A simple method to identify implant sites in totally edentulous arches: a pilot study with thermo-printed templates used with cone beam computed tomography.

Abstract

All dental implants must be placed following radiological, clinical and aesthetic indications in compliance with prosthetic principles avoiding iatrogenic damage to patients. In implantology, among the key choices, to obtain predictable results, it is essential to establish (by cone beam computed tomography [CBCT]) the sites where to insert the implants; these sites must be identified, during the surgical phase, in the oral cavity. Surgical guides represent a valid aid especially in complex cases that require multiple implants. For some clinical conditions, expert operators choose the free hand technique during which identifying the chosen implant sites on CBCT in the oral cavity is more difficult. This experimental study is based on the use of thermo-molded mask as an alternative to surgical guides when the freehand technique is adopted in totally edentulous patients. These innovative masks, containing radiopaque references, are initially worn by patients during the execution of the CBCT, and later during surgery to identify the implant sites in the oral cavity. The procedure described proved to be very useful and able to increase the precision of the freehand technique even if it does not provide information on the inclination of the implants. The metal references help clinical identification of the implant site. Our thermo-molded masks, in particular clinical conditions, could represent a valid and economical alternative to the classic surgical guide. The described procedure does not increase costs for the patient and significantly increases the precision in inserting the implants during free-hand techniques.