Evaluation of the accuracy of implant placement by using fully guided versus partially guided tissue-supported surgical guides with cylindrical versus C-shaped guiding holes: A split-mouth clinical study

Statement of problemThe accuracy of partially guided implant placement protocols in comparison with fully guided protocols is still unclear. C-shaped guide holes have become popular; however, their effect on drilling and implant position accuracy has not been thoroughly investigated.PurposeThe purpose of this split-mouth clinical study was to evaluate the accuracy of implant placement by using fully guided versus partially guided surgical guides with cylindrical versus C-shaped guiding holes.Material and methodsAdopting 80% power of the study in calculating sample size, a total of 48 implants were placed in the mandibular interforaminal area of 12 edentulous participants, who were randomly divided into 2 groups: a fully guided group, comprising 24 implants placed on 1 side by using a fully guided protocol and a partially guided group, comprising 24 implants placed on the other side in a partially guided protocol. Each group was further subdivided into 2 subgroups: cylindrical, including 12 implants placed through cylindrical guide holes, and C-shaped (12 implants) placed through C-shaped guiding holes. Postoperative cone beam computed tomography scans were made, and based on image fusion, the total deviations between the virtually preplanned and actual implant positions were determined and compared between both groups and subgroups. The linear horizontal deviation of the implant hexagon and apex, together with apical depth deviation and angular deviations between the position of the actually placed and virtually planned implants, were analyzed in 3 dimensions. The Kolmogorov-Smirnov test of normality was used. Comparisons were carried out by using the Kruskal-Wallis test. Post hoc pair-wise comparisons when the Kruskal-Wallis test was significant were carried out by using the Dunn-Sidak test (α=.05).ResultsNo statistically significant differences were found in coronal linear deviation (P>.05), apical linear deviation (P>.05), apical depth deviation (P=.086), or angular deviation (P=.247), between the fully guided protocol and the partially guided protocol.ConclusionsThe accuracy of partially guided implant placement was clinically comparable with that of fully guided placement whether the guiding holes were cylindrical or C-shaped.     

Accuracy of CAD-CAM Surgically Guided Tooth Autotransplantation Using Guided Templates and Custom-designed Osteotomes in Human Cadaver Mandibles

IntroductionA major challenge in dentistry is the replacement of teeth lost prematurely due to trauma, caries, or malformations; especially in growing patients. The aim of this study was to assess the accuracy of CAD-CAM surgically guided tooth autotransplantation in cryopreserved cadaver mandibles using guided templates and custom-designed osteotomes.MethodsCryopreserved human cadaver heads were digitized and scanned using an intraoral optical scanner and a large-volume cone beam computed tomography device. First, virtual surgical planning was performed to create a 3D tooth replica, 2 surgical guides, and a custom-made osteotome for each single-rooted tooth autotransplantation procedure/case. Surgical sockets were created in the selected mandibles using guided tooling consisting of an initial guided osteotomy with implant burs and a final guided osteotomy using custom osteotomes. After tooth autotransplantation, second large-volume cone beam computed tomography images of the 5 cadaver mandibles were obtained. The discrepancy in mm within the 3D space (apical and mesiodistal deviations) between the final position of the autotransplanted teeth and their digitally planned 3D initial position was calculated and analyzed statistically (P < .05).ResultsAll donor teeth were placed without incident within their newly created sockets in the real mandibles. The mean difference between the digitally planned root apex position and the final tooth position was 2.46 ± 1.25 mm. The mesiodistal deviation of the autotransplanted teeth was 1.63 ± 0.96 mm.ConclusionsThe autotransplantation of single-rooted teeth with custom-designed and 3D-printed surgical tooling provided promising results. The technique was able to create surgically prepared sockets that could accommodate transplanted teeth in mandibles.     

