Application and nursing cooperation of immediate implant placement supported by dynamic navigation: a retrospective study

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Therefore, standardized and smooth doctor-nurse cooperation is particularly important. The purpose of this study is to summarize the practical application of dynamic navigation system in immediate implant placement (IIP), and to preliminarily discuss the perioperative nursing cooperation. Methods In this study, 40 patients who underwent IIP using a dynamic navigation system in the Department of dentistry of our hospital from 1 January 2021 to 31 March 2024 were collected and the postoperative implantation accuracy was measured, including cervical deviation, apical deviation, depth deviation and angular deviation, and the key points of nursing cooperation were summarised. Results 62 implants were successfully placed in 40 patients, and all implants had good initial stability. The deviations of the neck and root under navigation guidance were (1.36 ± 0.65) mm and (1.48 ± 0.65) mm, respectively, and the angular deviation was (3.71 ± 1.32) °. Patients were generally satisfied with the results of the implantation and no serious complications occurred. Conclusion The dynamic navigation system can improve the precision and success rate of IIP. The preoperative quality nursing care, the full preparation of instruments and items, and the skilled operative nursing coordination can improve the surgical efficiency and reduce complications. Clinical trial number: not applicable Dynamic Navigation System Immediate Implant Placement Nursing Coordination Accuracy Figures Figure 1 Figure 2 Figure 3 Figure 4 1 Background Following the loss of a tooth, the chewing function of patient will be significantly impaired and the alveolar bone will also be subject to progressive resorption. Although traditional delayed dental implant techniques can effectively restore missing teeth, this method requires patients to undergo a long waiting period, and due to the resorption of the alveolar bone, dental implant techniques can face numerous difficulties during implementation 1 . In contrast, immediate implant placement, where tooth extraction and implant placement are performed simultaneously, has shown significant advantages. Compared to traditional tooth planting technology, IIP can significantly shorten the repair process, effectively reducing the time and cost burden on patients 2 , 3 . However, it should be noted that in practice, the IIP often results in implant site drift due to the guiding effect of the extraction socket slope. Incorrect implant positioning can lead to a number of restorative complications and adversely affect the treatment outcome 4 , 5 . Therefore, the improvement of implant placement accuracy during IIP and the assurance of accurate implant placement has become a key issue to be solved in the field of dental implantology. With the advancement of computer technology, dynamic real-time navigation systems have also been utilized in the field of dental implants. In recent years, the development and implementation of digital technology in stomatology medical domain has led to numerous advantages associated with digital assisted immediate implant placement (IIP), including a focus on restorative and biologically oriented implant design, minimally invasive surgical procedures and more precise results can be achieved 6 , 7 . However, dynamic navigation technology is used in implant surgery, which involves many instruments and complex procedures 8 , 9 . Therefore, standardised and efficient cooperation between doctors and nurses is particularly important. Since the application of the dental implant navigation system, our hospital has vigorously promoted its clinical application. Under the guidance of navigation, 40 cases of immediate maxillary implantation have been successfully completed. With appropriate nursing care during the perioperative period, all implants were successfully and accurately placed. In order to provide a reference for clinical staff, this study summarises the perioperative surgical data and the experience of nursing collaboration. 2 Materials and Methods 2.1 General information This study was retrospective study and was approved by the Medical Ethics Committee of the First Affiliated Hospital of Sun Yat-sen University. Forty patients, 22 males and 18 females, aged from 22 to 75 years, with a mean age of (52.31±16.74) years, who underwent immediate oral implant surgery with dynamic navigation system in the Department of Dentistry of our hospital from 1 January 2021 to 31 January 2024 were enrolled. A total of 62 implants were placed. Inclusion criteria :(1) Teeth that cannot be retained due to endodontic, periapical or periodontal disease. (2) Cone beam CT (CBCT) showing sufficient bone for implant placement; Exclusion criteria (1) There are contraindications for tooth extraction; (2) Severe periodontal and other oral diseases; (3) Severe mouth opening restriction, bruxism, heavy smoking, poor maintenance of oral hygiene, etc. 2.2 Main equipment and materials Dynamic real-time navigation and planning software (Iris-100, EPED Group, Taiwan), cone CBCT(beam computed tomography) (ICAT, USA), CBCT Design Software (In-vivo 5, Anatomage, USA), GOM Inspect Implant Accuracy Verification System (EPED Group, Taiwan), Nobel Biocare and Denton implants, Oral Implant (INTRAsurg 300 Plus, KaVo, Germany). 2.3. Clinical Process (1) Preoperative implant design The CBCT data were imported into DICOM format to complete the digital jaw reconstruction (Fig.1). The appropriate implant was selected, the implant treatment plan was designed, and the implantation was simulated in the best 3D site (Fig.2). Feature points were selected for intraoperative matching. (2)The patient is taken into the operating room, sterilized, and a sterile draping is applied. The usual preoperative preparations are made, and the navigation device is positioned. The instruments are connected, and the implant and feature points are aligned. Once the alignment is complete, the navigation system is activated, and the relationship between the implant drill bit and the bone of the socket is displayed on the navigation screen. Then, the surgeon performs the implant placement surgery under the guidance of the real-time navigation system, precisely completing the preparation of the implantation hole and the implantation of the implant (Fig. 3). After implant placement, a healing abutment was placed. If there was insufficient bone around the implant, autogenous bone or bone powder was implanted. The surgeon can observe the dynamic and static views on the display screen and follow the software instructions in real time to adjust the implantation position, angle, and depth to ensure that the implantation results meet the predetermined plan and minimize trauma and postoperative complications, thus completing a truly minimally invasive, precise computer-assisted surgery. 