Abstract
The aim of this study was to evaluate the accuracy and feasibility of flapless implant placement using a light-cured surgical template made of composite resin comprising dimethacrylate and diurethane, performed simultaneously with crestal sinus augmentation. This pilot study was a prospective, single-armed, controlled clinical trial. Four patients having an edentulous region in the posterior maxilla with 4 to 8 mm of residual ridge height were enrolled. Flapless fully-guided implant placement was performed using a zero-setup surgical template with simultaneous crestal sinus graft. Horizontal, vertical, and angular deviations of the placed implants from the planned positions were measured. Clinical observations were made, and implant stability was measured up to 3 months postoperatively. All four implants were placed and maintained successfully without complication. The mean deviations of the four implants were 1.27 and 1.85 mm horizontally at platform and apex, respectively, 0.84 mm vertically at apex, and 4.76° in angle. Satisfactory implant stability was obtained in all implants at placement and 3 months. Fully-guided implant placement and crestal sinus graft using a zero-setup surgical template can be a safe and feasible method with acceptable accuracy. A randomized controlled trial should be performed in the future to validate its clinical performance in terms of surgical time, accuracy, and patient-reported outcomes.
Highlights
In the modern era of implant dentistry, it has been well established that the implant fixture should be placed in its prosthetic-driven position [1]
From the four implants that had been placed using the VARO guide, the main the main findings of the study were: (i) the VARO guided surgery exhibited a range of findings of the study were: (i) the VARO guided surgery exhibited a range of deviation deviation from the planned position of around 1 mm, (ii) simultaneous crestal sinus graft from planned safely position ofwithout around complication, 1 mm, (ii) simultaneous crestal sinuswas graft can be can bethe performed and and (iii) good stability achieved performed safely and without complication, and (iii) good stability was achieved for the for the placed implants at the initial and late stages
The limitation of the present pilot study was the paucity of data
Summary
In the modern era of implant dentistry, it has been well established that the implant fixture should be placed in its prosthetic-driven position [1]. There are many obvious advantages that stem from the correct implant positioning, such as a realistic cervical emergence profile, efficient loading of the occlusal force, and simple oral hygiene [2]. The correct positioning of the implant fixture determines the long-term survival and success of the implant therapy [3]. Precise placement of the implant or several implants into the planned positions required the knowledge and skill of an experienced surgeon [4]. Even an experienced surgeon can be put under pressure in these circumstances, which may result in a severely deviated implant from the initially planned position
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