Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Maxillofacial Plastic and Reconstructive Surgery
Published in: Maxillofacial Plastic and Reconstructive Surgery 1/2023

Open Access 01-12-2023 | Bleeding on Probing | Research

Digital implant placement accuracy: a clinical study on a fully-guided flapless single-unit immediate-loading protocol

Authors: Parsa Pirooz, Faezeh Atri, Paria Gholami, Mohammad Bayat

Published in: Maxillofacial Plastic and Reconstructive Surgery | Issue 1/2023

Login to get access

Abstract

Aims

The primary aim of the present study was to measure the discrepancy between the virtual and the actual position of the single-unit implants placed via a digitally-designed fully-guided surgical template using a flapless surgical technique. Prefabricated provisional restorations and periodontal factors were evaluated after the immediate loading of implants and 3 months after the surgery, respectively.

Materials and methods

Fourteen implants in nine patients were virtually planned after importing intraoral scans and cone-beam computed tomography (CBCT) records into 3D planning software. Accordingly, fully-guided surgical templates, customized abutments, and provisional restorations were designed and fabricated. The implant position after the surgery was compared with its virtual counterpart in terms of angular and apical linear deviations. Implants were immediately loaded after the surgery, and the occlusal level of the delivered provisional restorations was compared with their designed positions. Early implant failure, bleeding on probing, and peri-implant pockets were documented on the 3-month follow-up.

Results

A mean angular deviation of 5.07 ± 2.06° and a mean apical linear deviation of 1.74 ± 0.63 mm resulted. Two out of 14 implants failed within the first 3 months of the surgery, and the occlusal level difference was calculated for nine prefabricated provisional restorations.

Conclusions

DIONAVI protocol has been evaluated regarding its accuracy, and an estimation of the expected deviation is presented to the clinicians using this protocol. However, before widespread use, immediate-loading protocols and provisional restorations must be studied further.

