Implant Restoration of Edentulous Jaws with 3D Software Planning, Guided Surgery, Immediate Loading, and CAD-CAM Full Arch Frameworks

Abstract

Purpose. The aim of this study was to analyze the clinical and radiographic outcomes of 23 edentulous jaws treated with 3D software planning, guided surgery, and immediate loading and restored with CAD-CAM full arch frameworks. Materials and Methods. This work was designed as a prospective case series clinical study. Twenty patients have been consecutively rehabilitated with an immediately loaded implant supported fixed full prosthesis. A total of 120 fixtures supporting 23 bridges were placed. 117 out of 120 implants were immediately loaded. Outcome measures were implants survival, radiographic marginal bone levels and remodeling, soft tissue parameters, and complications. Results. 114 of 117 implants reached a 30 months follow-up, and no patients dropped out from the study. The cumulative survival rate was 97.7%; after 30 months, mean marginal bone level was 1.25 ± 0.31 mm, mean marginal bone remodeling value was 1.08 ± 0.34, mean PPD value was 2.84 ± 0.55 mm, and mean BOP value was 4% ± 2.8%. Only minor prosthetic complications were recorded. Conclusion. Within the limitations of this study, it can be concluded that computer-guided surgery and immediate loading seem to represent a viable option for the immediate rehabilitations of completely edentulous jaws with fixed implant supported restorations. This trial is registered with Clinicaltrials.gov NCT01866696.

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

“…Although guided surgery has become increasingly popular and widespread, there are currently only a few studies in the literature that present the results obtained with the guided flapless placement of implants in postextraction sockets and their immediate functional loading by means of complete fixed-arch reconstructions without artificial gum [28][29][30][31].…”

“…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].…”

“…Today there are few scientific works on complete-arch fixed reconstruction without artificial gum, by means of guided surgery with flapless placement of implants also in postextraction sockets, and immediate functional loading [28][29][30][31].…”

Guided implant surgery after free-flap reconstruction: Four-year results from a prospective clinical trial

“…Moreover, implants can be inserted in minimal bone volumes, thereby avoiding the need for the removal of the screws and plate. Another advantage of this technique is the option of placing a provisional prosthetic restoration, either computer-generated or developed from the template, at the end of the operation (Malo et al, 2008;Meloni et al, 2013). The prosthesis can be loaded immediately if there is adequate primary stability, thereby reducing discomfort to the patient, shortening the treatment time, and initiating the remodelling of soft tissue overgrowth.…”

Accuracy of newly developed sleeve‐designed templates for insertion of dental implants: A prospective multicenters clinical trial

“…The insertion of dental implants by means of computer‐assisted template‐based surgery is an established method . One of the most important stages for the development of guided implant placement has been the diffusion of 3‐dimensional imaging technique and modern implant planning softwares . The increased demand for dental implants to replace teeth has encouraged advancement in digital technology to improve patients' acceptance and clinical outcomes .…”