Flapless Surgery Research Articles

7-Year Follow-Up of Maxillary Overdentures Supported by Mini-Dental Implants.

Background: Mini dental implants (MDIs) are alternatives to support an overdenture when a standard diameter implant cannot be placed due to lack of bone volume. They reduce the need for invasive bone grafting and lower the barrier for treatment. Aim: This prospective study reports on implant and patient-centered outcomes of flaplessly placed, early loaded MDIs supporting horseshoe-shaped maxillary overdentures after 7 years of function. Materials and Methods: Patients with a CBCT-confirmed thin alveolar crest received 5-6 one-piece MDIs using mentally guided flapless surgery. The conventional denture was relined and MDIs were provisionally loaded within one week. After 6 months the non-splinted MDIs were actively loaded with a horseshoe overdenture. Implant and prosthetic survival, peri-implant health (PPD and BoP) and patient-related outcomes using OHIP-14 and Subjective Masticatory Evaluation were assessed after 7 years. Results: 185 MDIs were placed in 14 females and 17 males. During provisional loading, 32 MDIs were lost, and 17 replacements were required in 16 patients. In total, 170 out of 202 totally placed MDIs were supporting 29 overdentures after 6 months. Cumulative implant failure increased from 15.8% at the moment of active loading to 34.7% at 7 years. After 7 years, 76% of the initially placed overdentures remained functional, mean PPD was 3.48 (SD 0.86), BoP was 0.20 (SD 0.40) and peri-implantitis incidence was 0.9%. The total OHIP-14 was reduced from 21.3/56 (SD: 13.1) preoperatively to 15.6/56 (SD 12.8) at provisional loading (p > 0.1) and 7.3/56 (SD 6.7) at final loading (p = 0.006), and it remained unchanged up to 7 years at 6.57/56 (SD: 8.92) (p > 0.5). Conclusions: Maxillary MDIs provide an acceptable treatment option in patients with deficient bone volume that cannot or refuse to be treated with bone grafting. Despite one third of the MDIs being lost, remaining MDIs had good peri-implant health, prosthetic success was 71% and Oral Health Related Quality of Life was beyond expectations.

Clinical Outcomes of Endonasal Dacryocystorhinostomy Using Fibrin Glue for Lacrimal Sac and Nasal Mucosal Flaps

Purpose: To assess the clinical outcomes of fibrin glue in endonasal dacryocystorhinostomy (DCR) for patients with primary nasolacrimal duct obstruction and to compare the surgical success rates between groups with the lacrimal sac flap using fibrin glue and without flap formation.Methods: In this prospective study, a total of 45 patients (63 eyes) underwent endonasal DCR. Fibrin glue was applied to the mucosal flap at the osteotomy site in the nasal cavity. The subjects were divided into two groups: group 1 (with lacrimal sac flap using fibrin glue), consisting of 20 patients (28 eyes), and group 2 (without flap), including 25 patients (35 eyes). To evaluate the two groups, subjective symptoms were asked to the patients, and endoscopic examinations were performed.Results: There were no statistically significant differences observed in terms of age, sex, timing of tube removal, or follow-up period between the groups. Group 1 showed significantly better results compared to the control group in terms of the degree of granuloma observed at 6 months postoperatively and the level of patient discomfort reported at 3 months postoperatively.Conclusions: Endonasal DCR with the lacrimal sac flap using fibrin glue achieves higher functional success, reduces patient discomfort at 3 months postoperatively, reduces granuloma formation at 6 months postoperatively, and improves membranous closure compared to flapless surgery.

Maxilla reconstruction with 100% BioOss: A clinical and tomographic follow-up study.