2.4 Key points in the co-ordination of care 2.4.1 Preoperative care (1) Psychological care Patients often had anxiety and fear before surgery, were unclear about the implantation and navigation technology, and worried about the operation cost, effect and postoperative pain. The attending physician introduced the operation plan and cost to the patients, and the attending nurses introduced the operation process, the key points of collaboration, the success rate of the operation, and the features and advantages of the navigation system to the patients in detail, thus enabling the patients to have a comprehensive and scientific cognitive implantation surgery, and to pay attention to the preoperative psychological changes and skillfully use psychological communication skills according to the actual situation of different patients. Relieve or alleviate their depression, anxiety, tension and other negative emotions, make patients actively cooperate with treatment and care, and help patients sign the informed consent for surgery. (2)Patient preparation On preoperative oral cavity clean and blood tests, including routine blood tests, screening, and clotting time and preoperative infection, etc. A positioning occlusion plate was prepared cooperatively and used as an intraoperative registration stent.The occlusion plate was placed in the mouth, the upper and lower jaws were separated, and CBCT images were taken. After CBCT was completed, the positioning occlusal splints were properly preserved and immersed in 75% alcohol solution for disinfection at 1 hour before operation. The patient's past history and allergy history were inquired in detail, whether there were systemic diseases, and the condition of the patient's mouth and jaw bone were evaluated. Female patients should avoid menstrual period. In patients with preoperative prophylactic use of antibiotics for 1 h. 2.4.2 Preparation of surgical instruments Surgical instruments, implant surgical tool kits and navigation tool kits for maxillofacial surgery should be prepared strictly in accordance with aseptic technique standards. All items should be disinfected and sterilised prior to use. Note that navigation surgical tools should be disinfected with low-temperature plasma. Prepare first aid equipment and supplies, disinfect with ultraviolet light 1 hour before surgery and wipe all surfaces with disinfectant. Prepare 0.9% saline, 75% ethanol, 0.5% iodopor, sterile gloves, cooling water tube, aspirator, periosteum, bone powder, implant machine and navigator. Check the type, size and number of implants. Due to the complexity of the procedure and the novel navigation technology, the scrub nurses and circulating nurses were all experienced implant nurses who were familiar with the anatomy of the site and experienced in surgical nursing collaboration. 2.4.3 Intraoperative care (1) Reference plate selection and Navigator calibration The patient was seated in the chair and asked to gargle with chlorine-containing mouthwash 3 times for 1 minute each time. The chair position and light were adjusted and the dentist assisted in injecting the local anaesthetic. 75% ethanol cotton balls were used for external disinfection, surgical gowns were worn and towels were spread out. This operation takes a long time and uses a lot of instruments and materials. Therefore, it is necessary to set up two sterile tables and place the navigation instruments and implant instruments separately. Adjust the shadowless light to make the surgical field clear, and install the planter and navigator correctly. This surgery using infrared optical positioning technology, the nurses should be prepared to wear special parts needed for navigation guidance and mobile phone reference version, reasonably adjust the navigator and mobile phone reference plate distance and angle, to ensure that the navigator optical tracking device can capture phone bit and the position of patients with jaw bone. The special drilling needle for calibration is installed on the mobile phone and given to the doctor. To calibrate this surgical navigation, the drill should be placed in the spherical groove of the reference plate so that the two fit closely together. The calibration step is carried out in the calibration module of the software to determine the tip of the drilling needle and the axial coordinate system of the mobile phone. (2) Equipment installation and registration The appropriate connecting rod and reflective ring should be correctly selected, sterilised and reserved according to the implant area. Calibration according to the operator, the patients wearing preoperative disinfection good positioning bite plate, and compared with the connecting rod and reflection ring assembly. Nurses should assist the dentist in placing the positioning device, which is usually placed in the appropriate position on the other side of the same jaw in the implant area, and ensure that the retention is stable and not easy to move. The mobile phone with the short probe was given to the dentist to help him align the jaw with the 3D virtual image using the registration marks to complete the registration. After the configuration is completed, it is necessary to carefully observe whether the position of the bit displayed by the system is accurate when the bit is placed on the tip to ensure the accuracy of registering. (3) The implant was placed under the guidance of navigation The open bite pad was placed in the patient's mouth to avoid opening for too long to cooperate with the surgery. Pass the mobile phone equipped with the positioning drill to the doctor to determine the implantation point, carefully observe the error control icon on the screen of the navigator, and be alert to the alarm of the system. The pioneer drill was transferred to the doctor, and the surgeon was assisted to determine the axial position according to the navigation software instructions. The reaming needles were replaced in time, and further reaming was performed until the depth of the prepared cavities was consistent with the design scheme. During the operation, nurses need to be familiar with the performance of the implant machine and the characteristics of the corresponding implant system, accurately transfer the surgical instruments, timely absorb saliva to ensure the surgical field is clear, correctly adjust the rotation speed and torque of the implant machine，closely observe whether the cooling water is flowing smoothly to prevent bone burns, and closely observe the patient's blood pressure, heart rate, heart rhythm, exhalation, pulse and other vital signs. The type and quantity of implants, bone substitutes and bio-collagen membranes were checked accurately. 