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Stomatologija 2010; 12 (2): 35-41 896 KB

Flapless surgery and immediately loaded implants: A retrospective comparison between implantation with and without computer-assisted planned surgical stent

Matteo Danza, Francesco Carinci

Summary

Objectives. Computer planned flapless surgery and immediate loading are the most recent topics in implantology. One new computer-planned implant system uses a three-dimensional parallelometer able to transfer the implant position from the virtual project to the master model. The aim of this study was to verify if the new medical device gives an advantage in term of implant failures and/or crestal bone remodeling.

Material and methods. A retrospective study was planned to analyze a series of 193 immediately loaded fixtures inserted by means of flapless surgery. From those sixty six implants were inserted with computer planning whereas 127 were inserted “free-hand”. Several variables related to patient, anatomy, implant, surgery and prosthesis were investigated. To detect the clinical outcome implant’ failure and peri-implant bone resorption were considered. Kaplan-Meier algorithm and Cox regression were then performed to detect those variables statistically associated with the clinical outcome.

Results. Implant length and diameter ranged from 10 to 16 mm and from 3.75 to 6.0 mm, respectively. Implants were inserted to replace 46 incisors, 30 cuspids, 75 premolars and 42 molars. The mean follow-up period was 15 months. Seven implants were lost (survival rate 96.4%) but no studied variable has a statistical impact on failures. On the contrary, implants inserted in sites with completed bone healing, wide diameter fixtures and implants inserted in totally edentulous jaw had a significantly lower crestal bone resorption. The other variables (age, gender, upper/lower jaws, tooth site, implant’ type and length, number of prosthetic units antagonist condition) did not have impact on crestal remodeling.

Conclusion. Computer-planned and cast model transferred implantology is a reliable technology that provides a slightly higher clinical outcome than “free hand” technique at least in healed sites, wider implants and totally edentulous jaws.

Key words: Bone, remodeling, resorption, ridge, alveolar, computer-guided, fixture, tomography.

Received: 24 07 2009

Accepted for publishing: 21 06 2010

¹Dental School, University of Pescara-Chieti, Italy
²Department of Maxillofacial Surgery, University of Ferrara, Corso Giovecca 203, 44100 Ferrara, Italy

Matteo Danza¹ – Senior Lecturer
Francesco Carinci² – Prof., M.D, Chair of Maxillofacial Surgery

Address correspondence to Prof. Francesco Carinci, Department of Maxillofacial Surgery, University of Ferrara, Corso Giovecca 203, 44100 Ferrara, Italy.
E-mail: crc@unife.it



	Baltic Dental and Maxillofacial Journal

June, 2010, Vol. 12, No. 2 CONTENTS SCIENTIFIC ARTICLES Flapless surgery and immediately loaded implants: A retrospective comparison between implantation with and without computer-assisted planned surgical stent Matteo Danza, Francesco Carinci 35-41 Technical aspects of endodontic treatment procedures among Lithuanian general dental practitioners Vytaute Peciuliene, Jurate Rimkuviene, Jolanta Aleksejuniene, Markus Haapasalo, Saulius Drukteinis, Rasmute Maneliene 42-50 Electromyographic and cephalometric correlation with the predominant masticatory movement Maria Julia P. Coelho-Ferraz, Fausto Berzin, Cesar Ferreira Amorim, Fabio Lourenco Romano, Dagmar de Paula Queluz 51-55 The impact of salivary mutans streptococci and sugar consumption on caries experience in 6-year olds and 12-year olds in Riga Jekaterina Gudkina, Anda Brinkmane 56-59 REVIEW Changes in oral health-related quality of life among children following dental treatment under general anaesthesia. A systematic review Birute Jankauskiene, Julija Narbutaite 60-64 © 2010 Stomatologija		Stomatologija 2010; 12 (2): 35-41 896 KB Flapless surgery and immediately loaded implants: A retrospective comparison between implantation with and without computer-assisted planned surgical stent Matteo Danza, Francesco Carinci Summary Objectives. Computer planned flapless surgery and immediate loading are the most recent topics in implantology. One new computer-planned implant system uses a three-dimensional parallelometer able to transfer the implant position from the virtual project to the master model. The aim of this study was to verify if the new medical device gives an advantage in term of implant failures and/or crestal bone remodeling. Material and methods. A retrospective study was planned to analyze a series of 193 immediately loaded fixtures inserted by means of flapless surgery. From those sixty six implants were inserted with computer planning whereas 127 were inserted “free-hand”. Several variables related to patient, anatomy, implant, surgery and prosthesis were investigated. To detect the clinical outcome implant’ failure and peri-implant bone resorption were considered. Kaplan-Meier algorithm and Cox regression were then performed to detect those variables statistically associated with the clinical outcome. Results. Implant length and diameter ranged from 10 to 16 mm and from 3.75 to 6.0 mm, respectively. Implants were inserted to replace 46 incisors, 30 cuspids, 75 premolars and 42 molars. The mean follow-up period was 15 months. Seven implants were lost (survival rate 96.4%) but no studied variable has a statistical impact on failures. On the contrary, implants inserted in sites with completed bone healing, wide diameter fixtures and implants inserted in totally edentulous jaw had a significantly lower crestal bone resorption. The other variables (age, gender, upper/lower jaws, tooth site, implant’ type and length, number of prosthetic units antagonist condition) did not have impact on crestal remodeling. Conclusion. Computer-planned and cast model transferred implantology is a reliable technology that provides a slightly higher clinical outcome than “free hand” technique at least in healed sites, wider implants and totally edentulous jaws. Key words: Bone, remodeling, resorption, ridge, alveolar, computer-guided, fixture, tomography. Received: 24 07 2009 Accepted for publishing: 21 06 2010 ¹Dental School, University of Pescara-Chieti, Italy ²Department of Maxillofacial Surgery, University of Ferrara, Corso Giovecca 203, 44100 Ferrara, Italy Matteo Danza¹ – Senior Lecturer Francesco Carinci² – Prof., M.D, Chair of Maxillofacial Surgery Address correspondence to Prof. Francesco Carinci, Department of Maxillofacial Surgery, University of Ferrara, Corso Giovecca 203, 44100 Ferrara, Italy. E-mail: crc@unife.it