Tooth loss and use of a complete denture is still a reality and results in bone loss. Adequate reconstruction of an extremely atrophic edentulous maxilla is a challenge, and different treatment methods have been described for its resolution. Patients seeking implant placement in edentulous upper jaw with atrophic maxilla were selected in a private clinic in Porto Alegre, Brazil. The bone graft was performed with bilateral sinus lift and horizontal bone graft in anterior region with 0,25-1mm particles of Bio-Oss (Geistlich) covered with a collagen membrane (Bio-Gide, Geistlich). CBCTs were evaluated to verify the need for bone graft, and 6-8 months after bone graft follow-up, to plan implant placement and assess horizontal bone gain. 124 implants were placed in 19 patients, 76 of those in the sinus region. The survival rate was 95.2%, with six implants lost over a mean implants follow-up time of 47.68 months. The horizontal bone gain ranged from 0.00 to 6.86 mm, a mean gain of 2.85mm. An average of 5.5g of Bio-Oss was used per patient, and in 73.7 % of the cases, a flapless surgery was possible for implant placement, and in 92 implants an immediate loading was possible. Final rehabilitation was accomplished with fixed prosthodontics in 16 patients with a mean follow-up of 38.4 months. Within the limitations of this study, it is possible to affirm that bone graft with 100% Bio-Oss in atrophic maxilla is a reliable treatment and allow rehabilitation with implants with a high survival rate and the higher the initial bone height, the greater the gain in bone width. Key words:Bone Regeneration, Dental Implants, Prosthodontics, Dentistry.

IMMEDIATE SINGLE IMPLANT PLACEMENT WITH FLAPLESS SURGERY MAY BETTER PRESERVE BUCCAL BONE THAN FLAP SURGERY, BUT CLINICAL SIGNIFICANCE IS UNCLEAR

Immediate implant placement with flap or flapless surgery: a systematic review and meta-analysis. Pitman J, Christiaens V, Callens J, Glibert M, Seyssens L, Blanco J, et al. J Clin Periodontol. 2023;50:755-64. The present study was funded by the authors and their institutions. The authors have no actual or potential conflicts of interest. Systematic review and meta-analysis.

Accuracy of flapless surgery using an autonomous robotic system in full-arch immediate implant restoration: A case series

ObjectivesThis observational study aimed to evaluate the accuracy of robotic computer-assisted implant surgery (r-CAIS) for full-arch immediate restoration and to analyse possible factors contributing to deviations. MethodsThree edentulous patients (five arches) underwent r-CAIS. Osteotomies were performed using an autonomous robot under the surgeon's supervision, and implant placement was performed in a freehand or robotic manner. Prefabricated provisional prostheses were delivered immediately after surgery. Postoperative cone beam computed tomography scans were performed to assess the deviations between the planned and placed implants. Statistics were compared with deviations of s-CAIS outlined in a meta-analysis. ResultsA sum of 28 implants were used. The mean global coronal and apical deviations measured 0.91 ± 0.43 mm and 1.01 ± 0.45 mm, respectively, and the mean angular deviation measured 1.21 ± 1.24 º. The r-CAIS showed significantly better precision than the s-CAIS in full-arch cases (P < 0.001). The implants inserted using the robotic arm exhibited fewer deviations than those placed in the freehand manner. Eighty percent of prefabricated provisional prostheses were successfully delivered. ConclusionsWithin the limitations of the present study, our data suggest that autonomous r-CAIS is a feasible approach for simultaneous immediate restoration in edentulous patients, showing better accuracy than s-CAIS. Further large-scale studies are necessary to verify the advantages and disadvantages of this novel technique and to explore possible factors that influence its accuracy. Clinical SignificanceAutonomous r-CAIS can provide clinically acceptable implant placement accuracy in edentulous patients, significantly surpassing s-CAIS. This level of accuracy may represent a viable therapeutic approach for simultaneous immediate full-arch restoration.

Early implant placement Type 2, using flapless technique in one surgical stage. Five years follow-up

Postextractional implants placement is frecvently discussed in the literature as a method aimed to facilitate implant-prosthetic rehabilitation and preservation of alveolar bone. However, the opinions are divergent while the obtained results often are unfavorable due to bone loss and mucosal recessions. An alternative for postextractional placement is early type 2 implants placement. The study was based on results evaluation of 51 implants insearted in early period after teeth extractions (type 2) in one surgical step, using flapless surgery, without removing the socket content. For evaluation of healing process in the socket, histological analyses of it’s content were performed at 2, 4 and 8 weeks periods. The obained results showed that early implant placement type 2 is a safe method with an integration rate similar to the conventional method. The presence of healed soft tissues is an advantage upon the postextractional placement. The preservation of socket primary matrix lead to a good bone healing around implants without necessity of grafting.

