demètrio MS, Picinini LS, et al. Accuracy of computer-guided surgery for dental implant placement in fully edentulous patients: a systematic review. Eur J Dent. 2018;12:153–60.
19. Ramasamy M, Raja R, Subramonian K, et al. Implant surgical guides: from the past to the present. J Pharm Bioallied Sci. 2013;5 Suppl 1:S98–102.
20. Bover-Ramos F, Viña-Almunia J, Cervera-Ballester J, et al. Accuracy of implant placement with computer-guided surgery: a systematic review and meta-analysis comparing cadaver, clinical, and in vitro studies. Int J Oral Maxillofac Implants. 2018;33:101–15.
21. Tahmaseb A, Wu V, Wismeijer D, et al. The accuracy of static computer-aided implant surgery: a systematic review and meta-analysis. Clin Oral Implants Res. 2018;29 Suppl 16:416–35.
22. Schneider D, Marquardt P, Zwahlen M, et al. A systematic review on the accuracy and the clinical outcome of computer-guided template-based implant dentistry. Clin Oral Implants Res. 2009;20 Suppl 4:73–86.
23. Soares MM, Harari ND, Cardoso ES, et al. An in vitro model to evaluate the accuracy of guided surgery systems. Int J Oral Maxillofac Implants. 2012;27:824–31.
24. Marquez Bautista N, Meniz-García C, López-Carriches C, et al. Accuracy of different systems of guided implant surgery and methods for quantification: a systematic review. Appl Sci. 2024;14:11479.
| Files | ||
| Issue | Vol 13, No 2 (Spring 2026) | |
| Section | Original Article(s) | |
| Keywords | ||
| Apical deviation; Dental implant; Digital implantology; Mandibular model; Surgical guide. | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Muwafaq AL Khashali R, Mahmood B. Evaluation of the Accuracy of Dental Implant Placement on Different Cast Models. J Craniomaxillofac Res. 2026;2026(2):178-184.
