Abstract
The aim of this study was to systematically review the current scientific literature regarding the accuracy of fully guided flapless implant positioning for complete-arch rehabilitations in edentulous patients and to assess if there was any statistically significant correlation between linear deviation at shoulder point, at apex point and angular deviation. The electronic and manual literature search of clinical studies was carried out using specified indexing terms. A total of 13 studies were eligible for qualitative analysis and 277 edentulous patients were rehabilitated with 1556 implants patients by means of fully guided mucosa-supported template-assisted flapless surgery. Angular deviation was 3.42° (95% CI 2.82–4.03), linear deviation at shoulder point 1.23 mm (95% CI 0.97–1.49) and linear deviation at apex point 1.46 mm (95% CI 1.17–1.74). No statistically significant correlations were found between the linear and angular deviations. A statistically significant correlation was found between the two linear deviations (correlation coefficient 0.91) that can be summarized by the regression equation y = 0.03080 + 0.8254x. Computer-assisted flapless implant placement by means of mucosa-supported templates in complete arch restorations can be considered a reliable and predictable treatment choice despite the potential effects that flapless approach could bring to the overall treatment.
Highlights
Driven dental implant placement in complete-arch restorations positively contributed to achieve both functionally and aesthetic results [1,2]
The focus was expressed in PICOS format: P, edentulous patients who received complete-arch rehabilitations; I, implants positioned by means of static mucosa-supported template assisted flapless surgery; C, positioned implants coordinate from preplanned implants coordinates; O, angular deviation, linear deviation at shoulder and at apex points; S, randomized clinical trials (RCTs) and prospective cohort studies
The aim of this systematic review was to assess the accuracy of implant placement by means of static template mucosa-supported computer-guided flapless surgery in completearch rehabilitations
Summary
Driven dental implant placement in complete-arch restorations positively contributed to achieve both functionally and aesthetic results [1,2]. Continuous development of digital technologies led to a more comprehensive pre-surgical evaluation of the implant recipient site, avoiding bad results during follow-up period [3,4]. The introduction of the cone-beam computed tomography (CBCT) scan, the ongoing development of intraoral optical scanners (IOS) and modeling softwires allowed the clinician to digitally navigate through the three-dimensional (3D) bone and soft tissue architecture of the virtual patients into implant-planning software [5,6]. The clinicians were not allowed to change the pathway of the drills unless a freehand implant positioning was performed [7].
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