Implant Restoration of Edentulous Jaws with 3D Software Planning, Guided Surgery, Immediate Loading, and CAD-CAM Full Arch Frameworks

Purpose. The aim of this study was to analyze the clinical and radiographic outcomes of 23 edentulous jaws treated with 3D software planning, guided surgery, and immediate loading and restored with CAD-CAM full arch frameworks. Materials and Methods. This work was designed as a prospective case series clinical study. Twenty patients have been consecutively rehabilitated with an immediately loaded implant supported fixed full prosthesis. A total of 120 fixtures supporting 23 bridges were placed. 117 out of 120 implants were immediately loaded. Outcome measures were implants survival, radiographic marginal bone levels and remodeling, soft tissue parameters, and complications. Results. 114 of 117 implants reached a 30 months follow-up, and no patients dropped out from the study. The cumulative survival rate was 97.7%; after 30 months, mean marginal bone level was ？mm, mean marginal bone remodeling value was , mean PPD value was ？mm, and mean BOP value was 4%？±？2.8%. Only minor prosthetic complications were recorded. Conclusion. Within the limitations of this study, it can be concluded that computer-guided surgery and immediate loading seem to represent a viable option for the immediate rehabilitations of completely edentulous jaws with fixed implant supported restorations. This trial is registered with Clinicaltrials.gov NCT01866696. 1. Introduction The standard surgical protocol for guided implant placement comprises a diagnostic step, (clinical and radiographic examination), a planning step, and a surgical step, where the surgeon implements what was planned [1]. The growing interest in minimally invasive surgery, together with the possibility of fitting prostheses with immediate function, has led to the development of software and digital workflows allowing for the planning and manufacturing of a surgical guide and provisional prosthesis that can be inserted immediately after the implant surgery step [2–5]. The typical dental implant surgical approach that was introduced in the early 1980s requires two steps [6] and the use of a removable bridge or denture during the healing period. In the 1990s, [7] it was first shown that implants could be placed and restored in a single visit: this procedure, known as immediate loading, needed a full day of coordinated surgical, restorative, and dental laboratory interaction. Advancements in computerized tomography (CT) scans, [8] coupled with computer-assisted treatment planning [9] and a double CT scan approach [3, 10], allowed for the virtual planning of placement of implants in 3-dimensional (3D) orientation