Abstract
BackgroundThis retrospective clinical study aims to present results of experience with a novel guided surgery system with a sleeveless, open-frame structure, in which the surgical handpiece (not the drills used for preparation) is guided.MethodsThis study was based on an evaluation of the records of partially edentulous patients who had been treated with a sleeveless open-frame guided surgery system (TWIN-Guide®, 2Ingis, Brussels, Belgium), between January 2015 and December 2017. Inclusion criteria were patients with good systemic/oral health and a minimum follow-up of 1 year. Exclusion criteria were patients who had been treated without a guide, or with a guide with sleeves, patients with systemic/oral diseases and who did not have a follow-up of 1 year. The main outcomes were surgical (fit and stability of the surgical guide, duration of the intervention, implant stability, and any intra-operative or immediate post-operative complication), biologic, and prosthetic.ResultsThirty-eight patients (24 males, 14 females; mean age 56.5 ± 14.0 years) were included in the study. These patients had been treated with 110 implants inserted by means of 40 sleeveless, open-frame guides. With regard to fit and stability, 34 guides were excellent, 4 acceptable, and 2 inadequate for use. The mean duration of the intervention was 23.7 (± 6.7) minutes. Immediately after placement, 2 fixtures were not stable and had to be removed. Two patients experienced pain/swelling after surgery. The 108 surviving implants were restored with 36 single crowns and 32 fixed partial prostheses (24 two-unit and 8 three-unit bridges); these restorations survived until the 1-year follow-up, with a low incidence of biologic and prosthetic complications.ConclusionsWithin the limits of this study, this novel guided surgery system with sleeveless, open frame–structure guides seems to be clinically reliable; further studies on a larger sample of patients are needed to confirm these outcomes.
Highlights
This retrospective clinical study aims to present results of experience with a novel guided surgery system with a sleeveless, open-frame structure, in which the surgical handpiece is guided
No sleeves are used; the surgical handpiece is guided, not the drills used for preparation
The records were accompanied by medical imaging, and any complications or problems registered during the guided surgery were appropriately noted
Summary
This retrospective clinical study aims to present results of experience with a novel guided surgery system with a sleeveless, open-frame structure, in which the surgical handpiece (not the drills used for preparation) is guided. The insertion of dental implants through a surgical guide in an ideal position, planned in the computer, would represent an undoubted advantage for the surgeon [1,2,3,4,5,6, 8]; it would allow one to reduce the risks related to the invasion of anatomical structures (such as the inferior alveolar nerve and maxillary sinus, or the periodontal ligament and the roots of adjacent teeth, where present) and to obtain an ideal prosthetic emergence through the preparation of a virtual 3D diagnostic wax-up [8, 9] This 3D wax-up, realized on a model captured by intraoral [10] or desktop [11] scanning within computer-assisted-design (CAD) software and imported into the guided surgery software, guides the insertion of the fixtures in the exact position and inclination, facilitating the prosthetic rehabilitation process [8, 9, 12]. Maybe these are not the real reasons why guided surgery has still not spread universally in the dental world, in the implant-supported restoration of partially edentulous patients [6, 18, 22]
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