• Italiano
    • English
    • Deutsch
    • Español
    • Français
    • Русский
    • 中文 (中国)
    • Türkçe
    • Ελληνικά
    • Magyar
    • Српски језик
    • Lietuviškai
    • Bahasa Indonesia
    • Slovenčina

info@c-tech-implant.com

+39 051 66 61 817

+ 49 721 60 95 32 38

Slide Pubblicazioni Scientifiche

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

Henriette Lerner, Uli Hauschild, Robert Sader & Shahram Ghanaati

Abstract
Guided implant surgery is considered as a safe and minimally invasive flapless procedure. However, flapless guided surgery, implant placement in post-extraction sockets and immediate loading of complete-arch fixed reconstructions without artificial gum are still not throughly evaluated. The aim of the present retrospective clinical study was to document the survival and success of complete-arch fixed reconstructions without artificial gum, obtained by means of guided surgery and immediate loading of implants placed also in fresh extraction sockets.

Results
One hundred ten implants (65 of them post-extractive) were placed flapless through a guided surgery procedure and then immediately loaded by means of provisional fixed full arches. Successful implant stability at placement was achieved in all cases. After a provisionalization period of 6 months, 72 fixed prosthetic restorations were delivered. Only 2 implants failed to osseointegrate and had to be removed, in one patient, giving a 1-year implant survival rate of 98.2% (108/110 surviving implants); 8/12 prostheses did not undergo any failure or complication during the entire follow-up period. At the 1-year follow-up control, soft-tissue was stable in all patients and showed satesfactory aesthetic results.

 

Conclusions
In our present study, 12 patients received 110 implants (65 of them post-extractive), placed flapless through a guided surgery procedure and then immediately loaded by means of a provisional fixed full arch. After a provisionalization period of 6 months, 72 fixed zirconia-ceramic prosthetic restorations (53 single crowns, 17 bridges, and 2 fixed full arches) were delivered. The results showed a 1-year implant survival rate of 98.2% (108/110 surviving implants) and good soft-tissue stability.

Our present surgical and prosthetic approach presents several advantages. First, only one surgical session is required for tooth extraction, implantation and application of provisional prosthesis. For the patients social life, this concept allows a reduction of discomfort and facilite their return to professional life. For the dental rehabilitation, provisional restoration guides the soft-tissue healing for an optimal aesthetic result. Within the limitations of this study, combining a CBCT-derived surgical guide to an immediate implant placement in post-extraction sockets together with immediate provisionalization and loading seems to be a safe and predictable therapy, with high survival rates and excellent aesthetic results, when applied in indicated cases. Further studies on larger samples of patients and with longer follow-up controls are needed to draw more specific conclusions about the long-term results with the present technique.

Click here to view the online Clinical Case

References

1. Peñarrocha-Oltra D, Covani U, Peñarrocha-Diago M, Peñarrocha-Diago M. Immediate loading with fixed full-arch prostheses in the maxilla: review of the literature. Med Oral Patol Oral Cir Bucal. 2014;19(5):e512–7.

2.Peñarrocha-Oltra D, Covani U, Peñarrocha M, Peñarrocha-Diago M. Immediate versus conventional loading with fixed full-arch prostheses in mandibles with failing dentition: a prospective controlled study. Int J Oral Maxillofac Implants. 2015;30(2):427–34.

3. Papaspyridakos P, Mokti M, Chen CJ, Benic GI, Gallucci GO, Chronopoulos V. Implant and prosthodontic survival rates with implant fixed complete dental prostheses in the edentulous mandible after at least 5 years: a systematic review. Clin Implant Dent Relat Res. 2014;16(5):705–17.

4. Peñarrocha-Oltra D, Covani U, Aparicio A, Ata-Ali J, Peñarrocha-Diago M, Peñarrocha-Diago M. Immediate versus conventional loading for the maxilla with implants placed into fresh and healed extraction sites to support a full-arch fixed prosthesis: non-randomized controlled clinical study. Int J Oral Maxillofac Implants. 2013;28(4):1116–24.

5. Mello CC, Lemos CAA, Verri FR, Dos Santos DM, Goiato MC, Pellizzer EP. Immediate implant placement into fresh extraction sockets versus delayed implants into healed sockets: A systematic review and meta-analysis. Int J Oral Maxillofac Surg. 2017;46(9):1162–77.

