A Randomized Controlled Clinical Trial Comparing Conventional and Computer-Assisted Implant Planning and Placement in Partially Edentulous Patients. Part 3: Time and Cost Analyses.

This paper performed time and cost analyses and compared conventional vs computer-assisted implant planning and placement (CAIPP) protocols when placing single implants in partially edentulous patients. Partially edentulous patients were randomly allocated to one of three treatment groups: preoperative planning based on a conventional two-dimensional radiograph and free-hand implant placement (control [C], n = 26) or computer-assisted implant planning based on three-dimensional (3D) computer-tomography (test group 1 [T1], n = 24; test group 2 [T2], n = 23). A surgical guide was produced by stereolithography in T1 and by 3D printing in T2. In all patients, open-flap implant placement procedures were performed. Time and costs derived from each working step were recorded for each treatment protocol. Descriptive and analytic statistics were used to display the data and uncover differences between treatment groups. Overall office time was similar in all groups (C = 63.8 min; T1 = 77.2 min; T2 = 81.7 min). CAIPP and conventional protocols required similar times to perform the preoperative diagnosis, radiographic exam, and implant surgery. CAIPP protocols required longer surgical planning and template-production times. Overall economic costs were 31% (T1) to 20% (T2) higher for the CAIPP protocols due to the radiographic investigation and the surgical template production (C = Swiss francs [CHF] 1,567; T1 = CHF 2,268; T2 = CHF 1,946). In the present indication and methodologic set-up, computer-assisted protocols did not show an advantage over conventional protocols in terms of time or financial savings. The temporal and financial expenses should be put into perspective to potential benefits.