Does flapless immediate implant placement lead to significant preservation of buccal bone compared to flap surgical protocol?

A systematic review and meta-analysis of randomized clinical trials. The electronic search included Pubmed, Web of Science, Embase, and Cochrane databases up to June 2022. Cross-referencing, searching for gray literature at ( www. gov ), and hand searching of seven relevant journals were also performed. Inclusion criteria consisted of: randomized clinical trials (RCTs) published in English comparing flapless to flap surgery for IIP using single titanium implants in the esthetic zone of healthy ≥18 years old patients. Prospective and retrospective case series, cross-sectional studies, letters to editors and reviews were excluded. The key study factor was to assess the impact of the surgical approach (flap versus flapless surgery) on buccal hard and soft tissue changes after single immediate implants for the anterior teeth in healthy adult patients. The primary outcome was horizontal buccal bone change (HBBC), measured by CBCT. Secondary outcomes were implant survival, vertical buccal bone change, postoperative pain, and clinical and esthetic parameters. Two independent reviewers conducted both electronic and manual searches for eligible clinical studies. The evaluation was carried out at the title level followed by the abstract level, and the full texts of the qualified articles were then examined. Any disagreements were resolved by discussion with a third reviewer. Quality assessment of the included RCTs was conducted by two additional reviewers who were not part in the search process using the revised Cochrane risk-of-bias tool for randomized trials (RoB 2). A meta-analysis was conducted on outcome variables that were documented in three or more articles. Five RCTs fully met the selection criteria for the final qualitative analysis comprising data of 140 patients who received 140 single immediate implants (flapless: 68; flap:72) with a mean age ranging from 30 to 67 years. Follow-up extended for 6-12 months. Two RCTs showed an overall low risk of bias, whereas the other three RCTs had an overall high risk, basically due to using inappropriate methods of outcome measurements. Meta-analysis included three RCTs and revealed a mean difference of 0.48 mm (95% CI [0.13,0.84], p = 0.007) in HBBC between surgical approaches, favoring flapless surgery. Heterogeneity among the studies was low (I2 = 29%; p = 0.250). For implant survival, however, meta-analysis failed to find a significant difference among the groups (RR 1.00, 95% CI [0.93, 1.07], p = 0.920). Due to limited data, meta-analyses could not be conducted for other secondary outcomes. Available studies consistently showed a favorable effect of flapless surgery in terms of vertical buccal bone change and pain, while only one study assessed the vertical midfacial soft tissue change, and no data were reported on esthetic outcomes. According to CBCT data, flapless IIP resulted in greater preservation of buccal bone as compared to flap IIP. However, the clinical significance of this finding remains uncertain since clinical and esthetic outcomes were insufficiently reported.

EAO Position Paper: Immediate Implant Placement: Managing Hard and Soft Tissue Stability from Diagnosis to Prosthetic Treatment.

In this position paper, the state of the art in immediate implant placement (IIP) at incisor-cuspid-premolar sites is described. The literature supports that the following prerequisites need to be simultaneously met for a predictable outcome: (1) there must be no acute infection; (2) there must be apical and palatal/lingual bone for implant anchorage; (3) the tooth must be inside the bone envelope; (4) the alveolar socket must have a favorable morphology (type I, IIa, IIb avoiding wide dehiscences); (5) there must be no midfacial recession; (6) the right implant must be selected; and (7) the surgeon needs to be experienced and skilled. A preoperative CBCT is required for IIP because multiple aforementioned prerequisites (2, 3, and 4) can only be assessed on the basis of 3D imaging. The final prerequisite relates to the importance of a perfect implant position, preferably leaving a horizontal gap of at least 2 mm between the implant shoulder and buccal bone wall. Guided surgery is preferred over free-hand surgery to accomplish this. Flapless surgery, socket grafting, connective tissue graft (CTG), and immediate provisionalization have been shown to contribute to hard and/or soft tissue stability. When the previously mentioned prerequisites are fulfilled, IIP may be considered over alternative treatment concepts (eg, early implant placement [EIP] and delayed implant placement [DIP]) based on time gain, minimal invasiveness, and similar outcomes in the literature. Given very strict selection criteria, clinicians should primarily screen patients for IIP before considering other treatment options with wider indications. Int J Prosthodont 2023;36:533-545.

