Guided-welded approach planning using a computer-aided designed prosthetic shell for immediately loaded complete-arch rehabilitations supported by conometric abutments.
In guided surgery, implants can be planned from radiographic guide information according to a restoratively driven treatment plan. Unfortunately, the palatal or lingual surface of teeth cannot be easily identified. The present article describes the use of a digitally designed prosthetic shell to improve the accuracy of guided-welded approach planning for immediate restorations supported by conometric abutments. Importing the virtual shell into the planning software provides an effective protocol for using the definitive prosthetic space information to plan the framework shape and position predictably. This method increases the accuracy of virtual planning and reduces the time needed to reline the prosthetic shell.
The Conometric Concept: Coupling Connection for Immediately Loaded Titanium-Reinforced Provisional Fixed Partial Dentures-A Case Series.
The aim of this prospective study was to demonstrate the feasibility of the conic coupling connection as a novel approach for the retention of immediately loaded, titanium-reinforced, temporary fixed partial restorations. The patients received a fixed, immediate partial restoration, attached using the conic coupling connection to two implants placed in a fresh extraction socket. Changes in marginal peri-implant bone level or probing depth measurements, biologic or technical complications, and any other adverse event were recorded at yearly follow-ups up to 3 years after implantation. A total of 78 implants placed in 39 patients reached the 3-year follow-up. A trend of bone overgrowth over the implant platform (mean: 0.2 mm) and a complete fill of the vertical gap between the implant platform level and the first point of contact of the bone with the implant surface was seen after the 6-month follow-up. No disconnection of any prosthesis was noted during 3 years of full occlusal function. The results of this study suggest that titanium-reinforced, temporary partial restorations with conic coupling retention supported by immediate implants provide a successful, cost-effective treatment modality.
A systematic review on the accuracy and the clinical outcome of computer-guided template-based implant dentistry.
INTRODUCTION
The aim of this systematic review was to analyze the dental literature regarding accuracy and clinical application in computer-guided template-based implant dentistry.


MATERIALS AND METHODS
An electronic literature search complemented by manual searching was performed to gather data on accuracy and surgical, biological and prosthetic complications in connection with computer-guided implant treatment. For the assessment of accuracy meta-regression analysis was performed. Complication rates are descriptively summarized.


RESULTS
From 3120 titles after the literature search, eight articles met the inclusion criteria regarding accuracy and 10 regarding the clinical performance. Meta-regression analysis revealed a mean deviation at the entry point of 1.07 mm (95% CI: 0.76-1.22 mm) and at the apex of 1.63 mm (95% CI: 1.26-2 mm). No significant differences between the studies were found regarding method of template production or template support and stabilization. Early surgical complications occurred in 9.1%, early prosthetic complications in 18.8% and late prosthetic complications in 12% of the cases. Implant survival rates of 91-100% after an observation time of 12-60 months are reported in six clinical studies with 537 implants mainly restored immediately after flapless implantation procedures.


CONCLUSION
Computer-guided template-based implant placement showed high implant survival rates ranging from 91% to 100%. However, a considerable number of technique-related perioperative complications were observed. Preclinical and clinical studies indicated a reasonable mean accuracy with relatively high maximum deviations. Future research should be directed to increase the number of clinical studies with longer observation periods and to improve the systems in terms of perioperative handling, accuracy and prosthetic complications.