Patient‐centred outcomes comparing transmucosal implant placement with an open approach in the maxilla: a prospective, non‐randomized pilot study

Abstract

It was the aim of the study to assess differences in patient morbidity between transmucosal implant placement and implant installation after elevation of mucoperiosteal flaps. In five of the patients, implants were placed in the maxilla transmucosally using a CAD/CAM surgical template [test group (TG)]. In the remaining five patients, the implants were installed after the elevation of mucoperiosteal flaps [control group (CG)]. Directly after surgery, at days 1 and 7 after surgery the patients rated pain and discomfort on a visual analogue scale (0=minimal pain and discomfort, 100=maximal pain and discomfort). Optical three-dimensional images were assessed preoperatively and at days 1 and 7 after surgery to determine the visible soft tissue swelling of the upper lip and cheeks. Directly postoperatively, the mean pairwise difference between both groups in view of pain and discomfort ratings (control minus test) was 45.6 (SD, 20.7). At days 1 and 7, the mean differences were 51.6 (SD, 21.8) and 19 (SD, 8), respectively. The overall test of the area under curve (AUC) against the null hypothesis 'AUC of pairwise differences of pain score over study time equals null' yielded a significant difference (P=0.01). The mean pairwise difference between both groups in view of soft tissue volume increase was 6.1 (SD, 2) cm(3) at day 1 after surgery and 4.6 (SD, 1.2) cm(3) at day 7. The overall test of the AUC against the null hypothesis 'AUC of pairwise differences of oedema measurements over study time equals null' yielded a significant difference (P=0.002). Within the limitations of this pilot study, it could be shown that transmucosal implant placement reduces patient morbidity significantly compared with an open approach.

Flapless versus Conventional Flapped Dental Implant Surgery: A Meta-Analysis

“…Ten RCTs [1], [4], [10]–[17], seven CCTs [3], [18]–[23] and six retrospective studies [5], [24]–[28] were included in the meta-analysis. Only three studies [1], [25], [27] were multicenter.…”

“…In five studies [4], [12]–[14], [17] both patients and operators/outcome assessors were blinded to the tested intervention. Six studies [3], [11], [12], [16], [17], [21] had a follow-up up to 6 months, and six studies [15], [18]–[20], [22], [23] with a follow-up up to 1 year.…”

“…Three split-mouth design studies were performed [13], [14], [16]. Eight studies [1], [10], [13], [18], [21], [25]–[27] made use of surgical guides when inserting implants through the flapless surgical technique, five studies [12], [15], [17], [22], [24] used the surgical guides in both groups, whereas in ten studies [3]–[5], [11], [14], [16], [19], [20], [23], [28] the implants were inserted without any kind of surgical guide.…”

Computergestützte chirurgische 3D-Planung und schablonengeführte Implantation

“…Grâce à la technologie CAO-FAO, la position de l'implant prévue peut être transféré dans un guide qui est utilisé pendant l'opération pour guider des instruments, ce qui souvant facilite l'implantation. Vorausgesetzt, dass genügend Knochen vorhanden ist, kann die Implantatinsertion auch nur durch eine kleine Öffnung der Schleimhaut mittels Stanze, ohne Aufklappung, erfolgen, was die postoperativen Beschwerden der Patienten deutlich reduziert [12].…”

Techniques to Preserve Keratinized Peri-Implant Mucosa in CT-Guided Oral Implant Surgery

“…1 Mucosa-supported surgical templates offer the possibility of minimally invasive flapless implant surgery associated with significant reduction of intraoperative discomfort and postoperative patient morbidity, 2 operative time efficiency as well as reduction of surgical error. 3 Virtual treatment planning may also reduce the need for bone augmentation procedures prior to oral implant placement in the rehabilitation of severely atrophic jaws.…”