2.4.4 Postoperative management Postoperative CBCT was performed. All patients received routine anti-infective therapy after surgery. Stitches were removed and temporary repair was performed 7 days after surgery, and permanent repair was completed 6 months after surgery. 2.5 Data collection: The preoperative design and postoperative CBCT data were imported into the dental implant dynamic navigation accuracy verification software. The preoperative and postoperative CBCT jaw-level three-dimensional registration was performed by the same clinician to analyse the error between the preoperative virtual implant design and the postoperative implant axial information. The actual implant top, apex, angle deviations were calculated and reported. 2.6 Statistical methods In this study, SPSS 23.0 statistical software was used to process the data of precision deviation after dynamic real-time navigation guided implant placement. All data included actual implant top, apical, and angular deviation. The measurement data in this study were in accordance with normal distribution, described by Mean ± SD, and the median, extreme value, and interquartile range Q1 and Q3 were recorded at the same time. 3 Results A total of 62 implants in 40 patients were successfully placed by the same surgeon, and the initial stability of implants were good. All patients experienced only common post-operative reactions such as swelling, mild pain, etc. No obvious post-operative adverse reactions were observed and patient satisfaction was high. The accuracy of the preoperative design was compared with that of the postoperative CBCT software.The deviations of the neck deviation and root under navigation guidance were (1.36 ± 0.65) mm and (1.48 ± 0.65) mm, respectively, and the angular deviation was (3.71 ± 1.32) °. 4 Discussion IIP is more difficult than delayed implant placement. After tooth extraction, the local alveolar bone often has varying degrees of defect and complex morphology. Free-hand implantation requires high technical requirements for surgeons. During the IIP process, implant deviation often occurs, which is easy to lead to implant failure, and even damage to the inferior alveolar nerve and maxillary sinus mucosa 10 , 11 . Therefore, greater accuracy is required for IIP. In recent years, dynamic real-time navigation systems have been introduced into the field of dental implant surgery, in order to improve the accuracy of implant placement and avoid potential risks 12 . 13 . The use of dynamic navigation-guided oral implants compared to conventional methods has been well documented to significantly reduce implant deviations 14 . Furthermore, dynamic navigation offers several advantages over static navigation. It allows for modifications to the surgical plan to be made in real time, as required 15 . Finally, the procedure can be performed on patients with insufficient mouth opening in the posterior region 16 , 17 . The accuracy error of implant implantation refers to the sum of errors that may occur from image acquisition, image data processing, systematic error, implant cavity preparation and implant implantation guidance level, registration process, human error, etc 18 . 19 . A series of systematic reviews and meta-analyses demonstrated that the mean platform error and apical error of dynamic navigation-assisted dental implantation were below 1.22 mm and 1.45 mm, respectively. Additionally, the mean angular deviation was less than 4.06° 20 . In this study, the platform error, apical error and Angle error of the dynamic navigation technology based on image data were (1.36 ± 0.65) mm, (1.48 ± 0.65) mm and (3.71 ± 1.32) °, respectively. The error result is slightly higher than that mentioned in the literature, and the potential causes for this error are as follows:1) Preoperative registration: when patients wear the registration device for CBCT photography before surgery, device loosening and sway may lead to intraoperative errors 21 . 2) System errors: errors in CBCT scanning and navigation software data processing, as well as errors in registration methods and tracking and positioning systems. 3) Poor human error: hand-eye coordination, familiarity with the navigation system, and medical cooperation may lead to certain errors 22 . 4) Research methods: This study was a clinical study. Compared with the in vitro research method in some literatures, the influence of gingiva, mucosa, blood and mouth opening were added. It has been pointed out in the literature that using the same dynamic navigation system, the error of performing clinical surgery is almost 4 times that of in vitro experiments 23 . The necessity for medical cooperation is also increased by the necessity for more precise implantation. The success of implant surgery is contingent on the existence of smooth and professional collaboration between the relevant medical professionals. The implementation of dynamic navigation technology requires the utilisation of a greater number of operations and equipment, which consequently increases the complexity of medical cooperation 24 . Firstly, the nurse conducts one-to-one communication with the patient, according to their physical and mental state, to help them understand the implantation process and what may happen following the operation. Secondly, the nurse introduces the advantages of the navigation system to the patient in order to help eliminate any doubts or fears the patient may have, thus increasing their sense of trust and easing any tension experienced, thereby further improving the patient's level of compliance. In addition, it is necessary to ensure that the patient wears an occlusal splint to achieve uniform occlusion and prevent the displacement of the registration device. The expert coordination of the medical team can reduce the error caused by improper cooperation. 5 Conclusion The use of computer-assisted dynamic navigation technology can obtain satisfactory clinical results, significantly shorten the treatment cycle, reduce the complexity of treatment, reduce postoperative complications, and the treatment effect is safe and reliable. Implant surgery under the guidance of dynamic navigation requires nursing staff to have a high comprehensive professional level and communication skills to ensure the smooth progress of surgery. High quality cooperation between doctors and nurses can eliminate patients' bad emotions, improve patients' compliance and improve the quality of nursing. Abbreviations IIP immediate implant placement CBCT Cone beam computed tomograph y Declarations Data availability Not applicable Acknowledgements We would like to thank all patients who participated in this study. Authors’ contributions Drafted the work and substantively revised it: Hua Deng and Ningbo Geng The acquisition, analysis, interpretation of data: Xiaolan Dou, Shuling Yang and Haishang Wang. Design of the work: Liufang Huang Ethics approval and consent to participate The protocol of this study and the informed consent and assent forms were approved by the Research Ethics Committee and Institutional Review Board of the First Affiliated Hospital of Sun Yat-sen University (Number: [2022]104). .Informed consent to participate was obtained from all of the participants. Consent for publication Not Applicable. Competing interests The authors declare no competing interests. Clinical trial number Not applicable References Amid R, Kadkhodazadeh M, Moscowchi A. 