Failures in implant guided surgeries – Literature review and case report

Abstract

Background : Although the computer guided surgery (CGS) can help the right positioning of the dental implants, by transfers three-dimensional data from CT to a surgery field, several aspects can interfere the accuracy of technique, it can lead to poor post-operative results with difference between planned and placed implants position that can even cause some injuries to the patients.Aim/Hypothesis : Our aim was review the scientific literature of the major failures within implant CGS. Despite that, we propose a CGS method, which eliminates some risk factors and allows the preparation of the surgical guide using the own tomographic guide in the office itself, without prototyping or drilling.Material and Methods : it was searched in PubMed and Google Scholar databases for terms such as-implant computer guided surgery failures, ìimplant guided surgery complicationsî, ìstate of art guided surgeryî. We also report a case of a fully edentulous 89 years-old lady, who was rehabilitated with dental implants in the mandible, using flapless approach and immediate loading, through the referred guided surgery technique.Results : the most common errors found in the literature were-inadequate planning, distortions during prosthesis duplication, failures during the tomographic examination, wrongs in aligning of the digital images, failures during the manufacture of the surgical guide, difference between tomographic and surgical templates, instability of the surgical guide, fully mucosa supported splints, among others. Conclusion and Clinical Implications :The knowledge of the factors that can generate mistakes during guided surgery is important as a way to prevent failures and improve the results. The technique presented showed to be, simple, safe and accurate, in order to minimize these error factors.