6. Cercadillo-Ibarguren I, Sánchez-Torres A, Figueiredo R, Valmaseda-Castellón E. Bimaxillary simultaneous immediate loading of full-arch restorations: A case series. J Clin Exp Dent. 2017;9(9):e1147–52.

7. Hsu JT, Wu AY, Fuh LJ, Huang HL. Effects of implant length and 3D bone-to-implant contact on initial stabilities of dental implant: a microcomputed tomography study. BMC Oral Health. 2017;17(1):132.

8. Javaheri D. Achieving Anterior Aesthetics in a Full-Arch Implant Case. Dent Today. 2016;35(1):118 120–1.

9. Mangano FG, Mastrangelo P, Luongo F, Blay A, Tunchel S, Mangano C. Aesthetic outcome of immediately restored single implants placed in extraction sockets and healed sites of the anterior maxilla: a retrospective study on 103 patients with 3 years of follow-up. Clin Oral Implants Res. 2017;28(3):272–82.

10.Buser D, Martin W, Belser UC. Optimizing esthetics for implant restorations in the anterior maxilla: anatomic and surgical considerations. Int J Oral Maxillofac Implants. 2004;19(Suppl):43–61.

11. Link-Bindo EE, Soltys J, Donatelli D, Cavanaugh R. Common Prosthetic Implant Complications in Fixed Restorations. Compend Contin Educ Dent. 2016;37(7):431–6 quiz 439.

12. Khzam N, Arora H, Kim P, Fisher A, Mattheos N, Ivanovski S. Systematic Review of Soft Tissue Alterations and Esthetic Outcomes Following Immediate Implant Placement and Restoration of Single Implants in the Anterior Maxilla. J Periodontol. 2015;86(12):1321–30.

13. Mangano F, Shibli JA, Fortin T. Digital Dentistry: New Materials and Techniques. Int J Dent. 2016;2016:5261247.

14. Vercruyssen M, Laleman I, Jacobs R, Quirynen M. Computer-supported implant planning and guided surgery: a narrative review. Clin Oral Implants Res. 2015;26(Suppl. 11):69–76.

15. D’haese J, Ackhurst J, Wismeijer D, De Bruyn H, Tahmaseb A. Current state of the art of computer-guided implant surgery. Periodontol. 2017;73(1):121–33.

16. Colombo M, Mangano C, Mijiritsky E, Krebs M, Hauschild U, Fortin T. Clinical applications and effectiveness of guided implant surgery: a critical review based on randomized controlled trials. BMC Oral Health. 2017;17(1):150.

17. Bornstein MM, Scarfe WC, Vaughn VM, Jacobs R. Cone beam computed tomography in implant dentistry: a systematic review focusing on guidelines, indications, and radiation dose risks. Int J Oral Maxillofac Implants. 2014;29(Suppl):55–77.

18. Bornstein MM, Horner K, Jacobs R. Use of cone beam computed tomography in implant dentistry: current concepts, indications and limitations for clinical practice and research. Periodontol. 2017;73(1):51–72.

19. Bell CK, Sahl EF, Kim YJ, Rice DD. Accuracy of Implants Placed with Surgical Guides: Thermoplastic Versus 3D Printed. Int J Periodontics Restorative Dent. 2018;38(1):113–9.

20. Moraschini V, Velloso G, Luz D, Barboza EP. Implant survival rates, marginal bone level changes, and complications in full-mouth rehabilitation with flapless computer-guided surgery: a systematic review and meta-analysis. Int J Oral Maxillofac Surg. 2015;44(7):892–901.

21. Jesch P, Jesch W, Bruckmoser E, Krebs M, Kladek T, Seemann R. An up to 17-year follow-up retrospective analysis of a minimally invasive, flapless approach: 18 945 implants in 7783 patients. Clin Implant Dent Relat Res. 2018;20(3):393–402.

22. Daas M, Assaf A, Dada K, Makzoumé J. Computer-Guided Implant Surgery in Fresh Extraction Sockets and Immediate Loading of a Full-Arch Restoration: A 2-Year Follow-Up Study of 14 Consecutively Treated Patients. Int J Dent. 2015;2015:824127.

23. Browaeys H, Dierens M, Ruyffelaert C, Matthijs C, De Bruyn H, Vandeweghe S. Ongoing Crestal Bone Loss around Implants Subjected to Computer-Guided Flapless Surgery and Immediate Loading Using the All-on-4® Concept. Clin Implant Dent Relat Res. 2015;17(5):831–43.

