Substantial deviations in three-dimensional directions are found between virtual planning and actually obtained implant position. This finding and additionally reported postsurgical complications leads to the conclusion that care should be taken whenever applying this technique on a routine basis.

The present study is the first to investigate the accuracy of stereolithographic, full, mucosally supported surgical guides in the treatment of fully edentulous maxillae. Clinicians should be warned that angular and linear deviations are to be expected. Short implants show significantly lower apical deviations compared with longer ones. Reasons for implant deviations are multifactorial; however, it is unlikely that the production process of the guide has a major impact on the total accuracy of a mucosal-supported stereolithographic guide.

Single implants yield an excellent prognosis with stable bone levels irrespective of the surgical technique, and free-handed flapless surgery is a viable alternative to more extensively planned guided surgery. Proper case selection and clinical experience are considered prerequisites for a predictable treatment outcome.

Introduction: Implant‐prosthetic rehabilitation of the completely edentulous mandible has evolved to a simplified procedure with shorter treatment time and survival rates of 95–100% depending on the implant system used. Purpose: The aim was to evaluate the 3‐year clinical success of Astra Tech TiOblast implants, functionally loaded on the day of surgery with a fixed full‐arch bridge in the mandible. Materials and methods: One hundred and twenty‐five implants of 3.5–4 mm width and 11–17 mm length were installed in 25 edentulous mandibles of 15 female and 10 male patients. Implants were functionally loaded on the day of surgery with a provisional, acrylic, glassfibre reinforced, 10 unit bridge. After 3–4 months, the final 12‐unit bridge was constructed. Radiographical bone loss was measured on peri‐apical radiographs after 3, 12, 24 and 36 months. Results: All implants were functional during the whole study period yielding a survival rate of 100%. None of the fixtures showed pain or mobility after manual torque with 20 N cm at the 3‐month control. Mean radiographical bone loss after 3 months and 1, 2 and 3 years was 0.6 mm (SD 0.7), 0.8 mm (SD 0.8), 1 mm (SD 0.8) and 1.3 (SD 1) respectively, which was statistically significantly increasing up to 1 year. Conclusion: Immediate loading of full‐arch mandibular bridgework on five TiOblast implants offers a long‐lasting clinical result with 100% fixture survival and stable bone‐to‐implant contact up to 3 years.

This 3-year study shows that machined surface Brånemark implants can be immediately loaded with cross-arch cantilever bridges with an average bone-remodelling pattern indicative of a steady state after 1 year of loading.