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Journal of Peking University (Health Sciences) ›› 2026, Vol. 58 ›› Issue (2): 365-371. doi: 10.19723/j.issn.1671-167X.2026.02.022

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Accuracy of dynamic navigation-assisted trephine method for bone harvesting

Jiayu LIU, Ning ZHU, Yuchen CHANG, Xianming GAO, Yu ZHANG*()   

  1. Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
  • Received:2024-02-05 Online:2026-04-18 Published:2026-02-25
  • Contact: Yu ZHANG
  • Supported by:
    the Program for New Clinical Techniques and Therapies of Peking University School and Hospital of Stomatology(PKUSSNCT-22A01)

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Abstract:

Objective: To evaluate the positional accuracy of dynamic navigation-assisted trephine bone harvesting in the symphysis and external oblique ridge. Methods: Ten standardized mandibular models were 3D-printed using polyetheretherketone (PEEK), mimicking natural mandibular mechanical properties. Pre-operative cone beam CT (CBCT) scans (70 kV, 70 mA, 0.25 mm×0.25 mm ×0.25 mm voxel) were acquired, and data were imported into dynamic navigation software (Dcarer, China). Two donor sites were designed in both the symphysis (≥15 mm from anterior teeth) and external oblique ridge (≥6 mm from molars), with 8 mm-diameter, 6 mm-deep cylindrical osteotomy tracts planned for each site.After calibrating the navigation system with 20 mm and 50 mm spherical burs, an 8 mm outer-diameter trephine prepared 40 tracts under real-time guidance. Post-operative CBCT scans were taken, and Mimics 20.0 software fitted actual tracts to standard cylinders. Superimposing actual and designed tracts via metal registration markers, we measured coronal/apical center point deviation, depth deviation, and axis angle deviation in order to compare site-specific accuracy. Results: Deviations of the dynamic navigation-assisted trephine method for bone harvesting was (1.91±0.69) mm at the coronal center point, (1.54±0.66) mm at the apical center point, (－0.83±0.77) mm at the depth of the apical center point and 3.02°±0.38° at the axis angle. The four deviations in symphysis and external oblique ridge were (1.32±0.36) mm and (2.50±0.35) mm at the coronal center point (P < 0.01), (1.06± 0.31) mm and (2.02±0.56) mm at the apical center point (P < 0.01), (－0.30±0.52) mm and (－1.38±0.57) mm at the depth of apical center point (P < 0.01), 3.03°± 0.38° and 3.00°± 0.39° at axis angle (P=0.80). Conclusion: Within the limitations of this study, dynamic navigation-assisted trephine harvesting shows good accuracy. The symphysis exhibits higher accuracy than the external oblique ridge, possibly due to surface morphology and operability differences. These findings support its clinical potential, but future clinical studies are needed to validate results.

Key words: Dental implant, Surgical navigation systems, Bone transplantation

CLC Number: 

  • R783

Figure 1

Workflow chart of in vitro study on accuracy of dynamic navigation-assisted trephine bone harvesting CBCT, cone beam computed tomography; DICOM, digital imaging and communications in medicine."

Figure 2

Digital plan and conduction of the navigation-assisted trephine method for bone harvesting A, digitally designed model of the in vitro study; B, registration device of dynamic navigation system was positioned on the lower anterior teeth; C, design digital trephine osteotomy tracts (red); D, use trephines to complete the osteotomy tracts under the guidance of dynamic navigation; E, real-time positioning and angular deviations of the trephine are displayed in the dynamic navigation system."

Figure 3

Statistical measurement for dynamic navigation-assisted trephine bone harvesting accuracy A, actual osteotomy tracts were adapted in the post-lab CBCT (red); B, superimpose the actual osteotomy tracts (red) to the planned ones (white) based on the mental fiducial markers on the registration device (black)."

Figure 4

Experimental accuracy evaluation index A, coronal center point deviation D1, apical center point deviation D2 and angulation deviation α; B, deviations in depths of apical centre points D3."

Table 1

Descriptive values of deviations in dynamic navigation-assisted trephine methods for bone harvesting"

Deviations n ${\bar x}$±s Minimum Maximum
Coronal center point/mm 40 1.91±0.69 0.64 3.12
Apical center point/mm 40 1.54±0.66 0.41 2.94
Depth of apical center point/mm 40 －0.84±0.77 －2.22 0.63
Axis angle/(°) 40 3.02±0.38 2.11 3.72

Table 2

Descriptive values of deviations in dynamic navigation-assisted trephine methods for bone harvesting in the symphysis and external oblique line area"

Deviations Donor sites n ${\bar x}$±s Minimum Maximum t P
Coronal center point/mm Symphysis 20 1.32±0.36 0.64 1.98 －10.42 ＜0.01
External oblique line 20 2.50±0.35 1.98 3.12
Apical center point/mm Symphysis 20 1.06±0.31 0.41 1.57 －6.70 ＜0.01
External oblique line 20 2.02±0.56 0.86 2.94
Depth of apical center point/mm Symphysis 20 －0.30±0.52 -1.13 0.63 4.81 ＜0.01
External oblique line 20 －1.38±0.57 -2.22 -0.55
Axis angle/(°) Symphysis 20 3.03±0.38 2.43 3.72 0.26 0.80
External oblique line 20 3.00±0.39 2.11 3.56

Figure 5

Analysis of differences in bone harvesting accuracy using dynamic navigation-assisted trephine in extraoral oblique line and symphysis A, deviations in coronal center points; B, deviations in apical center points; C, deviations in depth of apical center points; D, deviations in the axial angles. ns, correlation is not significant at the 0.05 level (2-tailed); * * * correlation is significant at the 0.001 level (2-tailed)."

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