The conometric concept‐ immediate definitive full arch rehabilitation of the edentulous maxilla supported by cone‐in‐cone abutments and guided implants‐ a preliminary report

Abstract

Background The use of a cone in cone Morse taper connection between the abutment and the crown to retain an implant-supported definitive fixed dental prosthesis (FDPs) has been recently proposed in the literature. This prosthetic approach, named Conometric Concept, was used to retain both lithium disilicate and zirconia structures. Aim/Hypothesis The aim of this study was to evaluate the rehabilitation of fully edentulous maxillae with immediate full arch zirconia restorations supported by implants placed using guided surgery and cone in cone connection abutments. Material and Methods A maxillary surgical guide was manufactured using CBCT and six implants were placed in the planned sites. The fixtures were inserted in both healed sites or fresh extraction sockets. The definitive planned abutments and the respective conical caps were placed in the planned position and the full-arch zirconia restoration cemented to the caps intra-orally. The restoration was then removed from the oral cavity with a spring bridge remover, the excess of cement was removed, the structure was polished and reinserted. Peri-implant bone levels and pocket depths were recorded for three years at each follow-up visit. Esthetic, functional and biologic United States Public Health Services (USPHS) parameters modified by the FDI World Dental Federation study design were assessed at the last follow-up appointment. The opposing dentition was categorization by type of restoration and supporting structure at the time of placement of the full-arch restoration and at the three-year follow-up. Results A total of 12 full-arch restorations supported by 72 implants reached the three-year follow-up. None of the prostheses broke, became loose or detached. No significant difference involving peri-implant bone and probing levels between the experimental times were found. Conclusions and Clinical Implications The results of this preliminary report demonstrated that the edentulous maxilla can be restored with an immediate full-arch zirconia restoration placed the day of the surgery supported by implants placed using guided surgery and cone in cone connection abutments.