Trephination-based,guided surgical implant placement: A clinical study

Statement of problem

Conventional guided implant surgery promises clinical success through implant placement accuracy; however, it requires multiple drills along with surgical sleeves and sleeve adapters for the horizontal and vertical control of osteotomy drills. This results in cumbersome surgery, problems with patients having limited mouth opening, and restriction to specific drill or implant manufacturers. A protocol for using trephination drills to simplify guided surgery and accommodate multiple implant systems is introduced.

Accuracy of a chairside fused deposition modeling 3D-printed single-tooth surgical template for implant placement: An in vitro comparison with a light cured template

PurposeTo compare the accuracy of a chairside fused deposition modeling (FDM) 3D-printed surgical template with that of a light-cured template for implant placement.Materials and methodsTwenty standard mandibular resin models with missing teeth 36 and 46 were selected. Surgical templates were fabricated using a chairside FDM 3D-printer (test group) or a light-curing 3D printer (control group) (n = 20/group). Forty implants were placed by a clinician blinded to group allocation. The angular, 3D, mesiodistal, buccolingual, and apicocoronal deviations at the implant base and tip between preoperative design and postoperative implant position were recorded.ResultsThe mean angular (test vs control groups: 3.22° ± 1.55° vs 2.74° ± 1.24°, p = 0.343) and 3D deviations at the implant base (test vs control groups: 0.41 ± 0.13 mm vs 0.35 ± 0.11 mm, p = 0.127) and tip (test vs control groups: 0.91 ± 0.34 mm vs 0.75 ± 0.28 mm, p = 0.150) were similar. The mesiodistal, buccolingual, and apicocoronal deviations at the implant base and tip also did not differ significantly between groups (p > 0.05).ConclusionsFor single tooth gap indications, implant placement with an FDM 3D-printed surgical template was as accurate as that with a light-cured template, and more efficient.     

2D/3D accuracies of implant position after guided surgery using different surgical protocols: A retrospective study

PurposeTo compare the 2D and 3D positional accuracy of four guided surgical protocols using an analysis of linear and angular deviations.MethodsDICOM and .STLs files obtained from a CBCT and a digital impression were superimposed with software to plan implant position. Fifty-six patients were subdivided into 4 groups: FGA group (template support [Ts]: teeth [T]; bed preparation [Bp]: fully guided [FG]; implant insertion [Ii]: 3D template [3Dt]; device [D]: manual adapter [MA], FGM group (Ts: T; Bp: FG; Ii: 3Dt; D: fully guided mounter [FGM]), PG group (Ts: T; Bp: FG; Ii: manual; D: none) and MS group (Ts: mucosa; Bp: FG; Ii: 3Dt; D: FGM). The position of 120 implants was assessed by superimposing the planned and final position recorded with a digital impression.ResultsIn FGA group, 3D deviations were 0.92 ± 0.52 mm at the implant head and 1.14 ± 0.54 mm at the apex, and the angular deviation (ang. dev.) was 2.45 ± 1.24°. In FGM group, were 0.911 ± 0.44 mm (head) and 1.11 ± 0.54 mm (apex), and the ang. dev. was 2.73 ± 1.96°. In PG group, were 0.95 ± 0.47 mm (head) and 1.17 ± 0.488 mm (apex), and the ang. dev. was 3.71 ± 1.67°. In MS group, were 1.15 ± 0.45 mm (head) and 1.42 ± 0.45 mm (apex), and the ang. dev. was 4.19 ± 2.62°. Ang. dev. of MS group was different from the other groups (P < 0.05).ConclusionsGuided surgery showed a sufficient accuracy.     

