A suggested protocol to increase the accuracy of prosthetic phases in case of full-arch model-free fully guided computer-aided implant placement and immediate loading.

Abstract

The accuracy of fully digital model-free surgical and prosthetic procedures depends on the cumulative effect and interaction of all errors gathered along the entire workflow process. In the present case series, a technique is described that increases the accuracy in the transition from the surgical to the prosthetic phase to reduce the risk of developing prosthetic complications in the case of immediate loading protocols. Overall, 86 dental implants were placed and immediately loaded with definitive prostheses in 11 edentulous patients following computer-guided implant surgery according to a fully digital model-free workflow. The same reference template used to anchor the surgical stent during computer-aided implant placement was used to guide the insertion of the definitive abutments and to seat in the correct position the final screw-retained implant-supported fixed restoration. The template used during all surgical and prosthetic procedures, which served as a stable and reproducible connection between the digital and surgical environments, was finally removed. Healing proceeded uneventfully in all subjects. The implant survival and success rates were 100% over a minimum follow-up period of 1year from the prosthetic loading. No biological or prosthetic complications were clinically and radiographically observed up to the last follow-up recall. The use of a reference template used to transfer the digital project to the surgical field increased the accuracy and the integration of the surgical and prosthetic phases during the entire workflow.