24. Yamada K, Hoshina H, Arashiyama T, Arasawa M, Arai Y, Uoshima K, Tanaka M, Nomura S. Immediate implant loading following computer-guided surgery. J Prosthodont Res. 2011;55(4):262–5.

25. Allum SR. Immediately loaded full-arch provisional implant restorations using CAD/CAM and guided placement: maxillary and mandibular case reports. Br Dent J. 2008;204(7):377–81.

26. Montero J, Macedo de Paula C, Albaladejo A. The “Toronto prosthesis”, an appealing method for restoring patients candidates for hybrid overdentures: A case report. J Clin Exp Dent. 2012;4(5):e309–12.

27. Ata-Ali J, Flichy-Fernández AJ, Alegre-Domingo T, Ata-Ali F, Palacio J, Peñarrocha-Diago M. Clinical, microbiological and immunological aspects of healthy versus periimplantitis tissue in full-arch reconstruction patients: a prospective cross-sectional study. BMC Oral Health. 2015;15:43.

28. Ciabattoni G, Acocella A, Sacco R. Immediately restored full arch-fixed prosthesis on implants placed in both healed and fresh extraction sockets after computer-planned flapless guided surgery. A 3-year follow-up study. Clin Implant Dent Relat Res. 2017;19(6):997–1008.

29. Polizzi G, Cantoni T. Five-year follow-up of immediate fixed restorations of maxillary implants inserted in both fresh extraction and healed sites using the NobelGuide™ system. Clin Implant Dent Relat Res. 2015;17(2):221–33.

30. Meloni SM, De Riu G, Pisano M, Tullio A. Full arch restoration with computer-assisted implant surgery and immediate loading in edentulous ridges with dental fresh extraction sockets. One year results of 10 consecutively treated patients: guided implant surgery and extraction sockets. J Maxillofac Oral Surg. 2013;12(3):321–5.

31. Meloni SM, De Riu G, Pisano M, Lolli FM, Deledda A, Campus G, Tullio A. Implant Restoration of Edentulous Jaws with 3D Software Planning, Guided Surgery, Immediate Loading, and CAD-CAM Full Arch Frameworks. Int J Dent. 2013;2013:683423.

32. Zita Gomes R, de Vasconcelos MR, Lopes Guerra IM, de Almeida RAB, de Campo Felino AC. Implant stability in the posterior maxilla: a controlled clinical trial. Biomed Res Int. 2017;2017:6825213.

33. Bechara S, Kubilius R, Veronesi G, Pires JT, Shibli JA, Mangano FG. Short (6-mm) dental implants versus sinus floor elevation and placement of longer (=10-mm) dental implants: a randomized controlled trial with a 3-year follow-up. Clin Oral Implants Res. 2017;28(9):1097–107.

34. Furhauser R, Florescu D, Benesch T, Haas R, Mailath G, Watzek G. Evaluation of soft tissue around single-tooth implant crowns: the pink esthetic score. Clin Oral Implants Res. 2005;16(6):639–44.

35. Hultin M, Svensson KG, Trulsson M. Clinical advantages of computer-guided implant placement: a systematic review. Clin Oral Implants Res. 2012;23:124–35.

36. Marra R, Acocella A, Alessandra R, Ganz SD, Blasi A. Rehabilitation of Full-Mouth Edentulism: Immediate Loading of Implants Inserted With Computer-Guided Flapless Surgery Versus Conventional Dentures: A 5-Year Multicenter Retrospective Analysis and OHIP Questionnaire. Implant Dent. 2017;26(1):54–8.

37. Arisan V, Karabuda CZ, Ozdemir T. Implant surgery using bone- and mucosa-supported stereolithographic guides in totally edentulous jaws: surgical and post-operative outcomes of computer-aided vs. standard techniques. Clin Oral Implants Res. 2010;21:980–8.

38. Arisan V, Bölükbasi N, Öksüz L. Computer- assisted flapless implant placement reduces the incidence of surgery-related bacteremia. Clin Oral Investig. 2013;17:1985–93.

39. Fortin T, Isidori M, Bouchet H. Placement of posterior maxillary implants in partially edentulous patients with severe bone deficiency using CAD/CAM guidance to avoid sinus grafting: a clinical report of procedure. Int J Oral Maxillofac Implants. 2009;24:96–102.