Accuracy of a newly developed integrated system for dental implant planning

Objectives: To evaluate the accuracy of the first integrated system for cone-beam CT (CBCT) imaging, dental implant planning and surgical template-aided implant placement.
Materials and methods: On the basis of CBCT scans, a total of 54 implant positions were planned for 10 partially edentulous anatomical patient-equivalent models. Surgical guides were ordered from the manufacturer (SICAT). Two different types of guidance were assessed: for assessment of the SICAT system inherent accuracy vendor's titanium sleeves of 2 mm internal diameter and 5 mm length were utilized for pilot drills. The guide sleeves of the NobelGuide system were implemented for fully guided surgery and implant insertion. Deviations perpendicular to the implant axes at the crestal and apical end, as well as the angle deviations between the virtual planning data and the surgical results, were measured utilizing a follow-up CBCT investigation and referential marker-based registration.
Results: The SICAT system inherent mean deviation rates for the drilled pilot osteotomies were determined to be smaller than 500 μm even at the apical end. Mean angle deviations of 1.18° were determined. Utilizing the NobelGuide sleeve-in-sleeve system for fully guided implant insertion in combination with the investigated template technology enabled to insert dental implants with the same accuracy. Crestal deviations, in general, were significantly lower than the apical deviations.
Conclusion: Although hardly comparable due to different study designs and measurement strategies, the investigated SICAT system's inherent accuracy corresponds to the most favourable results for computer-aided surgery systems published so far. In combination with the NobelGuide surgical set for fully guided insertion, the same accuracy level could be maintained for implant positioning.     

Accuracy and complications of computer-designed selective laser sintering surgical guides for flapless dental implant placement and immediate definitive prosthesis installation

Background: Computer‐aided dental implant placement seems to be useful for placing implants by using a flapless approach. However, evidence supporting such applications is scarce. The aim of this study is to evaluate the accuracy of and complications that arise from the use of selective laser sintering surgical guides for flapless dental implant placement and immediate definitive prosthesis installation. Methods: Sixty implants and 12 prostheses were installed in 12 patients (four males and eight females; age range: 41 to 71 years). Lateral (coronal and apical) and angular deviations between virtually planned and placed implants were measured. The patients were followed up for 30 months, and surgical and prosthetic complications were documented. Results: The mean ± SD angular, coronal, and apical deviations were 6.53° ± 4.31°, 1.35 ± 0.65 mm, and 1.79 ± 1.01 mm, respectively. Coronal and apical deviations of <2 mm were observed in 82.67% and 58.33% of the implants, respectively. The total complication rate was 34.41%; this rate pertained to complications such as pulling of the soft tissue from the lingual surface during drilling, insertion of an implant that was wider than planned, implant instability, prolonged pain, midline deviation of the prosthesis, and prosthesis fracture. The cumulative survival rates for implants and prostheses were 98.33% and 91.66%, respectively. Conclusions: The mean lateral deviation was <1.8 mm, and the mean angular deviation was 6.53°. However, 41.67% of the implants had apical deviation >2 mm. The complication rate was 34.4%. Hence, computer‐aided dental implant surgery still requires improvement and should be considered as in the developmental stage.     

Digital versus conventional implant impressions for partially edentulous arches: An evaluation of accuracy

Statement of problem

To the authors’ knowledge, while accuracy outcomes of the TRIOS scanner have been compared with conventional impressions, no available data are available regarding the accuracy of digital scans with the Omnicam and True Definition scanners versus conventional impressions for partially edentulous arches.

Three‐Dimensional Accuracy of Guided Implant Placement: Indirect Assessment of Clinical Outcomes