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Tables Table 1 Deviation of immediate implant placement under dynamic navigation (n=62) Indicator Mean ± SD Minimum~Maximum Interquartile spacing Q1 Interquartile spacing Q3 median Neck deviation (mm) 1.36±0.65 0.37～3.14 0.57 2.03 1.42 Root deviation (mm) 1.48±0.65 0.39～3.29 0.95 2.31 1.25 Angular deviation (°) 3.71±1.32 1.13～6.68 1.68 4.84 3.33 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5272183","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":369581215,"identity":"88fb43a8-abe4-4885-8f56-b5d87743938f","order_by":0,"name":"Hua Deng","email":"","orcid":"","institution":"The First Affiliated Hospital of Sun Yat-sen University","correspondingAuthor":false,"prefix":"","firstName":"Hua","middleName":"","lastName":"Deng","suffix":""},{"id":369581216,"identity":"ea7e939b-5a18-465c-9df3-0e6207db06bf","order_by":1,"name":"Ningbo Geng","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABD0lEQVRIiWNgGAWjYLACxgYbBgZm5sYHMAEJIrSkAbUwNhuQouUwiGyDq8SrRd699/Drwh3no/nbGRskGP4ctjc4wHzwNg+DXR4uLYZnzqVZzzxzO3fGYcYGA8a2w4kbDrAlW/MwJBfj1DIjx8yYt+12bgNQSwLQhQkGB3jMpHkYDiQ24NIy/w1Iy7nc+UAtByAO4/+GV4u8BI/xY962A7kbDjM2NjCwHWbccICHDa8WA54cM2beM8m5Gw8zNjMktqUnzjzMZmw5xyAZty3tZ4w/8+6wy513/vDxHx/+WNvzHW9+eONNhR1uWw4wsCFiIYGhGRinYHEc6kG2NDAwf0Di1+FWOgpGwSgYBSMWAABCb1t+bICAFAAAAABJRU5ErkJggg==","orcid":"","institution":"The First Affiliated Hospital of Sun Yat-sen University","correspondingAuthor":true,"prefix":"","firstName":"Ningbo","middleName":"","lastName":"Geng","suffix":""},{"id":369581217,"identity":"154c496a-ee0e-4dd8-ac87-eed08ec3a2b0","order_by":2,"name":"Xiaolan Dou","email":"","orcid":"","institution":"The First Affiliated Hospital of Sun Yat-sen University","correspondingAuthor":false,"prefix":"","firstName":"Xiaolan","middleName":"","lastName":"Dou","suffix":""},{"id":369581218,"identity":"61584604-0c56-4004-8bd5-783646110731","order_by":3,"name":"Shuling Yang","email":"","orcid":"","institution":"The First Affiliated Hospital of Sun Yat-sen University","correspondingAuthor":false,"prefix":"","firstName":"Shuling","middleName":"","lastName":"Yang","suffix":""},{"id":369581219,"identity":"fc6c4e70-b432-4e31-9b0c-dd33afea9fb6","order_by":4,"name":"Haishang Wang","email":"","orcid":"","institution":"The First Affiliated Hospital of Sun Yat-sen University","correspondingAuthor":false,"prefix":"","firstName":"Haishang","middleName":"","lastName":"Wang","suffix":""},{"id":369581220,"identity":"7fddc2af-140a-411f-bab5-bad87ef839c5","order_by":5,"name":"Liufang Huang","email":"","orcid":"","institution":"The First Affiliated Hospital of Sun Yat-sen University","correspondingAuthor":false,"prefix":"","firstName":"Liufang","middleName":"","lastName":"Huang","suffix":""}],"badges":[],"createdAt":"2024-10-16 03:08:09","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5272183/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5272183/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":67471149,"identity":"bf01e60f-eea7-4cbc-8221-6e64602e1560","added_by":"auto","created_at":"2024-10-25 11:34:35","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":110268,"visible":true,"origin":"","legend":"\u003cp\u003eCone-beam CT (CBCT) was performed before implantation\u003c/p\u003e","description":"","filename":"Figure1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-5272183/v1/3d3048c103ff01d4d898d1af.jpg"},{"id":67471150,"identity":"2aefa044-eb27-4bff-a164-653cca5bb650","added_by":"auto","created_at":"2024-10-25 11:34:35","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":66756,"visible":true,"origin":"","legend":"\u003cp\u003ePreoperative implant planning was designed\u003c/p\u003e","description":"","filename":"Figure2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-5272183/v1/8f85e22831d7ad3e835075b1.jpg"},{"id":67472187,"identity":"da511811-c0fe-4749-8159-9f1e23aab31e","added_by":"auto","created_at":"2024-10-25 11:42:35","extension":"jpg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":61824,"visible":true,"origin":"","legend":"\u003cp\u003eReal -time monitoring of the position between the drill and the alveolar bone\u003c/p\u003e","description":"","filename":"Figure3.jpg","url":"https://assets-eu.researchsquare.com/files/rs-5272183/v1/a6d87a5eff2a4f51524a92a9.jpg"},{"id":67471151,"identity":"99b28d5f-d623-4405-a8fb-946a1c895e79","added_by":"auto","created_at":"2024-10-25 11:34:35","extension":"jpg","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":53587,"visible":true,"origin":"","legend":"\u003cp\u003eClinical implantation process\u003c/p\u003e\n\u003cp\u003eA: Preoperative photographs；B: Dental implants were placed; C: Implanted bone powder\u003c/p\u003e\n\u003cp\u003eD: The mucoperiosteal flap was reattached; E and F: Postoperative Imaging\u003c/p\u003e","description":"","filename":"Figure4.jpg","url":"https://assets-eu.researchsquare.com/files/rs-5272183/v1/49edf6b52e948c7034945e6f.jpg"},{"id":67472636,"identity":"910b60ab-8af7-45f5-bd68-1da7d0cb30d1","added_by":"auto","created_at":"2024-10-25 11:50:37","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":638568,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5272183/v1/81d78b7e-606e-45cb-8a80-6f88f361d31b.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Application and nursing cooperation of immediate implant placement supported by dynamic navigation: a retrospective study","fulltext":[{"header":"1 Background","content":"\u003cp\u003eFollowing the loss of a tooth, the chewing function of patient will be significantly impaired and the alveolar bone will also be subject to progressive resorption. Although traditional delayed dental implant techniques can effectively restore missing teeth, this method requires patients to undergo a long waiting period, and due to the resorption of the alveolar bone, dental implant techniques can face numerous difficulties during implementation\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eIn contrast, immediate implant placement, where tooth extraction and implant placement are performed simultaneously, has shown significant advantages. Compared to traditional tooth planting technology, IIP can significantly shorten the repair process, effectively reducing the time and cost burden on patients \u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e,\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e. However, it should be noted that in practice, the IIP often results in implant site drift due to the guiding effect of the extraction socket slope. Incorrect implant positioning can lead to a number of restorative complications and adversely affect the treatment outcome \u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e,\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e. Therefore, the improvement of implant placement accuracy during IIP and the assurance of accurate implant placement has become a key issue to be solved in the field of dental implantology.