UPPER JAW IMPLANT RESTORATION ON SIX IMPLANTS WITH FLAPLESS GUIDED TEMPLATE SURGERY AND IMMEDIATE LOADINGS: 5 YEARS RESULTS OF PROSPECTIVE CASE SERIES

Abstract

Background. 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.
Methods. Healthy patients aged 18 years or older at the time of implant placement, in need to be re-stored 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), prosthe-sis survival, any technical and biologic complications, and peri-implant marginal bone level changes, probing pocket depth (PPD), and bleeding on probing (BOP).
Results. Twenty-two patients (16 females and 6 males) with a mean age of 63.4 years received 132 im-plants to support 22 cross-arch screw-retained fixed dental prostheses. At the end of the study, no pa-tients dropped out. Three implants failed in 3 patients resulting in a CSR of 97.77%. No final prosthe-sis 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 months 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 months 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. 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.