Purpose: Precise preoperative implant planning and its exact intraoperative transfer are crucial for successful implant‐supported rehabilitation of partially or completely edentulous patients. In the present pilot study, optical laser scanning was used to evaluate deviations between three‐dimensonal computer‐assisted planned and actual implant positions by indirect methods. Material and Methods: Five patients receiving a total of 15 implants were included in this study. The used planning software was SimPlant 12.0 (Materialise Dental, Leuven, Belgium) to visualize the implant positions, and with an appropriate guided surgery protocol (Navigator?, Biomet 3i, Palm Beach Gardens, FL, USA) implant positions were implemented via tooth‐supported stereolithografic surgical guides. All implants (Osseotite?, Biomet 3i) were inserted in a flapless approach and immediately provided with prefabricated temporary splinted restorations. Intraoral pickup impressions were taken postoperatively, and the implant positions of the master casts were compared with presurgical casts. Implant replica deviations were evaluated by three‐dimensional optical laser scanning providing distances and angulations between implant replicas. Results: Overall, the postsurgical implant replica positions were found to deviate from the positions in the preoperative cast by a mean of 0.46 ± 0.21 mm (range: 0.09–0.85 mm). Positional deviations were 0.27 ± 0.19 mm (range: 0.04–0.60 mm) along the x‐axis representing the buccal‐lingual directions, 0.15 ± 0.13 mm (range: 0.0–0.34 mm) along the y‐axis representing the ventrodorsal direction, and 0.28 ± 0.19 mm (range: 0.02–0.59 mm) along the z‐axis representing cranial and apical directions. Rotational deviations amounted to 14.04 ± 11.6° (range: 0.09–36.47°). Conclusions: The results of this pilot study demonstrate precise transfer of implant replica position by means of simulated guided implant insertion into a preoperative cast and a postoperative cast obtained from impressioning. Further studies are needed to identify appropriate evaluation techniques and mechanisms to increase the transfer precision of three‐dimensional planning and guiding systems.     

A prospective,controlled clinical trial evaluating the clinical and radiological outcome after 3 years of immediately placed implants in sockets exhibiting periapical pathology

Objectives: The aim of the present study was to compare the clinical and radiological outcome of immediately placed implants in sockets with or without periapical pathology 3 years after implant placement. Materials and methods: Twenty‐nine patients with immediate implant placement were clinically and radiologically followed 3 years after implant placement (test group: 16 patients without periapical pathology, control group: 13 patients with periapical pathologies). Clinical (full‐mouth bleeding score, full‐mouth plaque score, clinical attachment level measurements and width of keratinized mucosa buccaly of the implant) and radiological parameters (vertical distance from the implant shoulder to the first bone‐to‐implant contact [IS‐BIC]) were assessed. Both 95% confidence intervals, as well as results of statistical tests (one‐sample, two‐sample and paired t‐test) were provided. Results: The implant survival rate was 100% for all 29 implants after 3 years. The clinical and radiological parameters showed no statistically significant difference between the test and the control group at 3 years (two‐sample t‐test). The IS‐BIC was between 1.54 ± 0.88 mm (mesial, test) and 1.69 ± 0.92 mm (distal, test). Between the 1‐ and 3‐year visit the IS‐BIC increased in both groups significantly on one side of the implant: 0.30 ± 0.37 mm (mesial, test) and 0.33 ± 0.43 mm (distal, control) (one‐sample t‐test). None of the 13 examined radiographs of implants immediately placed in sockets with periapical pathologies revealed retrograde peri‐implantitis after 3 years. Conclusion: It is concluded within the limitations of this study, that after careful debridement of the extraction socket, immediate placement of implants into sites with periapical pathologies can be a successful treatment modality for at least 3 years with no disadvantages in clinical and radiological parameters to immediately placed implants into healthy sockets. To cite this article:
Truninger TC, Philipp AOH, Siegenthaler DW, Roos M, Hämmerle CHF, Jung RE. A prospective, controlled clinical trial evaluating the clinical and radiological outcome after 3 years of immediately placed implants in sockets exhibiting periapical pathology.

Clin. Oral Impl. Res. 22 , 2011; 20–27.
doi: 10.1111/j.1600‐0501.2010.01973.x     

A randomized controlled clinical trial comparing guided with nonguided implant placement: A 3-year follow-up of implant-centered outcomes