Immediate Implant Placement with Flap or Flapless Surgery

Immediate Implant Placement with Flap or Flapless Surgery

LIMITED DATA SHOWS POTENTIAL OF FLAPLESS SURGERY FOR ENHANCED BUCCAL BONE PRESERVATION IN IMMEDIATE IMPLANT PLACEMENT

Pitman J, Christiaens V, Callens J, Glibert M, Seyssens L, Blanco J, Cosyn J. Immediate implant placement with flap or flapless surgery: A systematic review and meta-analysis. J Clin Periodontol. 2023 Jun;50(6):755-764. doi: 10.1111/jcpe.13795. Epub 2023 Mar 5. PMID: 36843361. The study was funded by the authors and their affiliated institutions. Systematic review with meta-analysis.

A Case report of full-mouth implant placement utilizing 3D-guided surgery

Dental implants are widely recognized as a dependable and cost-effective solution for replacing missing teeth. Achieving successful outcomes in modern implantology and prosthetics depends on rigorous diagnostic methods and diligent planning that meet the expectations of patients and dentists and leverage advancements in materials and digital technologies. The predictability and success rates of implant dentistry have significantly improved following the development of computed tomography, implant planning software, guided implant surgery techniques, and advanced materials. This report presents the case of a 54 year-old healthy male with partial tooth loss who received seven implants in the upper jaw and six in the lower jaw. Based on comprehensive Cone Beam Computed Tomography imaging, the treatment plan was devised to support a fixed prosthesis. Precise implant placement, guided by the treatment plan, addressed the optimal prosthodontic requirements while minimizing invasiveness through a flapless surgery approach. The landscape of rehabilitation practices is evolving due to the incorporation of computer-aided design in treatment planning and the increased application of computer-assisted manufacturing. Guided implant techniques have emerged as a means to mitigate the limitations associated with traditional methods. Compared to conventional approaches, guided implant surgery significantly improves implant placement precision by reducing chairside time, involves minimally invasive procedures, and augments predictability.

Healing of Peri-Implant Tissue following Flapless Implant Surgery.

Flapless surgery for implant placement has been gaining popularity among implant surgeons. it has numerous advantages, including preservation of circulation, decreased surgical time; improved patient comfort; and accelerated recuperation. As a part of the study to evaluate crestal bone loss changes after placement of implant using the flapless technique, we placed twenty endosseous implants. Access was achieved to the crestal bone using a tissue punch. Clinical and radiographic analyses were performed second and fourth months after placement of the implant. Postoperative pain was measured by the visual analog scale at the 4th, 8th, and 24th hour. The findings of the present study demonstrate that the average crestal bone loss around the implant at 4 months using the flapless technique was 0.19 mm. No implants failed to osseointegrate, and no implants exhibited bone loss greater than 0.5 mm in the first four months. This present study shows significantly less postoperative pain in the flapless technique of implant placement. The flapless approach is a predictable procedure when patient selection and surgical technique are appropriate.

Incidence of Peri-Implantitis, Technical and Biological Complications of Single Implants Placed with Flap or Flapless Surgery-A 10-12-Year Case-Series.