\u003c/p\u003e \u003cp\u003eWith the advancement of computer technology, dynamic real-time navigation systems have also been utilized in the field of dental implants. In recent years, the development and implementation of digital technology in stomatology medical domain has led to numerous advantages associated with digital assisted immediate implant placement (IIP), including a focus on restorative and biologically oriented implant design, minimally invasive surgical procedures and more precise results can be achieved \u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e,\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eHowever, dynamic navigation technology is used in implant surgery, which involves many instruments and complex procedures \u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e,\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e. Therefore, standardised and efficient cooperation between doctors and nurses is particularly important. Since the application of the dental implant navigation system, our hospital has vigorously promoted its clinical application. Under the guidance of navigation, 40 cases of immediate maxillary implantation have been successfully completed. With appropriate nursing care during the perioperative period, all implants were successfully and accurately placed. In order to provide a reference for clinical staff, this study summarises the perioperative surgical data and the experience of nursing collaboration.\u003c/p\u003e"},{"header":"2 Materials and Methods","content":"\u003cp\u003e2.1 General information\u003c/p\u003e\n\u003cp\u003eThis study was retrospective study and was approved by the Medical Ethics Committee of the First Affiliated Hospital of Sun Yat-sen University. Forty patients, 22 males and 18 females, aged from 22 to 75 years, with a mean age of (52.31\u0026plusmn;16.74) years, who underwent immediate oral implant surgery with dynamic navigation system in the Department of Dentistry of our hospital from 1 January 2021 to 31 January 2024 were enrolled. A total of 62 implants were placed.\u003c/p\u003e\n\u003cp\u003eInclusion criteria :(1) Teeth that cannot be retained due to endodontic, periapical or periodontal disease. (2) Cone beam CT (CBCT) showing sufficient bone for implant placement;\u003c/p\u003e\n\u003cp\u003eExclusion criteria\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e(1) There are contraindications for tooth extraction; (2) Severe periodontal and other oral diseases; (3) Severe mouth opening restriction, bruxism, heavy smoking, poor maintenance of oral hygiene, etc.\u003c/p\u003e\n\u003cp\u003e2.2 Main equipment and materials\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eDynamic real-time navigation and planning software (Iris-100, EPED Group, Taiwan), cone CBCT(beam computed tomography) (ICAT, USA), CBCT Design Software (In-vivo 5, Anatomage, USA), GOM Inspect Implant Accuracy Verification System (EPED Group, Taiwan),\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eNobel Biocare and Denton implants, Oral Implant (INTRAsurg 300 Plus, KaVo, Germany).\u003c/p\u003e\n\u003cp\u003e2.3. Clinical Process\u003c/p\u003e\n\u003cp\u003e(1) Preoperative implant design\u003c/p\u003e\n\u003cp\u003eThe CBCT data were imported into DICOM format to complete the digital jaw reconstruction (Fig.1). The appropriate implant was selected, the implant treatment plan was designed, and the implantation was simulated in the best 3D site (Fig.2). Feature points were selected for intraoperative matching.\u003c/p\u003e\n\u003cp\u003e(2)The patient is taken into the operating room, sterilized, and a sterile draping is applied. The usual preoperative preparations are made, and the navigation device is positioned. The instruments are connected, and the implant and feature points are aligned. Once the alignment is complete, the navigation system is activated, and the relationship between the implant drill bit and the bone of the socket is displayed on the navigation screen. Then, the surgeon performs the implant placement surgery under the guidance of the real-time navigation system, precisely completing the preparation of the implantation hole and the implantation of the implant (Fig. 3). After implant placement, a healing abutment was placed. If there was insufficient bone around the implant, autogenous bone or bone powder was implanted. The surgeon can observe the dynamic and static views on the display screen and follow the software instructions in real time to adjust the implantation position, angle, and depth to ensure that the implantation results meet the predetermined plan and minimize trauma and postoperative complications, thus completing a truly minimally invasive, precise computer-assisted surgery.\u003c/p\u003e\n\u003cp\u003e2.4 Key points in the co-ordination of care\u003c/p\u003e\n\u003cp\u003e2.4.1 Preoperative care\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e(1) Psychological care\u003c/p\u003e\n\u003cp\u003ePatients often had anxiety and fear before surgery, were unclear about the implantation and navigation technology, and worried about the operation cost, effect and postoperative pain. The attending physician introduced the operation plan and cost to the patients, and the attending nurses introduced the operation process, the key points of collaboration, the success rate of the operation, and the features and advantages of the navigation system to the patients in detail, thus enabling the patients to have a comprehensive and scientific cognitive implantation surgery, and to pay attention to the preoperative psychological changes and skillfully use psychological communication skills according to the actual situation of different patients. Relieve or alleviate their depression, anxiety, tension and other negative emotions, make patients actively cooperate with treatment and care, and help patients sign the informed consent for surgery.