Purpose: To compare virtual planning accuracy of novel computer-assisted, template-based implant placement techniques, which make use of CAD/CAM stereolithographic surgical templates with or without metallic sleeves. Furthermore, to compare open versus closed sleeves for templates without metallic sleeves. Materials and methods: Any partially edentulous patients requiring at least one implant to be placed according to a computer-assisted template-based protocol were enrolled. Patients were randomized according to a parallel group design into two arms: Surgical template with or without metallic sleeves. Three deviation parameters (angular, horizontal, vertical) were defined to evaluate the discrepancy between the planned and placed implant positions. Results: No implants failed, and no complications were experienced. Forty-one implants were placed using surgical templates with metallic sleeves while 49 implants were placed with a surgical template without metallic sleeves. Of these, 16 implants were placed through open sleeves and 33 through closed sleeves. There was a statistically significant difference in angle (p = 0.0212) and in the vertical plan (p = 0.0073) with lower values for implants placed with a surgical template without metallic sleeves. In the test group, close sleeves were more accurate compared with open sleeves in angle (p = 0.0268) and in horizontal plan (p = 0.0477). Conclusion: With the limitations of the present study, surgical templates without metallic sleeves were more accurate in the vertical plan and angle compared to the conventional template with metallic sleeves. Open sleeves should be used with caution in the molar region only in case of reduced interarch space. Further research is needed to confirm these preliminary results.

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Oral bisphosphonate therapy did not appear to significantly affect implant survival and success in case of accurate treatment time selection, minimally invasive surgical approach and constant follow-up. Further prospective studies involving larger sample sizes and longer durations of follow-up are required to confirm these results.

To correlate soft tissue thickness and peri-implant bone remodeling of platform-switching implants. Materials and Methods: This comparative prospective trial evaluated, for up to 3 years after implant loading, the influence of soft tissue thickness on changes in peri-implant marginal hard tissue levels. Any patient who was partially edentate in the mandible and required at least two adjacent implant-supported restorations was recruited at the University of Valencia in Spain. A 3-mm tissue punch biopsy, which corresponded to a diameter slightly smaller than the coronal diameter of the implants, was performed using a circular mucotome. Afterward, implants with a length of 10 to 13 mm and a diameter of 3.8 mm were inserted. Outcome measures were implant and prosthesis survival rates, marginal hard tissue changes, any complications, and results of morphologic and histomorphometric analyses. Correlation between mucosa width components (epithelium, connective tissue, and epithelium and connective tissue) and radiographic bone loss at 1 and 3 years after loading was performed at the patient level. Statistical significance was set at P ≤ .05. Results: A total of 26 samples in 26 patients with 68 implants were analyzed. The specimens were divided into two groups: group 1 (16 patients, 40 implants), with thin mucosa (≤ 2 mm), and group 2 (10 patients, 28 implants), with thick mucosa (> 2 mm). Two dropouts (two specimens) were recorded at the 3-year follow-up. None of the implants or definitive prostheses failed during the healing period, resulting in an overall implant and prosthesis cumulative survival rate of 100%. No major biologic or mechanical complications were recorded. The mean (standard deviation, SD) epithelium thickness was 430.33 (250.21) µm; the mean (SD) connective tissue thickness was 1,324.31 (653.46) µm, and the mean (SD) mucosa thickness was 1,751.29 (759.53) µm. Comparisons of radiographic bone loss between group 1 and group 2 failed to show any statistically significant differences at the 1-year (P = .290) or 3-year (P = .090) follow-up examinations. Conclusion: The initial mucosa thickness surrounding a bone-level platform-switching implant seems not to influence the pattern of physiologic marginal bone loss. Int J Oral MaxIllOfac IMplants 2017 (7 pages).

immediately loaded implants placed in edentulous patients using computer-assisted template-guided surgery to support a FCDP is a valid treatment concept in the medium term follow-up, for edentulous patients.