Long-term follow-up of single implants and crowns is scarce, especially when inserted using flapless surgery. Evaluate survival, peri-implantitis incidence, and technical/biologic complications of solitary implants/crowns after 10-12 years of function. 49 patients with 53 single implants, initially operated with a one-stage flap (F) or flapless (FL) surgery and delayed loading, were recalled. Implant survival, radiographic bone-level changes compared to baseline, peri-implant health, and soft tissue aesthetics were registered. Differences in implant level between and within groups were statistically tested using the Mann-Whitney U-Test and Wilcoxon Signed Ranks Test, respectively. 36 patients with 40 implants were reassessed, yielding 100% implant and 97.5% crown survival. The bone loss in F (n = 19) was 0.56 mm (SD 0.89; range -0.9-2.02) and -0.85 mm (SD 0.98; range -2.84-0.53) in FL (n = 21), indicative of bone gain in FL (p = 0.003), the latter due to a difference at baseline but bone-level was comparable (p = 0.126). Groups were comparable for probing pocket depth (PPD); (3.32 vs. 3.19 mm), Bleeding Index (BI); (0.15 vs. 0.22), and gingival recession; (0.38 vs. 0.17 mm). According to international criteria, the peri-implantitis incidence was 0%, but 32.5% of the implants/crowns experienced biological or technical complications irrespective of surgical technique. Solitary implants and crowns show good long-term clinical outcomes and peri-implant health. Flapless surgery is a good alternative to conventional in straightforward cases with sufficient bone volume and proper treatment planning.

Comparative Assessment of Crestal Bone Loss by Flapless and Flap Technique for Implant Placement: A Prospective Study.

The use of flapless surgery for placing dental implants is extremely popular due to better radiological tools and the availability of software that help in the planning of dental implants. The present study was done to assess crestal bone loss by using flapless and flap techniques for placing implants. A total of 50 subjects who satisfied the inclusion criteria were selected for this study.Selected patients were then divided equally into two study groups i.e., those who are and those who are notundergoing flap surgery. Statistical analysis was done using the Mann-Whitney U test. Statistically considerable P values were obtained. Bone loss was lesser with the flapless technique. Flapless implant placement demonstrated less crestal bone loss compared to flap surgery.

Mini-implant mandibular overdentures under a two-step immediate loading protocol: A 4-6-year retrospective study.

This retrospective study to evaluate the treatment outcomes of mandibular mini-implant overdentures (MIODs) placed under a two-step immediate loading protocol. The mini-implant overdenture emphasises the advantages of simplicity using flapless surgery and immediate loading. However, some mini-implant have lowe initial stability. A total of 30 participants who used mandibular MIODs and maxillary removable complete dentures (RCDs) over 4 years were included. Four one-piece mini-implants (<3 mm in diameter) were placed by a flapless surgical approach after fabrication of new RCDs, and the O-ring attachment was attached at least 8 weeks after implant placement. The average observation period was 58.9 ± 9.2months after mini-implant loading. The survival rate of the implants was 100.0%, and the overall change in mean marginal bone level (ΔMBL) was -0.9 ± 1.1 mm. The implant success rate was 83.3% at the implant level, and 66.7% at the patient level. The mean initial Periotest value was 0.9 ± 3.1, and it was positively associated with ΔMBL and implant success (P < .05). Patient satisfaction improved after conversion from RCDs to MIODs (P < .05), and mastication and pain showed greater satisfaction with longer loading time (P < .05). The mandibular MIODs could be chosen as an alternative treatment under a two-step immediate-loading protocol in edentulous patients with limited alveolar bone volume. To ensure superior treatment outcomes of MIODs, initial stability of implant must be obtained using as wide a diameter as possible within the anatomically allowable limits.

Immediate implant placement with flap or flapless surgery: A systematic review and meta-analysis.

