Abstract
ObjectivesTo compare short-term outcomes after immediate restoration of a single implant in the esthetic zone with one-abutment one-time technique comparing a conventional (control) vs. a fully digital workflow (test).Materials and methodsEighteen subjects were randomly assigned to the two groups, and a digital implant planning was performed for all. In the test group, a custom-made zirconia abutment and a CAD–CAM provisional crown were prepared prior to surgery; implants were placed using a s-CAIS guide allowing immediate restoration after surgery. In the control group, the implant was placed free-handed using a conventional surgical guide, and a custom-made zirconia abutment to support a stratified provisional crown was placed 10 days thereafter, based on a conventional impression. Implant accuracy (relative to the planning), the provisional restoration outcomes, as well as PROMs were assessed.ResultsThe implant positioning showed higher accuracy with the s-CAIS surgical guide compared to free-handed surgery (angular deviation (AD): 2.41 ± 1.27° vs. 6.26 ± 3.98°, p < 0.014; entry point deviation (CGD): 0.65 ± 0.37 mm vs. 1.27 ± 0.83 mm, p < 0.059; apical deviation (GAD): 1.36 ± 0.53 mm vs. 2.42 ± 1.02 mm, p < 0.014). The occlusion and interproximal contacts showed similar results for the two workflows (p = 0.7 and p = 0.69, respectively). The PROMs results were similar in both groups except for impression taking with intra-oral scanning preferred over conventional impressions (p = 0.014).ConclusionsBoth workflows allowed implant placement and immediate/early restoration and displayed similar clinical and esthetic outcomes. The fully digital workflow was associated with a more accurate implant position relative to planning.Clinical relevanceOur results show that both conventional and digital workflow are predictive and provide similar clinical outcomes, with extra precision provided by digitalisation.
Highlights
Driven implant dentistry is the optimal way to treat patients with dental implants [1]
The implant positioning showed higher accuracy with the static computer‐assisted implant surgery (s-CAIS) surgical guide compared to free-handed surgery (angular deviation (AD): 2.41 ± 1.27° vs. 6.26 ± 3.98°, p < 0.014; entry point deviation (CGD): 0.65 ± 0.37 mm vs. 1.27 ± 0.83 mm, p < 0.059; apical deviation (GAD): 1.36 ± 0.53 mm vs. 2.42 ± 1.02 mm, p < 0.014)
The Patient‐reported outcome measures (PROMs) results were similar in both groups except for impression taking with intra-oral scanning preferred over conventional impressions (p = 0.014)
Summary
Driven implant dentistry is the optimal way to treat patients with dental implants [1]. It requires detailed pretreatment planning to ensure a correct threedimensional implant position, relative to the planned prosthetic restoration [2]. Hanozin et al International Journal of Implant Dentistry (2022) 8:7 has obvious advantages, such as favorable esthetic and prosthetic outcomes, as well as the long-term stability of peri-implant hard and soft tissues. It was described in the literature that the position of finishing line and the abutment emergence profile are of extreme importance to avoid cement fusion [11,12,13]. The use of an individualized abutment with an optimal finishing line and an ideal emergence profile would help to prevent such complications. An impression just after the surgery and a period of about a week has been necessary to design and manufacture a custom-made abutment, optimal for one-abutment one-time procedures in the esthetic zone
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