\u003c/p\u003e\n\u003cp\u003e(2)Patient preparation\u003c/p\u003e\n\u003cp\u003eOn preoperative oral cavity clean and blood tests, including routine blood tests, screening, and clotting time and preoperative infection, etc. A positioning occlusion plate was prepared cooperatively and used as an intraoperative registration stent.The occlusion plate was placed in the mouth, the upper and lower jaws were separated, and CBCT images were taken. After CBCT was completed, the positioning occlusal splints were properly preserved and immersed in 75% alcohol solution for disinfection at 1 hour before operation. The patient\u0026apos;s past history and allergy history were inquired in detail, whether there were systemic diseases, and the condition of the patient\u0026apos;s mouth and jaw bone were evaluated. Female patients should avoid menstrual period. In patients with preoperative prophylactic use of antibiotics for 1 h.\u003c/p\u003e\n\u003cp\u003e2.4.2 Preparation of surgical instruments\u003c/p\u003e\n\u003cp\u003eSurgical instruments, implant surgical tool kits and navigation tool kits for maxillofacial surgery should be prepared strictly in accordance with aseptic technique standards. All items should be disinfected and sterilised prior to use. Note that navigation surgical tools should be disinfected with low-temperature plasma. Prepare first aid equipment and supplies, disinfect with ultraviolet light 1 hour before surgery and wipe all surfaces with disinfectant. Prepare 0.9% saline, 75% ethanol, 0.5% iodopor, sterile gloves, cooling water tube, aspirator, periosteum, bone powder, implant machine and navigator. Check the type, size and number of implants. Due to the complexity of the procedure and the novel navigation technology, the scrub nurses and circulating nurses were all experienced implant nurses who were familiar with the anatomy of the site and experienced in surgical nursing collaboration.\u003c/p\u003e\n\u003cp\u003e2.4.3 Intraoperative care\u003c/p\u003e\n\u003cp\u003e(1) Reference plate selection and Navigator calibration\u003c/p\u003e\n\u003cp\u003eThe patient was seated in the chair and asked to gargle with chlorine-containing mouthwash 3 times for 1 minute each time. The chair position and light were adjusted and the dentist assisted in injecting the local anaesthetic. 75% ethanol cotton balls were used for external disinfection, surgical gowns were worn and towels were spread out. This operation takes a long time and uses a lot of instruments and materials. Therefore, it is necessary to set up two sterile tables and place the navigation instruments and implant instruments separately. Adjust the shadowless light to make the surgical field clear, and install the planter and navigator correctly. This surgery using infrared optical positioning technology, the nurses should be prepared to wear special parts needed for navigation guidance and mobile phone reference version, reasonably adjust the navigator and mobile phone reference plate distance and angle, to ensure that the navigator optical tracking device can capture phone bit and the position of patients with jaw bone. The special drilling needle for calibration is installed on the mobile phone and given to the doctor. To calibrate this surgical navigation, the drill should be placed in the spherical groove of the reference plate so that the two fit closely together. The calibration step is carried out in the calibration module of the software to determine the tip of the drilling needle and the axial coordinate system of the mobile phone.\u003c/p\u003e\n\u003cp\u003e(2) Equipment installation and registration\u003c/p\u003e\n\u003cp\u003eThe appropriate connecting rod and reflective ring should be correctly selected, sterilised and reserved according to the implant area. Calibration according to the operator, the patients wearing preoperative disinfection good positioning bite plate, and compared with the connecting rod and reflection ring assembly. Nurses should assist the dentist in placing the positioning device, which is usually placed in the appropriate position on the other side of the same jaw in the implant area, and ensure that the retention is stable and not easy to move. The mobile phone with the short probe was given to the dentist to help him align the jaw with the 3D virtual image using the registration marks to complete the registration. After the configuration is completed, it is necessary to carefully observe whether the position of the bit displayed by the system is accurate when the bit is placed on the tip to ensure the accuracy of registering.\u003c/p\u003e\n\u003cp\u003e(3) The implant was placed under the guidance of navigation\u003c/p\u003e\n\u003cp\u003eThe open bite pad was placed in the patient\u0026apos;s mouth to avoid opening for too long to cooperate with the surgery. Pass the mobile phone equipped with the positioning drill to the doctor to determine the implantation point, carefully observe the error control icon on the screen of the navigator, and be alert to the alarm of the system. The pioneer drill was transferred to the doctor, and the surgeon was assisted to determine the axial position according to the navigation software instructions. The reaming needles were replaced in time, and further reaming was performed until the depth of the prepared cavities was consistent with the design scheme. During the operation, nurses need to be familiar with the performance of the implant machine and the characteristics of the corresponding implant system, accurately transfer the surgical instruments, timely absorb saliva to ensure the surgical field is clear, correctly adjust the rotation speed and torque of the implant machine，closely observe whether the cooling water is flowing smoothly to prevent bone burns, and closely observe the patient\u0026apos;s blood pressure, heart rate, heart rhythm, exhalation, pulse and other vital signs. The type and quantity of implants, bone substitutes and bio-collagen membranes were checked accurately.\u003c/p\u003e\n\u003cp\u003e2.4.4 Postoperative management\u003c/p\u003e\n\u003cp\u003ePostoperative CBCT was performed. All patients received routine anti-infective therapy after surgery. Stitches were removed and temporary repair was performed 7 days after surgery, and permanent repair was completed 6 months after surgery.\u003c/p\u003e\n\u003cp\u003e2.5 Data collection: The preoperative design and postoperative CBCT data were imported into the dental implant dynamic navigation accuracy verification software. The preoperative and postoperative CBCT jaw-level three-dimensional registration was performed by the same clinician to analyse the error between the preoperative virtual implant design and the postoperative implant axial information. The actual implant top, apex, angle deviations were calculated and reported.