To assess the impact of mucoperiosteal flap elevation for single immediate implant placement (IIP) on buccal hard and soft tissue changes, and on clinical, aesthetic and patient-reported outcomes. Two independent reviewers conducted an electronic literature search in Pubmed, Web of Science, Embase and Cochrane databases as well as a manual search to identify eligible clinical studies up to June 2022. Randomized controlled trials (RCTs) comparing IIP without flap elevation to IIP with flap elevation were included for a qualitative and quantitative analysis. The primary outcome was horizontal buccal bone change. Secondary outcomes were implant survival, vertical buccal bone change, pain, and clinical and aesthetic parameters. Out of 1029 records, 5 RCTs were selected reporting on 140 patients who received 140 single immediate implants (flapless: 68; flap: 72). Patients had a mean age ranging from 30 to 67 years and were followed between 6 and 12 months. Four RCTs pertained to (nearly) intact alveoli. Risk of bias assessment yielded low risk for two RCTs and high risk for three RCTs. Meta-analysis demonstrated a mean difference of 0.48 mm (95% confidence interval [CI] [0.13, 0.84], p= .007) in horizontal buccal bone change between surgical approaches, favouring flapless surgery. Meta-analysis failed to demonstrate a significant difference in implant survival between the groups (RR 1.00, 95% CI [0.93, 1.07], p= .920). Given the scarcity of data, meta-analyses could not be performed on other secondary outcomes. Available studies were consistent in the direction of the effect favouring flapless surgery for vertical buccal bone change as well as for pain. Clinical and aesthetic parameters were underreported. Based on CBCT data, flapless surgery resulted in more buccal bone preservation at immediate implants. However, the clinical relevance of this finding is unclear, since clinical and aesthetic outcomes were underreported.

Anatomically Driven Immediate Implant Placement in the Esthetic Zone: Two Case Reports as Proof of Principle.

Achieving favorable and stable esthetic outcomes with immediate implants used to replace maxillary anterior teeth can be challenging. Osteotomies need to be initiated along the palatal socket wall, and it is often difficult to stabilize initial drilling. An immediate implant was planned for a hopeless maxillary incisor. Using a flapless surgery technique, the tooth was removed and decoronated, and an entry point was made in the root to guide the osteotomy drills. The root was reinserted and stabilized while a precision drill and 2-mm twist drill were used in sequence to drill through the tooth root, establishing the osteotomy location but stopping 3-4 mm short of final depth. The root was then removed, and the final implant bur for a 3.5 × 11.5-mm implant was drilled to depth, engaging the necessary native bone apically. The original tooth crown was then used to prepare and insert a transitional crown. Reinserting the extracted root of a maxillary anterior tooth and using it as a guide for osteotomy preparation is an excellent method to optimally position an immediate implant palatally in the socket wall.

Buccal bone thickness and mid-facial soft tissue recession after various surgical approaches for immediate implant placement: A systematic review and network meta-analysis of controlled trials.

To evaluate the relative efficacy and confidence in the precision of the results of different surgical interventions for immediate implant placement in the anterior area. Electronic searches were performed in PubMed, Embase, and Cochrane CENTRAL. Randomized controlled trials comparing different surgical techniques in anterior jaws for type 1 implant placement were included. Outcome measures included implant survival (primary outcome), buccal bone thickness (BBT) reduction, and mid-facial soft tissue recession (MSTR). Risks of bias assessment, network meta-analysis (NMA), sensitivity analysis, and quality-of-evidence assessment were performed. Twenty-two studies reporting on 948 subjects and 5 surgical interventions were included. Fourteen early failures were reported. Compared with open-flap surgery without tissue augmentation (F-N) and looking at BBT preservation, NMA showed that there was moderate confidence that flapless surgery with hard tissue augmentation (FL-HTA) was better than flapless surgery without tissue augmentation (FL-N) or open-flap surgery with hard tissue augmentation (F-HTA) (mean difference -0.8 mm, 95% confidence interval: -1.1 to -0.5 mm; -0.6 mm, -0.9 to -0.4 mm; and -0.5 mm, -0.7 to -0.3 mm, respectively). There was moderate confidence that flapless surgery with hard and soft tissue augmentation (FL-HTA&STA) could significantly prevent MSTR compared with FL-HTA (-0.5 mm, -0.7 to -0.3 mm) and FL-N (-0.6 mm, -1.2 to -0.04 mm). However, there was no significant additional benefit in BBT with the FL-HTA&STA approach compared to the FL-HTA approach (-0.30 mm, -0.81 to 0.21 mm). For immediate implant placement in the anterior areas, the FL-HTA approach better preserves BBT (moderate confidence); adding STA improves the stability of the mid-facial soft tissue level (moderate confidence) but at the expense of BBT (low confidence).