Trial registration

IRCT, IRCT20211208053334N1. Registered 6 August 2022.
Literature
1.
Brodala N (2009) Flapless surgery and its effect on dental implant outcomes. Int J Oral Maxillofac Implants 24(Suppl):118–125PubMed
2.
Fortin T, Bosson JL, Isidori M, Blanchet E (2006) Effect of flapless surgery on pain experienced in implant placement using an image-guided system. Int J Oral Maxillofac Implants 21(2):298–304PubMed
3.
Kumar D, Sivaram G, Shivakumar B, Kumar T (2018) Comparative evaluation of soft and hard tissue changes following endosseous implant placement using flap and flapless techniques in the posterior edentulous areas of the mandible-a randomized controlled trial. Oral Maxillofac Surg 22(2):215–223PubMedCrossRef
4.
Llamas-Monteagudo O, Girbés-Ballester P, Viña-Almunia J, Peñarrocha-Oltra D, Peñarrocha-Diago M (2017) Clinical parameters of implants placed in healed sites using flapped and flapless techniques: A systematic review. Medicina oral, patologia oral y cirugia bucal 22(5):e572–e581PubMedPubMedCentral
5.
Maier FM (2016) Initial Crestal Bone Loss After Implant Placement with Flapped or Flapless Surgery-A Prospective Cohort Study. Int J Oral Maxillofac Implants 31(4):876–883PubMedCrossRef
6.
Naeini EN, Atashkadeh M, De Bruyn H, D’Haese J (2020) Narrative review regarding the applicability, accuracy, and clinical outcome of flapless implant surgery with or without computer guidance. Clin Implant Dent Relat Res 22(4):454–467PubMedPubMedCentralCrossRef
7.
Vohra F, Al-Kheraif AA, Almas K, Javed F (2015) Comparison of crestal bone loss around dental implants placed in healed sites using flapped and flapless techniques: a systematic review. J Periodontol 86(2):185–191PubMedCrossRef
8.
Yadav R, Agrawal KK, Rao J, Anwar M, Alvi HA, Singh K et al (2018) Crestal bone loss under delayed loading of full thickness versus flapless surgically placed dental implants in controlled type 2 diabetic patients: a parallel group randomized clinical trial. J Prosthodont 27(7):611–617PubMedCrossRef
9.
Yang Y, Hu C, Zhang Y, Wang L, Shao L, You J (2022) Comparing digital and traditional guides in first molar implant surgery: a randomized clinical trial. Technol Health Care 30(S1):403–412PubMedPubMedCentralCrossRef
10.
Jacobs R, Adriansens A, Verstreken K, Suetens P, van Steenberghe D (1999) Predictability of a three-dimensional planning system for oral implant surgery. Dentomaxillofac Radiol 28(2):105–111PubMedCrossRef
11.
D’Haese J, Ackhurst J, Wismeijer D, De Bruyn H, Tahmaseb A (2000) (2017) Current state of the art of computer-guided implant surgery. Periodontol 73(1):121–133CrossRef
12.
Romandini M, Ruales-Carrera E, Sadilina S, Hämmerle CHF (2000) Sanz M (2022) Minimal invasiveness at dental implant placement: a systematic review with meta analyses on flapless fully guided surgery. Periodontol 91(1):89–112CrossRef
13.
Tattan M, Chambrone L, González-Martín O, Avila-Ortiz G (2020) Static computer-aided, partially guided, and free-handed implant placement: a systematic review and meta-analysis of randomized controlled trials. Clin Oral Implant Res 31(10):889–916CrossRef
14.
Frizzera F, Calazans NNN, Pascoal CH, Martins ME, Mendonça G (2021) Flapless guided implant surgeries compared with conventional surgeries performed by nonexperienced individuals: randomized and controlled split-mouth clinical trial. Int J Oral Maxillofac Implants 36(4):755–761PubMedCrossRef
15.
Magrin GL, Rafael SNF, Passoni BB, Magini RS, Benfatti CAM, Gruber R et al (2020) Clinical and tomographic comparison of dental implants placed by guided virtual surgery versus conventional technique: a split-mouth randomized clinical trial. J Clin Periodontol 47(1):120–128PubMedCrossRef
16.
Varga E Jr, Antal M, Major L, Kiscsatári R, Braunitzer G, Piffkó J (2020) Guidance means accuracy: a randomized clinical trial on freehand versus guided dental implantation. Clin Oral Implant Res 31(5):417–430CrossRef
17.
Vercruyssen M, Coucke W, Naert I, Jacobs R, Teughels W, Quirynen M (2015) Depth and lateral deviations in guided implant surgery: an RCT comparing guided surgery with mental navigation or the use of a pilot-drill template. Clin Oral Implant Res 26(11):1315–1320CrossRef
18.
Younes F, Cosyn J, De Bruyckere T, Cleymaet R, Bouckaert E, Eghbali A (2018) A randomized controlled study on the accuracy of free-handed, pilot-drill guided and fully guided implant surgery in partially edentulous patients. J Clin Periodontol 45(6):721–732PubMedCrossRef
19.
Oh KC, Kim JH, Woo CW, Moon HS (2019) Accuracy of customized prefabricated screw-type immediate provisional restorations after single-implant placement. J Clin Med 8(4):490PubMedPubMedCentralCrossRef
20.