\u003c/p\u003e\n\u003cp\u003e2.6 \u0026nbsp;Statistical methods\u003c/p\u003e\n\u003cp\u003eIn this study, SPSS 23.0 statistical software was used to process the data of precision deviation after dynamic real-time navigation guided implant placement. All data included actual implant top, apical, and angular deviation. The measurement data in this study were in accordance with normal distribution, described by Mean \u0026plusmn; SD, and the median, extreme value, and interquartile range Q1 and Q3 were recorded at the same time.\u003c/p\u003e"},{"header":"3 Results","content":" \u003cp\u003eA total of 62 implants in 40 patients were successfully placed by the same surgeon, and the initial stability of implants were good. All patients experienced only common post-operative reactions such as swelling, mild pain, etc. No obvious post-operative adverse reactions were observed and patient satisfaction was high. The accuracy of the preoperative design was compared with that of the postoperative CBCT software.The deviations of the neck deviation and root under navigation guidance were (1.36\u0026thinsp;\u0026plusmn;\u0026thinsp;0.65) mm and (1.48\u0026thinsp;\u0026plusmn;\u0026thinsp;0.65) mm, respectively, and the angular deviation was (3.71\u0026thinsp;\u0026plusmn;\u0026thinsp;1.32) \u0026deg;.\u003c/p\u003e "},{"header":"4 Discussion","content":" \u003cp\u003eIIP is more difficult than delayed implant placement. After tooth extraction, the local alveolar bone often has varying degrees of defect and complex morphology. Free-hand implantation requires high technical requirements for surgeons. During the IIP process, implant deviation often occurs, which is easy to lead to implant failure, and even damage to the inferior alveolar nerve and maxillary sinus mucosa \u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e,\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e. Therefore, greater accuracy is required for IIP. In recent years, dynamic real-time navigation systems have been introduced into the field of dental implant surgery, in order to improve the accuracy of implant placement and avoid potential risks \u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e.\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e. The use of dynamic navigation-guided oral implants compared to conventional methods has been well documented to significantly reduce implant deviations \u003csup\u003e\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e. Furthermore, dynamic navigation offers several advantages over static navigation. It allows for modifications to the surgical plan to be made in real time, as required \u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e. Finally, the procedure can be performed on patients with insufficient mouth opening in the posterior region \u003csup\u003e\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e,\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThe accuracy error of implant implantation refers to the sum of errors that may occur from image acquisition, image data processing, systematic error, implant cavity preparation and implant implantation guidance level, registration process, human error, etc \u003csup\u003e\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e.\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u003c/sup\u003e. A series of systematic reviews and meta-analyses demonstrated that the mean platform error and apical error of dynamic navigation-assisted dental implantation were below 1.22 mm and 1.45 mm, respectively. Additionally, the mean angular deviation was less than 4.06\u0026deg;\u003csup\u003e\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u003c/sup\u003e. In this study, the platform error, apical error and Angle error of the dynamic navigation technology based on image data were (1.36\u0026thinsp;\u0026plusmn;\u0026thinsp;0.65) mm, (1.48\u0026thinsp;\u0026plusmn;\u0026thinsp;0.65) mm and (3.71\u0026thinsp;\u0026plusmn;\u0026thinsp;1.32) \u0026deg;, respectively. The error result is slightly higher than that mentioned in the literature, and the potential causes for this error are as follows:1) Preoperative registration: when patients wear the registration device for CBCT photography before surgery, device loosening and sway may lead to intraoperative errors \u003csup\u003e\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e. 2) System errors: errors in CBCT scanning and navigation software data processing, as well as errors in registration methods and tracking and positioning systems. 3) Poor human error: hand-eye coordination, familiarity with the navigation system, and medical cooperation may lead to certain errors \u003csup\u003e\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e. 4) Research methods: This study was a clinical study. Compared with the in vitro research method in some literatures, the influence of gingiva, mucosa, blood and mouth opening were added. It has been pointed out in the literature that using the same dynamic navigation system, the error of performing clinical surgery is almost 4 times that of in vitro experiments \u003csup\u003e\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThe necessity for medical cooperation is also increased by the necessity for more precise implantation. The success of implant surgery is contingent on the existence of smooth and professional collaboration between the relevant medical professionals. The implementation of dynamic navigation technology requires the utilisation of a greater number of operations and equipment, which consequently increases the complexity of medical cooperation \u003csup\u003e\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u003c/sup\u003e. Firstly, the nurse conducts one-to-one communication with the patient, according to their physical and mental state, to help them understand the implantation process and what may happen following the operation. Secondly, the nurse introduces the advantages of the navigation system to the patient in order to help eliminate any doubts or fears the patient may have, thus increasing their sense of trust and easing any tension experienced, thereby further improving the patient's level of compliance. In addition, it is necessary to ensure that the patient wears an occlusal splint to achieve uniform occlusion and prevent the displacement of the registration device. The expert coordination of the medical team can reduce the error caused by improper cooperation.\u003c/p\u003e "},{"header":"5 Conclusion","content":"\u003cp\u003eThe use of computer-assisted dynamic navigation technology can obtain satisfactory clinical results, significantly shorten the treatment cycle, reduce the complexity of treatment, reduce postoperative complications, and the treatment effect is safe and reliable. Implant surgery under the guidance of dynamic navigation requires nursing staff to have a high comprehensive professional level and communication skills to ensure the smooth progress of surgery. High quality cooperation between doctors and nurses can eliminate patients' bad emotions, improve patients' compliance and improve the quality of nursing.