Full-mouth rehabilitation of upper and lower jaws with computer-guided flapless surgery and immediate loading of implants inserted and mastication analysis

ABSTRACT Although a number of approaches to implant-supported restoration of severely atrophic maxillae and mandibles have been developed, most of these treatments are expensive and protracted. An exception is the concept, which uses only guided implant surgeries and immediate loading with a hybrid, screw-retained provisional prosthesis delivered on implant placement, followed by a definitive hybrid prosthesis later. The present article describes full-arch rehabilitations using implant-supported prostheses and analyzes the functional efficacy of the treatment done by mastication analysis. This innovative technique allows for full-arch implant-supported prosthesis without the need for any bone grafting procedures even in atrophic situations and immediate function. In this technique, four or six or more implants are placed in the jaws, immediately loaded with temporalization, and put into function.

Clinical Outcome of Immediate Loading UV-Photofunctionalized Implants in Patients with Completely Edentulous Mandible, Placed with Guided Surgery.

The purpose of this study was to evaluate clinical results of immediate loading UV-photofunctionalized dental implants placed using guided surgery in patients with completely edentulous mandible. In this study, 58 fully edentulous patients were treated with immediate loading implant-supported mandibular prostheses. All patients underwent a thorough clinical examination according to the generally accepted scheme; qualitative and quantitative parameters of the jaw bones patients were diagnosed with cone beam computerized tomography (CBCT). Surgical templates modeled in the 3 Shape software were made from biocompatible polymeric materials and provided with depth-calibrated drill sleeves for preparing osteotomies using a 3D printer (Stratasys). Before short implant placement, ultraviolet functionalization of implant surfaces was performed by UV Activator YWJ-QSY001 (Foshan, Wenjian Medikal Enstriman) in the device for 20s. After flapless surgery, implant sockets were prepared with guided surgery and implants were placed through the sleeves of the surgical template tightening torque of 35-45 Ncm. An implant-supported temporary prosthesis made of acrylic resin was installed 6h after implantation. Final dental prosthetics was performed 2months after implant placement.The patients had 128 short (length 5-6mm, diameters 4,5-5mm) and 256 implants with length greater than 10mm in bone segments with sufficient bone parameters. The following parameters were assessed: implant success, prosthetics survival and changes in peri-implant marginal bone loss(MBL). During a clinical examination, no serious biological or prosthetic complications have been reported. The esthetic result evaluated from patients was excellent. The mean ISQ of short implants was 69.2 ± 8 for primary stability at implant placement and 73.6 ± 4 ISQ after 3months. The mean of implants with length greater than 10mm was 71,2ISQ at implant placement, respectively, and 75,6 ISQ after 3months. After 3months of prosthetic loading for short implants marginal bone loss (MBL) 0.74mm, after 1year of MBL 11.21mm, after 5years of MBL 1,37mm, for implants with length greater than 10mm after 3months of MBL 0.72mm, after 1year of MBL 1.19mm and after 5years of MBL 1.35. There was no statistically significant difference in clinical indices between short and standard implants. After 5years of follow-up, stable levels of bone tissue around the implants and healthy tissues around the implants were recorded, and postoperative occlusal function was favorable. The success rates of the short implants in maxilla were 95.5%, and the success rates of the short implants in mandible were 98.7%. The success rates of the implants with length greater than 10mm in maxilla were 97.8%, and the success rates of the implants with length greater than 10mm in mandible were 98.8%. Computer-guided implant surgery and immediate loading of UV-photofunctionalized implants in patients with completely edentulous mandible are a predictable and effective method with a minimum rehabilitation period.