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.
Minimally traumatic implantation and bone regeneration: a systematic review
Introduction: Dental implant procedures have reached about one million dental implants per year worldwide. In this context, it is necessary to establish the state of the art of minimally traumatic procedures for dental implants, especially after bone grafting procedures and/or use of biomaterials for bone elevation. Objective: Conducted a systematic review of the main considerations for optimizing techniques for dental implants by proposing minimally invasive procedures, especially after bone recovery or elevation processes through the use of biomaterials such as FRP and Bio-Oss®. Methods: The survey was conducted from June 2021 to July 2021 and developed based on Scopus, PubMed, Science Direct, Scielo and Google Scholar, following the rules of Systematic Review-PRISMA. Study quality was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: Studies have shown that guided preoperative planning and dental implant-guided jaw reconstruction provide high success rates for implant and dental rehabilitation. Furthermore, the concept of using personalized implants with the help of 3D virtual treatment planning can greatly improve mandibular restoration and help to achieve good facial profile, esthetics and dental rehabilitation, avoiding complications with grafts in general.
Split-mouth comparison of the accuracy of computer-generated and conventional surgical guides.
PURPOSE
Recent clinical studies have shown that implant placement is highly predictable with computer-generated surgical guides; however, the reliability of these guides has not been compared to that of conventional guides clinically. This study aimed to compare the accuracy of reproducing planned implant positions with computer-generated and conventional surgical guides using a split-mouth design.


MATERIALS AND METHODS
Ten patients received two implants each in symmetric locations. All implants were planned virtually using a software program and information from cone beam computed tomographic scans taken with scan appliances in place. Patients were randomly selected for computer-aided design/computer-assisted manufacture (CAD/CAM)-guided implant placement on their right or left side. Conventional guides were used on the contralateral side. Patients underwent operative cone beam computed tomography postoperatively. Planned and actual implant positions were compared using three-dimensional analyses capable of measuring volume overlap as well as differences in angles and coronal and apical positions. Results were compared using a mixed-model repeated-measures analysis of variance and were further analyzed using a Bartlett test for unequal variance (α = .05).


RESULTS
Implants placed with CAD/CAM guides were closer to the planned positions in all eight categories examined. However, statistically significant differences were shown only for coronal horizontal distances. It was also shown that CAD/CAM guides had less variability than conventional guides, which was statistically significant for apical distance.


CONCLUSION
Implants placed using CAD/CAM surgical guides provided greater accuracy in a lateral direction than conventional guides. In addition, CAD/CAM guides were more consistent in their deviation from the planned locations than conventional guides.