\u003c/p\u003e "},{"header":"Abbreviations","content":"\u003cp\u003eIIP immediate implant placement\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eCBCT Cone beam computed tomograph\u003cstrong\u003ey\u003c/strong\u003e\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eData availability\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe would like to thank all patients who participated in this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDrafted the work and substantively revised it: Hua Deng and Ningbo Geng\u003c/p\u003e\n\u003cp\u003eThe acquisition, analysis, \u0026nbsp;interpretation of data: Xiaolan Dou, Shuling Yang and Haishang Wang.\u003c/p\u003e\n\u003cp\u003eDesign of the work: Liufang Huang\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe protocol of this study and the informed consent and assent forms were approved by the Research Ethics Committee and Institutional Review Board of the First Affiliated Hospital of Sun Yat-sen University (Number: [2022]104). .Informed consent to participate was obtained from all of the participants.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot Applicable.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial number\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eAmid R, Kadkhodazadeh M, Moscowchi A. 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J Dent. 2022;123:104170. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.jdent.2022.104170\u003c/span\u003e\u003cspan address=\"10.1016/j.jdent.2022.104170\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTable 1\u0026nbsp;Deviation of immediate implant placement under dynamic navigation (n=62)\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"632\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 16.7722%;\"\u003e\n \u003cp\u003eIndicator\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.7152%;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003eMean \u0026plusmn; SD\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003eMinimum~Maximum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.1899%;\"\u003e\n \u003cp\u003eInterquartile spacing Q1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.0886%;\"\u003e\n \u003cp\u003eInterquartile spacing Q3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2342%;\"\u003e\n \u003cp\u003emedian\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 16.7722%;\"\u003e\n \u003cp\u003eNeck deviation (mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.7152%;\"\u003e\n \u003cp\u003e1.36\u0026plusmn;0.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003e0.37～3.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.1899%;\"\u003e\n \u003cp\u003e0.57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.0886%;\"\u003e\n \u003cp\u003e2.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2342%;\"\u003e\n \u003cp\u003e1.42\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 16.7722%;\"\u003e\n \u003cp\u003eRoot deviation (mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.7152%;\"\u003e\n \u003cp\u003e1.48\u0026plusmn;0.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003e0.39～3.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.1899%;\"\u003e\n \u003cp\u003e0.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.0886%;\"\u003e\n \u003cp\u003e2.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2342%;\"\u003e\n \u003cp\u003e1.25\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 16.7722%;\"\u003e\n \u003cp\u003eAngular deviation (\u0026deg;)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.7152%;\"\u003e\n \u003cp\u003e3.71\u0026plusmn;1.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25%;\"\u003e\n \u003cp\u003e1.13～6.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.1899%;\"\u003e\n \u003cp\u003e1.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.0886%;\"\u003e\n \u003cp\u003e4.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2342%;\"\u003e\n \u003cp\u003e3.33\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Dynamic Navigation System, Immediate Implant Placement, Nursing Coordination, Accuracy","lastPublishedDoi":"10.21203/rs.3.rs-5272183/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5272183/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe dynamic navigation technique is used in implant surgery, and there are many instruments and complex procedures during the operation. Therefore, standardized and smooth doctor-nurse cooperation is particularly important. The purpose of this study is to summarize the practical application of dynamic navigation system in immediate implant placement (IIP), and to preliminarily discuss the perioperative nursing cooperation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn this study, 40 patients who underwent IIP using a dynamic navigation system in the Department of dentistry of our hospital from 1 January 2021 to 31 March 2024 were collected and the postoperative implantation accuracy was measured, including cervical deviation, apical deviation, depth deviation and angular deviation, and the key points of nursing cooperation were summarised.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e62 implants were successfully placed in 40 patients, and all implants had good initial stability. The deviations of the neck and root under navigation guidance were (1.36 ± 0.65) mm and (1.48 ± 0.65) mm, respectively, and the angular deviation was (3.71 ± 1.32) °. Patients were generally satisfied with the results of the implantation and no serious complications occurred.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe dynamic navigation system can improve the precision and success rate of IIP. The preoperative quality nursing care, the full preparation of instruments and items, and the skilled operative nursing coordination can improve the surgical efficiency and reduce complications.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial number: not applicable\u003c/strong\u003e\u003c/p\u003e","manuscriptTitle":"Application and nursing cooperation of immediate implant placement supported by dynamic navigation: a retrospective study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-10-25 11:34:30","doi":"10.21203/rs.3.rs-5272183/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"cf35c864-bff2-4f29-8b18-d50f5f02bbde","owner":[],"postedDate":"October 25th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-10-26T16:25:35+00:00","versionOfRecord":[],"versionCreatedAt":"2024-10-25 11:34:30","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5272183","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5272183","identity":"rs-5272183","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}