Statement of problemImplant-based prosthetic solutions can be time consuming. If implants can be placed successfully with a guide, surgery time can be reduced.PurposeThe purpose of this randomized controlled clinical trial was to assess implant outcomes, both clinical and radiological, comparing guided with nonguided implant placement after 3 years of follow-up.Material and methodsA total of 314 implants were placed in 72 jaws (60 participants). The jaws were randomly assigned to 1 of the 6 treatment groups: Materialise Universal/mucosa (Mat Mu), Materialise Universal/bone (Mat Bo), Facilitate/mucosa (Fac Mu), Facilitate/bone (Fac Bo), freehand navigation (Freehand), and a pilot-drill template (Templ). Radiographic and clinical parameters (bone loss, pocket probing depth, bleeding on probing, and plaque scores) were recorded at the time of implant placement, prosthesis installment (baseline), and 1-year, 2-year, and 3-year follow-up. Analysis was performed using a linear mixed model, and correction for simultaneous hypothesis was made according to Sidak (α=.05).ResultsThree participants left the study before the 3-year follow-up; hence, 302 implants in 69 jaws were included in this study. None of the implants failed. The mean marginal bone loss after the third year of loading was 0.7 ±1.3 mm for the guided surgery group and 0.5 ±0.6 mm for the control group. No significant intergroup or follow-up period differences were observed (P>.05). In the guided surgery groups, the mean number of surfaces with bleeding on probing and plaque at 3-year follow-up was 1.7 ±1.5 and 1.7 ±1.7, respectively; for the control groups, this was 1.6 ±1.4 and 1.6 ±1.6, respectively. The mean pocket probing depth was 3.0 ±1.3 mm for the guided group and 2.6 ±1.0 mm for the control group. No significant differences were found (P>.1).ConclusionsWithin the limitation of this study, no statistically significant differences could be found between the guided group and the control group at the 3-year follow-up.     

Ridge alterations following immediate implant placement and the treatment of bone defects with Bio-Oss in an animal model

Background: Conflicting data exist on the outcome of placing Bio‐Oss® (Geitslich Pharm AG, Wolhausen, Switzerland) into extraction sockets. It is therefore relevant to study whether the incorporation of Bio‐Oss into extraction sockets would influence bone healing outcome at the extraction sites. Purpose: The aim of this study was to assess peri‐implant bone changes when implants were placed in fresh extraction sockets and the remaining defects were filled with Bio‐Oss particles in a canine mandible model. Materials and Methods: Six mongrel dogs were used in the study. In one jaw quadrant of each animal, the fourth mandibular premolars were extracted with an elevation of the mucoperiosteal flap; implants were then placed in the fresh extraction sockets and the remaining defects were filled with Bio‐Oss particles. After 4 months of healing, micro‐computed tomography at the implant sites was performed. Osseointegration was calculated as the percent of implant surface in contact with bone. Additionally, bone height was measured in the peri‐implant bone. Results: Average osseointegration was 28.5% (ranged between 14.8 and 34.2%). The mean crestal bone loss was 4.7 ± 2.1 mm on the buccal aspect, 0.4 ± 0.5 mm on the mesial aspect, 0.4 ± 0.3 mm on the distal aspect, and 0.3 ± 0.4 mm on the lingual aspect. Conclusion: The findings from this study demonstrated that the placement of implants and Bio‐Oss® particles into fresh extraction sockets resulted in significant buccal bone loss with low osseointegration.     

Influence of Metal Guide Sleeves on the Accuracy and Precision of Dental Implant Placement Using Guided Implant Surgery: An In Vitro Study

Purpose

Metal sleeves are commonly used in implant guides for guided surgery. Cost and sleeve specification limit the applications. This in vitro study examined the differences in the implant position deviations produced by a digitally designed surgical guide with no metal sleeve in comparison to a conventional one with a metal sleeve.

Materials and Methods

The experiment was conducted in two steps for each step: n = 20 casts total, 10 casts each group; Step 1 to examine one guide from each group with ten implant placements in a dental cast, and Step 2 to examine one guide to one cast. Implant placement was performed using a guided surgical protocol. Postoperative cone-beam computed tomography images were made and were superimposed onto the treatment-planning images. The implant horizontal and angulation deviations from the planned position were measured and analyzed using t-test and F-test (p = 0.05).