Ganeles J, Wismeijer D (2004) Early and immediately restored and loaded dental implants for single-tooth and partial-arch applications. Int J Oral Maxillofac Implants 19(Suppl):92–102PubMed
21.
Valente F, Schiroli G, Sbrenna A (2009) Accuracy of computer-aided oral implant surgery: a clinical and radiographic study. Int J Oral Maxillofac Implants 24(2):234–242PubMed
22.
23.
Jemt T, Nilsson M, Olsson M, Stenport VF (2017) Associations between early implant failure, patient age, and patient mortality: a 15-year follow-up study on 2,566 patients treated with implant-supported prostheses in the edentulous jaw. Int J Prosthodont 30(2):189–197PubMedCrossRef
24.
Blustein R, Jackson R, Rotskoff K, Coy RE, Godar D (1986) Use of splint material in the placement of implants. Int J Oral Maxillofac Implants 1(1):47–49PubMed
25.
Jabero M, Sarment DP (2006) Advanced surgical guidance technology: a review. Implant Dent 15(2):135–142PubMedCrossRef
26.
Schubert O, Schweiger J, Stimmelmayr M, Nold E, Güth JF (2019) Digital implant planning and guided implant surgery - workflow and reliability. Br Dent J 226(2):101–108PubMedCrossRef
27.
Beretta M, Poli PP, Maiorana C (2014) Accuracy of computer-aided template-guided oral implant placement: a prospective clinical study. J Periodontal Implant Sci 44(4):184–193PubMedPubMedCentralCrossRef
28.
de Oliveira G, de Souza MW, Albaricci M, Marcantonio É, Queiroz TP, Margonar R (2019) Analysis of linear and angular deviations of implants installed with a tomographic-guided surgery technique: a prospective cohort study. J Oral Implantol 45(4):281–287PubMedCrossRef
29.
Farley NE, Kennedy K, McGlumphy EA, Clelland NL (2013) Split-mouth comparison of the accuracy of computer-generated and conventional surgical guides. Int J Oral Maxillofac Implants 28(2):563–572PubMedCrossRef
30.
Soares MM, Harari ND, Cardoso ES, Manso MC, Conz MB, Vidigal GM Jr (2012) An in vitro model to evaluate the accuracy of guided surgery systems. Int J Oral Maxillofac Implants 27(4):824–831PubMed
31.
Alzoubi F, Massoomi N, Nattestad A (2016) Accuracy assessment of immediate and delayed implant placements using CAD/CAM surgical guides. J Oral Implantol 42(5):391–398PubMedCrossRef
32.
Derksen W, Wismeijer D, Flügge T, Hassan B, Tahmaseb A (2019) The accuracy of computer-guided implant surgery with tooth-supported, digitally designed drill guides based on CBCT and intraoral scanning. A prospective cohort study. Clin Oral Implants Res 30(10):1005–15PubMedCrossRef
33.
Kiatkroekkrai P, Takolpuckdee C, Subbalekha K, Mattheos N, Pimkhaokham A (2020) Accuracy of implant position when placed using static computer-assisted implant surgical guides manufactured with two different optical scanning techniques: a randomized clinical trial. Int J Oral Maxillofac Surg 49(3):377–383PubMedCrossRef
34.
Smitkarn P, Subbalekha K, Mattheos N, Pimkhaokham A (2019) The accuracy of single-tooth implants placed using fully digital-guided surgery and freehand implant surgery. J Clin Periodontol 46(9):949–957PubMedCrossRef
35.
Tallarico M, Xhanari E, Kim YJ, Cocchi F, Martinolli M, Alushi A et al (2019) Accuracy of computer-assisted template-based implant placement using conventional impression and scan model or intraoral digital impression: A randomised controlled trial with 1 year of follow-up. Int J Oral Implantol (Berlin, Germany) 12(2):197–206
36.
Ko KA, Song YW, Park JM, Park YB, Kim CS, Lee JS (2021) Immediate loading protocols increase the risk of failure of implants placed by fully guided surgery in partially edentulous jaws: a randomized clinical trial. Clin Implant Dent Relat Res 23(5):735–744PubMedCrossRef
Metadata
Title
Digital implant placement accuracy: a clinical study on a fully-guided flapless single-unit immediate-loading protocol
Authors
Parsa Pirooz
Faezeh Atri
Paria Gholami
Mohammad Bayat
Publication date
01-12-2023
Publisher
Springer Nature Singapore
Published in
Maxillofacial Plastic and Reconstructive Surgery / Issue 1/2023
Electronic ISSN: 2288-8586
DOI
https://doi.org/10.1186/s40902-023-00387-5

Other articles of this Issue 1/2023

Maxillofacial Plastic and Reconstructive Surgery 1/2023 Go to the issue

Case report

Arthrogryposis multiplex congenita with maxillofacial involvement: a case report

Methodology

Mixed reality for extraction of maxillary mesiodens

Review

Redefining precision and efficiency in orthognathic surgery through virtual surgical planning and 3D printing: a narrative review

Case report

Total mandible and bilateral TMJ reconstruction combining a customized jaw implant with a free fibular flap: a case report and literature review

Methodology

Methodology: workflow for virtual reposition of mandibular condyle fractures

Review

Nanomedicine and nanoparticle-based delivery systems in plastic and reconstructive surgery