Does the operator’s generational cohort influence the accuracy of orthodontic miniscrews insertion in the palatine vault in dynamic computer-guided surgery? A randomized prospective study

Purpose: This study aimed to evaluate intergenerational differences in miniscrew placement accuracy in the palatine vault using dynamic computer-assisted surgery (d-CAS), and to assess the correlation between the number of surgeries, and both accuracy variables and procedure duration. Materials and methods: 72 subjects were enrolled and for each two miniscrews were inserted in the paramedian region via d-CAS (144 overall). Subjects were randomly allocated into three groups according to the operator’s generation: Group A (Generation X), Group B (Generation Y), and Group C (Generation Z). CBCT scans were superimposed to evaluate five variables: Entry-3D, Entry-2D, Apex-3D, Apex-Vertical, and angular deviation. Procedure duration was calculated. Statistical analyses included descriptive statistics, Shapiro-Wilk, ANOVA, Kruskal-Wallis, Tukey and Dunn’s tests and Pearson Correlation. P-value was set at ≤ 0.05. Results: ANOVA test demonstrated significant differences between the three groups in Entry-3D (P < 0.001), Entry-2D (P < 0.001), and Apex-3D (P = < 0.001) parameters, while Kruskal-Wallis test found a significant difference in angular deviation (P = 0.003). Post-hoc comparison revealed significant differences between groups A and C, and groups B and C. Pearson correlation indicated a negative correlation between intervention time and number of surgeries. Conclusions: Miniscrew insertion using d-CAS is operator-dependent, and the generational cohort of the operator is a factor that influences certain accuracy parameters. There is a correlation between the progression of surgeries and a reduction in the time employed. Understanding the impact of generational differences can encourage the use of digital technologies for novices in clinical practice. Clinical trial number: NCT06661551 (clinicaltrials.gov; 10/25/2024).