40. Fürhauser R, Mailath-Pokorny G, Haas R, Busenlechner D, Watzek G, Pommer B. Esthetics of Flapless Single-Tooth Implants in the Anterior Maxilla Using Guided Surgery: Association of Three-Dimensional Accuracy and Pink Esthetic Score. Clin Implant Dent Relat Res. 2015;17(Suppl 2):e427–33.

41. Vercruyssen M, Cox C, Naert I, Jacobs R, Teughels W, Quirynen M. Accuracy and patient-centered outcome variables in guided implant surgery: a RCT comparing immediate with delayed loading. Clin Oral Implants Res. 2016;27(4):427–32.

42. Vercruyssen M, Cox C, Coucke W, Naert I, Jacobs R, Quirynen M. A randomized clinical trial comparing guided implant surgery (bone- or mucosa-supported) with mental navigation or the use of a pilot-drill template. J Clin Periodontol. 2014;41(7):717–23.

43. Van Assche N, Vercruyssen M, Coucke W, Teughels W, Jacobs R, Quirynen M. Accuracy of computer-aided implant placement. Clin Oral Implants Res. 2012;23(Suppl 6):112–23.

44. Mangano F, Gandolfi A, Luongo G, Logozzo S. Intraoral scanners in dentistry: a review of the current literature. BMC Oral Health. 2017;17(1):149.

45. Joda T, Zarone F, Ferrari M. The complete digital workflow in fixed prosthodontics: a systematic review. BMC Oral Health. 2017;17(1):124.

46. Mangano FG, Hauschild U, Admakin O. Full in-Office Guided Surgery with Open Selective Tooth-Supported Templates: A Prospective Clinical Study on 20 Patients. Int J Environ Res Public Health. 2018;15(11).

47. Spielau T, Hauschild U, Katsoulis J. Computer-assisted, template-guided immediate implant placement and loading in the mandible: a case report. BMC Oral Health. 2019;19(1):55.

Scientific Publications

Clinical case of total reconstruction in the upper jaw with guided surgery protocol and immediate loading

Clinical case of total reconstruction in the upper jaw with guided surgery protocol and immediate loading Dr. Fabio Lo Meo Introduction Nowadays modern surgical techniques are more and more moving towards simplified and minimally invasive protocols, aimed at offering patients more effective and highly predictable solutions with shorter treatment times. In addition, this approach makes treatments better tolerated, faster, with more comfortable postoperative courses and reduced costs. ImplRead more

Dentist Michael Weiland: excellent care is important to me!

Magazine PIP • Practical implantology and implant prosthetics • 08 June 2022 Dentist Michael Weiland: excellent care is important to me! In times of skilled labor bottlenecks and a fundamental lack of staff, the first thing that many lose is the services that were once seen as so essential. But the more a piece of hardware is interchangeable and discount battles want to be avoided, the more a company stands out from the customer with the many free little help. Interview with dentist MichRead more

Rehabilitation of the jaw by means of immediate implantation and immediate restoration Digital workflow

Magazine PIP • Practical Implantology and Implant Prosthetics • August 2022 | Issue 4' Rehabilitation of the jaw by means of immediate implantation and immediate restoration Digital workflow Catarina G. Rodrigues, DDS, MSc – Manuel D. Marques, DDS - Raquel Bandeira, CDT The success of any complex dental treatment depends on proper diagnostics and treatment planning. Digital treatment planning, prosthetic backward planning and guided implant surgery can help improve success rates and preRead more

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

Henriette Lerner, Uli Hauschild, Robert Sader & Shahram Ghanaati Abstract Guided implant surgery is considered as a safe and minimally invasive flapless procedure. However, flapless guided surgery, implant placement in post-extraction sockets and immediate loading of complete-arch fixed reconstructions without artificial gum are still not throughly evaluated. The aim of the present retrospective clinical study was to document the survival and success of complete-arch fixed reconstructioRead more

Webinar | Treatment of patients with totally edentulous arches: clinical applications of mini implants

Dental Tribune Magazine • Webinar • 11 May 2020 Treatment of patients with totally edentulous arches: clinical applications of mini implants. by Dr. Aldo De Blasi, expert in dentistry applied to mini implants. Abstract Mini implants are a valid alternative to traditional implants to stabilize the rehabilitation of edentulous arches. Patients with full arch prostheses can benefit from this technique which, with a minimally invasive approach, allows to stabilize them with a single operaRead more

Prefooter ENG