Introduction: With the use of computer-aided design/computer-aided manufacturing (CAD/CAM), along with cone beam computed tomography (CBCT), clinicians can have a static surgical guide fabricated to aid in the placement of implants. Dynamic navigation forgoes the step of fabricating a static surgical guide. A new software and protocol have been created for dynamic navigation surgery. Data for the accuracy of this protocol on fully edentulous arches is limited and therefore leads us to this study.

Purpose: The aim of this study is to compare the accuracy of implant placement in an edentulous ridge using static tissue level surgical guides vs. dynamic navigation using the edentulous surgical protocol.

Materials and Methods: Virtually planned implants were placed in edentulous mandibular models with either a 3D printed static tissue level surgical guide (n = 24) or by using dynamic navigation (n = 24) (X-Guide, X-Nav Technologies, LLC, Lansdale, PA). Post-operative CBCT scans were taken of models and the position of the implants were compared for accuracy against the original virtual plan to determine deviations.

Results: The results showed mean deviations of 4.25° ± 2.01° angular, 2.47 ± 0.82 mm global platform and 2.88 ± 0.69 mm global apical with the use of tissue level surgical guides. The dynamic navigation group had deviations of 0.80° ± 0.38° angular, 1.84 ± 0.60 mm global platform and 1.84 ± 0.57 mm global apical. Statistically significant differences in deviations were found for the parameters of angular (p = <.001), global platform (p = 0.004) and global apical (p = <.001). Conclusion: The accuracy of implant placement was shown to be more accurate when using dynamic navigation when compared to a tissue level surgical guide. The clinical relevance of this study is that treatment planning time could be decreased. Also, changes can be made to the surgical plan at the time of surgery, this could be done chairside and then the clinician would still be able to continue with a completely guided surgery

LLU Discipline





School of Dentistry

First Advisor

Yoon Jeong Kim

Second Advisor

Dwight Rice

Third Advisor

Brian Goodacre

Degree Name

Doctor of Science (DSc)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Computer-Aided Design; Cone-Beam Computed Tomography -- methods; Dental Implantation -- methods; Patient Care Planning; Surgery, Computer-Assisted; Mouth, Edentulous



Page Count

ix, 29 p.

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives