Computer-Guided Implant Surgery in Fresh Extraction Sockets and Immediate Loading of a Full Arch Restoration: A 2-Year Follow-Up Study of 14 Consecutively Treated Patients

Abstract

Statement of Problem. Low scientific evidence is identified in the literature for combining implant placement in fresh extraction sockets with immediate function. Moreover, the few studies available on immediate implants in postextraction sites supporting immediate full-arch rehabilitation clearly lack comprehensive protocols. Purpose. The purpose of this study is to report outcomes of a comprehensive protocol using CAD-CAM technology for surgical planning and fabrication of a surgical template and to demonstrate that immediate function can be easily performed with immediate implants in postextraction sites supporting full-arch rehabilitation. Material and Methods. 14 subjects were consecutively rehabilitated (13 maxillae and 1 mandible) with 99 implants supporting full-arch fixed prostheses followed between 6 and 24 months (mean of 16 months). Outcome measures were prosthesis and implant success, biologic and prosthetic complications, pain, oedema evaluation, and radiographic marginal bone levels at surgery and then at 6, 12, 18, and 24 months. Data were analyzed with descriptive statistics. Results. The overall cumulative implant survival rate at mean follow-up time of 16 months was 97.97%. The average marginal bone loss was 0,9 mm. Conclusions. Within the limitations of this study, the results validate this treatment modality for full-arch rehabilitations with predictable outcomes and high survival rate after 2 years.

Complete-arch fixed reconstruction by means of guided surgery and immediate loading: a retrospective clinical study on 12 patients with 1 year of follow-up

“…Most of the studies in the literature, in fact, refer to the immediate loading of hybrid prostheses (such as Toronto Bridges, "all-on-four," and "all-on-six" dentures), characterized by the presence of a bar connecting the implants and, more relevant, artificial gum [22][23][24][25][26]. It is obvious how such prosthetic rehabilitations differ so thoroughly from a full-arch fixed prosthesis, which is characterized by the absence of artificial gum and much more delicately manageable for the clinician, from an aesthetic point of view [28][29][30][31].…”

“…However, in most clinical studies in the literature, fullarch restorations are represented by Toronto Bridges, also known as "all-on-four" and "all-on-six" dentures, i.e., hybrid fixed prostheses characterized by the presence of a bar connecting the implants and, more importantly, artificial gum (either in porcelain or in resin, depending by the restorative treatment chosen) [22][23][24][25]. There is no doubt that even in this context, guided implant surgery offers advantages, such as more precise implant placement, especially with respect to the screw holes, and the availability to pre-fabricate a milled provisional for same-(or next-) day delivery [14-16, 20, 22-25].…”

Immediate implant placement into fresh extraction sockets versus delayed implants into healed sockets: A systematic review and meta-analysis

“…Specifically, there is less interference during analysis of the results, because a smaller number of teeth are involved; moreover, it is easier to manufacture this type of prosthesis. Nonetheless, because immediate implant insertion has clear advantages in the case of edentulous patients, many clinical studies have involved this group of patients 53,54 .…”

From Guided Surgery to Final Prosthesis with a Fully Digital Procedure: A Prospective Clinical Study on 15 Partially Edentulous Patients

“…The ability to plan the insertion of dental implants virtually and subsequently place the fixtures in the exact position at the desired depth and angle using accurately milled or 3D-printed surgical guides has long been a clinical reality [ 2 , 3 , 5 , 12 ]. Guided surgery has been a successful procedure for over 10 years, as evidenced by several clinical studies [ 12 , 13 ] and systematic reviews [ 3 , 14 , 15 ]. Initially, the use of guided surgery techniques was limited to complex cases (patients who were fully edentulous, with manufacture of bone-supported or mucosa-supported templates); in fact, in order to obtain bone anatomy information, the patient had to be subjected to conventional computerised axial tomography (CT scanning), involving exposure to significant amounts of ionising radiation [ 3 , 14 , 15 ].…”