Results

For Step 1 and 2, respectively, implant deviations for the surgical guide with sleeve were –0.3 ±0.17 mm and 0.15 ±0.23 mm mesially, 0.60 ±1.69 mm, and –1.50 ±0.99 mm buccolingual at the apex, 0.20 ±0.47 mm and –0.60 ±0.27 mm buccolingual at the cervical, and 2.73° ±4.80° and –1.49° ±2.91° in the buccolingual angulation. For Step 1 and 2, respectively, the implant deviations for the surgical guide without sleeve were –0.17 ±0.14 mm and –0.06 ±0.07 mm mesially, 0.35 ±1.04 mm and –1.619 ±1.03 mm buccolingual at the apex, 0.10 ±0.27 mm and –0.62 ±0.27 mm buccolingual at the cervical, and 1.73° ±3.66° and –1.64° ±2.26° in the buccolingual angulation. No statistically significant differences were found in any group except for mesial deviation of the Step 2 group (F-test, p < 0.001).

Conclusions

A digitally designed surgical guide with no metal sleeve demonstrates similar accuracy but higher precision compared to a surgical guide with a metal sleeve. Metal sleeves may not be required for guided surgery.     

CBCT fractal dimension changes at the apex of immediate implants placed using undersized drilling

Objectives: To evaluate, on the base of cone beam computed tomography (CBCT) fractal dimension, bone quality changes surrounding the apical portion of immediate implants placed under higher insertion torque utilizing an undersized drilling technique. Materials and methods: Three patients were enrolled in this study. Single implants were placed into fresh extraction sockets in the anterior maxilla and provisionalized immediately. Adequate stability was ensured on all the implants by a 28.5% undersizing of the apical portion of the osteotomy. Bone quality at the most apical 1.15 mm peri‐implant bone portion were measured by CBCT at placement and after 6 months. This analysis was carried out by evaluating the box counting fractal dimension of 15 consecutive CBCT slices related to the most apical part of each implant. Results: All the three implants were successful after an 18‐month follow‐up period. The mean fractal dimension at the implant apex exhibited a 3% increase 6 months following placement. Conclusions: Within the limitations of an explorative study, an undersized drilling resulting in high insertion torque would seem to induce no adverse changes in radiographic bone quality after 6 months of follow‐up. The most favorable entity of drilling undersizing and its effect on peri‐implant bone remodeling, should be evaluated on a larger patient population. To cite this article :
González‐Martín O, Lee EA, Veltri M. CBCT fractal dimension changes at the apex of immediate implants placed using undersized drilling
Clin. Oral Impl. Res. 23 , 2012; 954–957
doi: 10.1111/j.1600‐0501.2011.02246.x     

Sinus floor elevation via the maxillary premolar extraction socket with immediate implant placement: a case series

Background: When immediate implant placement is considered for teeth with close proximity to the sinus floor, apical extension of the osteotomy is significantly limited, and often a staged approach is used. Implant placement into fresh extraction sockets and sinus floor manipulation using bone‐added osteotome sinus floor elevation with implant placement are techniques most often used independently or sequentially. Very few reports have described the combined use of immediate implant placement in fresh sockets and the bone‐added osteotome sinus floor elevation technique. Methods: We present five cases in which a maxillary premolar was extracted and an implant placed into the extraction site with simultaneous abfracture of the sinus floor using osteotomes. All teeth were extracted atraumatically, and sockets carefully debrided and checked for integrity of the walls. After ideal osteotomy preparation, particulate bone graft was placed in the osteotomy and appropriately sized osteotomes were used for sinus floor elevation. After sufficient elevation, implant placement was completed and particulate bone was packed in the bone–implant gap when indicated. Results: All implants were restored after a minimum healing period of 6 months. At the time of final restoration, bone was seen surrounding the implants from the apical portion to the most coronal thread. All five implants healed without complications and were in function for periods ranging from 6 to 12 months. Conclusions: Immediate implant placement with simultaneous osteotome sinus floor elevation is an advantageous combination of two successfully used techniques. This combined approach can significantly reduce the treatment time for implant therapy in teeth with close sinus proximity and provide the operator with the ability to place implants of desired length.     

