The present study aims at evaluating computer-aided dental implant planning, comparing the results to traditional implant surgery.

METHODS
24 patients aged between 25 and 65 years were included in this study, 11 males and 13 females.

The patients were divided into two groups made of 12 patients. The first group was treated with computer-assisted implant surgery using SimPlant®-Pro (Materialise™) and Facilitate®-Pro (Astra Tech™); the second group of patients was treated with traditional implant surgery, which was not computer-guided.

All cases were rehabilitated through fixed cement-retained prostheses with mesostructures and through screw-retained “Toronto” prostheses. The total number of implants inserted was 108 (52 in group A, 56 in group B).

RESULTS
All patients of group A (computer-guided implantology) did not show intraoperative complications. Complications arose in 2 cases of group B (traditional implantology) with an implant bone dehiscence and consequent need of unplanned Guided Bone Regeneration (GBR).

2 other cases of the same group showed the presence of disparallelism with prosthetic complications compromising the final result. On the contrary, good parallelism was reported in all cases of group A.

The surgical times of patients of group A treated with flapless technique were lower than group B and their postoperative discomfort was minimum. For 1 patient of group A the clinical evaluation led to an implant failure, as confirmed by the radiological examination.

The same happened for 2 implants of group B.

The 12-month follow-up revealed that 1 patient of group B contracted severe mucositis and peri-implantisis. Bleeding on probing and a 3,5 mm peri-implant pocket were present; endoral radiography showed bone resorption. A case of mucositis was reported even in group A.

1 case of group B reported screw loosening in the fixture-abutment connection.
All other cases fulfilled the success criteria. Almost all patients expressed a degree of satisfaction from ‘very satisfied’ to ‘extremely satisfied’ in terms of comfort and esthetics. However, the patients of group A complained about the cost of the treatment. All patients showed a good level of compliance; higher levels were reported by patients of group A.

CONCLUSIONS
The benefits of computer-assisted implant surgery are clear. This procedure proved reliable, predictable and accurate, and confirms what is reported in the literature.

Computer-guided surgery, if compared to traditional implantology, is more expensive but superior, since it reduces or cancels human errors, significantly reduces the risk of surgical complications, improves the functional and esthetic results of prosthetic rehabilitation, reduces the time needed and minimizes the postoperative discomfort.

 

 

Università degli Studi di Bari “A. Moro” Dipartimento di Odontostomatologia e Chirurgia
XX Congresso nazionale Docenti di Odontoiatria

Authors:
Inchingolo F., INGROSSO M.P., Ingrosso A.M., Colella A., Marrelli M., Palladino A., Tatullo M., Inchingolo A.M., Carbotti F., Inchingolo A.D., Schinco F., Dipalma G.

BIBLIOGRAFIA
Abad-Gallegos M, Gòmez-Santos L, Sanchez-Garcès MA, Piñera-Penalva M, Freixes-Gil J, Castro-Garcìa A, Gay-Escoda C. Complications of guided surgery and immediate loading in oral implantology : A report of 12 cases. Med Oral Patol Oral Cir Bucal. 2011, Mar: 220-224.  Adell R, Lekholm U, Cocker B, Branemark Pl. A 15-year study of osseointegrated implants in the treatments of the edentulous jaw. Int J Oral Surg. 1981 Dec; 10(6) : 387-416.  Albrektsson T, Branemark PL, et Al. Osseointegrated titanium implants. Requirements for ensuring a long-lasting, direct bone anchorage in man. Acta Orthop Scand. 1981; 52: 155-170.  Albrektsson T, Branemark PL, et Al. The interface zone of inorganics implants in vivo : titanium implants in bone. Ann Biomed Eng. 1983 ;11:1-27.  Albrektsson T, Zarb G, et Al. The long term efficacy of currently used dental implants: a review and proposed criteria of success. Int J Oral Maxillofac Implants. 1986; 52:155-170.  Almong DM, Torrado E, Meitner SW. Fabrication of imaging and surgical guides for dental implants. J Prosthet Dent. 2001, May, 85: 504-508. Bolin A, Eliasson S. Panoramic and tomographic dimensional determinations for maxillary osseointegrated implants. Comparison of the morphologic information potential of two and three dimensional radiographic systems. Swed Dent J. 1995;19(1-2):65-71.