The Use of Computer-Guided Flapless Dental Implant Surgery (NobelGuide) and Immediate Function to Support a Fixed Full-ArchProsthesis inFresh-Frozen Homologous Patients with Bone Grafts

Abstract

The behavior of fresh-frozen homologous bone (FFB) when used in combination with computer-guided implant surgery has not been investigated yet, and there is a lack of clinical evidence in the literature. The purpose of this retrospective study is to evaluate the implant survival and related fixed full-arch prostheses at the 1- to 5-year follow-up when performed with immediate function using a flapless surgical procedure and computer-aided technology (NobelGuide; Nobel Biocare AB, Goteborg, Sweden) in patients previously treated with FFB grafts. Furthermore, the related values of torque and complications observed were analyzed and discussed. Clinical charts of patients with edentulous arches treated with FFB grafts and NobelGuide system with at least 1 year follow-up were reviewed retrospectively.A total of 65 patients met the criteria of inclusion, receiving a total of 342 implants and 77 full-arch prostheses, with a mean follow-up of 32.87 months (range, 1-5 years). Survival of implants and prostheses was high, reaching 96.5% and 95%, respectively. Factors significantly related to failure of the implants were smoking, position of the implant as last distal abutment, and fracture of basal maxillary bone. Prostheses survival was influenced by bruxism, failure of multiple implants, and torque level of implant equal to 0 at implant insertion. All implants and prostheses failures occurred in the first year. A higher torque level at implant insertion did not correspond to a lower risk of implant failure.Within the limitations of our retrospective study, this treatment modality was predictable with high survival rates and high insertion torque. However, a few implant and prosthetic failures were found, together with several complications.

Management of anticoagulated patients in implant therapy: a clinical comparative study

“…In Germany for example, around 700,000 patients are under conventional oral anticoagulant therapy such as Vitamin‐K inhibitors and the number of affected people will certainly increase due to the demographic development (Nocini et al. ). Since minor dental surgical treatments like tooth extractions are one of the most common procedures in health care, there will always be the question of managing this patient cohort among dentists, general practitioners and cardiologists, as well as affected patients (Doonquah & Mitchell ).…”

“…Anticoagulant drugs are prescribed for a large number of diseases and commonly used in patients with atrial fibrillation, artificial heart valves, deep vein thrombosis, myocardial infarction, and pulmonary embolisms (Al-Mubarak et al 2006;Wahl et al 2015). In Germany for example, around 700,000 patients are under conventional oral anticoagulant therapy such as Vitamin-K inhibitors and the number of affected people will certainly increase due to the demographic development (Nocini et al 2013). Since minor dental surgical treatments like tooth extractions are one of the most common procedures in health care, there will always be the question of managing this patient cohort among dentists, general practitioners and cardiologists, as well as affected patients (Doonquah & Mitchell 2012).…”

The Accuracy of Computer-Assisted Implant Surgery Performed Using Fully Guided Templates versus Pilot-Drill Guided Templates

“…Each patient received an orthopantomography (OPG) and a computed tomography (CT) for evaluation of bone volume and planning of implantsupported restoration. All virtual implant planning was performed by the same expert operator, following the manufacture guidelines for guided implant surgery (NobelGuide5, Nobel Biocare Holding AG, Zurich, Switzerland) [19][20][21][22]. Radiographic templates were prepared for completely edentulous patients.…”

Flapless Dental Implant: Contemporary Trends in Literature Coverage

“…It was reported that flapless implant insertion caused less peri-implant loss than implant insertion with flap preparation. Therefore, the flapless procedure represents a protective and promising method in implant surgery [1,6,7] Laleman et al [8] reported a systemic review for guided implant surgery in the edentulous maxilla, nevertheless, almost all implants included in this review were placed without flaps.…”