Upper jaw Implant restoration on six implants with flapless guided template surgery and immediate loadings. 5-years results of prospective study

16277 ORAL COMMUNICATION CLINICAL RESEARCH – PROSTHETICS

Background

In the last decade, treatment planning involving implant placement has changed from a surgical approach, focused on bone availability, to prosthetically driven planning using a computer-guided, template-assisted approach.

Aim/Hypothesis

The aim of this prospective study is to evaluate the clinical and radiographic outcomes of upper jaws fixed cross-arches prosthesis on 6 implants installed with 3D software planning, flapless guided surgery, and immediate loading.

Material and Methods

Healthy patients aged 18 years or older at the time of implant placement, in need to be restored with an immediately loaded implant-supported screw-retained cross-arch fixed dental prosthesis in the maxilla, were included in the present study and treated using computer-assisted template-guided surgery. In order to be immediately loaded implant sites were prepared and an insertion torque ranging between 35–45 Ncm was applied. A prefabricated screw-retained temporary prosthesis was delivered the day of the surgery. The evaluated outcomes were- implant cumulative survival rate (CSR), prosthesis survival, any technical and biologic complications, and peri-implant marginal bone level changes, probing pocket depth (PPD), and bleeding on probing (BOP).

Results

At the end of the study, no patients dropped out. 22 patients (16 females and 6 males) with mean age 63.4 years received 132 implants to support 22 cross-arch screw-retained fixed dental prostheses. 3 implants failed in 3 patients resulting in a CSR of 97.77%. No final prosthesis failed resulting in a CSR of 100%. No major biological or prosthesis complications were recorded. After an initial mean marginal bone loss of 1.10 ± 0.38 mm, (95% CI 0.95 to 1.25 mm), at 12-month follow-up , slightly marginal bone loss was reported with time, resulting in a mean marginal bone loss of 1.58 ± 0.41 mm, (95% CI 1.41 to 1.75 mm), at the 5-year follow-up. At 60-month follow-up mean PPD value was 2.44 ± 0.49 mm, (95% CI 2.24 to 2.64 mm), mean BOP value was 1.34 ± 0.87, (95% CI 0.98 to 1.70 mm).

Conclusion and clinical implications

Within the limitations of this study it can be concluded that computer guided surgery and immediate loading on 6 implants seem to represent a viable option for the immediate fix rehabilitations of completely edentulous upper jaws.