A Randomized Controlled Clinical Trial Comparing Conventional And Computer-Assisted Implant Planning and Placement in Partially Edentulous Patients. Part 2: Patient Related Outcome Measures.

Abstract

The objective of this study was to compare patient-related outcomes of conventional protocols with computer-assisted implant planning and template-guided implant placement (CAIPP) protocols. Partially edentulous patients (N = 73) were assigned to either surgical planning based on two-dimensional radiographs and freehand implant placement (control; n = 26) or using three-dimensional computer-tomography data and implant placement using a tooth-supported surgical guide (test groups T1 [n = 24] and T2 [n = 23]). The two test groups differed from each other in digital data acquisition, software functionality, and the guide-manufacturing process. All surgeries were performed as open-flap procedures. Patient-related outcome measures were evaluated using questionnaires. Statistical tests were performed to investigate differences between treatment groups. Before treatment, 53% of patients in the control group and 83% of patients in the test groups (T1: 88%, T2: 78%) were satisfied with their group allocation. In the control group, 37% of patients favored CAIPP technology, while only 11% in the test groups would have preferred a conventional procedure. After treatment, 50% of patients in the control and 86% in the test groups (T1: 76%, T2: 94%) were satisfied with their allocation. Twenty-one percent of control-group patients favored the CAIPP treatment, while 6% of the test-group patients would have preferred a conventional treatment. The quality-of-life parameters during and after surgery did not show significant differences between groups. More postoperative discomfort was reported after longer and more-complex surgeries including guided bone regeneration and surgeries with two surgical sites. Generally, patients preferred computer-based technologies. No differences in the intra- or postoperative discomfort were observed compared to control protocols. More-extensive surgical procedures negatively affected the intra-and postoperative quality of life, irrespective of the treatment group allocation.