Rationale for a reverse tapered body shift implant for immediate placement

Immediate implant placement holds considerable value, yet primary implant stability is often a critical factor. The aim of this study was to evaluate the stability, volumetric viability, and buccal gap size of reverse tapered body shift (RTBS) implants after immediate placement. Peak insertion torque measurements of two RTBS designs (apical 40% vs. apical 50%), relative to conventionally tapered implants, were assessed in simulated extraction sockets prepared in synthetic bone blocks. Additionally, the proximity of the RTBS implants to neighbouring teeth and anatomical structures, and the buccal gap distance were evaluated in human cadavers. The mean (± standard deviation) insertion torque was 12.00 ± 1.40 N•cm for the conventionally tapered implants (n = 50), 35.36 ± 2.74 N•cm (n = 50) for RTBS-1, and 48.20 ± 2.90 N•cm (n = 50) for RTBS-2; the difference between designs was statistically significant (P < 0.01). In total, 40 RTBS implants (20 per design) were placed in six cadaveric premaxillae. Only one locus was inappropriate for both RTBS implant designs, due to the proximity of neighbouring teeth. The average buccal gap for both implant designs was 2.8 mm (P = 0.104). The improved primary stability and increased buccal gap size with RTBS implants may enhance the feasibility of immediate placement. The study findings should be further validated in clinical trials.     

Immediately restored single implants in the aesthetic zone of the maxilla using a novel design: 1-year report

Objectives: To evaluate immediate placement and immediate restoration of a novel implant with a 12°‐angled prosthodontic platform, in fresh extraction sockets of the aesthetic zone of the maxilla. Materials and methods: Tapered, roughened surface implants of 4 mm (n=15) or 5 mm (n=13) diameter were placed in 27 participants (mean age: 47.1 years; range: 21–71 years) requiring an immediate replacement of single anterior maxillary teeth. Provisional screw‐retained all‐ceramic crowns were placed within 4 h following optical impressions. At 8 weeks (baseline), definitive screw‐retained all‐ceramic crowns were placed in occlusion. Results: Twenty‐six of the 28 implants met the inclusion criteria at surgery. Marginal bone levels revealed bone gain between surgery and baseline, and between baseline and 1 year of 0.2 mm (SD 0.75) and 0.78 mm (SD 2.45). Mean mid‐buccal mucosal margins showed gains of 0.2 mm (SD 0.44). Prosthodontic maintenance and the aesthetics of the screw‐retained implant crowns were facilitated by the external hex 12°‐angled prosthodontic platform on the novel implant design, re‐orientating the access cavity to the palatal or occlusal surfaces. All‐ceramic implant crowns showed a high success rate with low maintenance issues over 1 year. Conclusion: Tapered, roughened‐surfaced implants with a novel 12°‐angled prosthodontic platform immediately placed in fresh extraction sockets, immediately restored with provisional crowns and subsequent definitive crowns at 8 weeks were successful for 1 year. To cite this article:
Brown SDK, Payne AGT. Immediately restored single implants in the aesthetic zone of the maxilla using a novel design: 1‐year report.
Clin. Oral Impl. Res. 22 , 2011; 445–454.     

数字化导板引导下全口种植即刻负重可行性与精准度的研究

目的 探究数字化导板引导下全口种植即刻负荷的可行性,根据影像学数据评价导板引导的种植精准度,探讨可能影响植体位置精度的相关因素.方法 按照准入排除标准,收集2017年至2019年使用数字化导板引导下的全口种植即刻负重固定修复患者16例(98枚植体),跟踪随访患者评价长期的临床修复效果.利用CBCT数据测量30颗植体实际...