Dynamic and static computer-assisted implant surgery for completely edentulous patients. A proof of a concept

Objectives: To assess the accuracy and patient reported outcome measures (PROMs) of the computer-guided "double factor" technique for treating fully edentulous patients.Methods: A proof of concept prospective study was designed. Ten consecutive patients requiring full arch dental implant supported rehabilitation in a private practice were enrolled between October 2021 and March 2022. All patients were treated by means of an All-on-four (R), and implants were planned and placed according to the "double factor" technique. This technique merges the static and dynamic computer-guided surgical approach in the same surgery. The primary outcome was the accuracy of implant placement, measured by overlapping post-and pre-operative cone-beam computerized tomography with the implant planning. Additionally, PROMs and patient quality of life after surgery were evaluated using different questionnaires. Descriptive and bivariate data analyses were performed. Statistical significance was considered for p < 0.05. Results: A total of 48 implants were placed using the "double factor" technique, and 12 full-arch immediate loading prostheses were delivered. The mean angular deviation was 3.74<degrees> (standard deviation [SD]: 2). The total linear deviation at the apex and platform of the implant was 1.25 mm (SD: 0.55) and 1.42 mm (SD: 0.64), respectively. No statistically significant differences were found between tilted and axial implants, the upper and lower jaw, or the right and left side. High self-reported satisfaction was registered, and the Oral Health Impact Profile-14 (OHIP-14) score improved postoperatively (p = 0.002).Conclusions: The "double factor" technique is a valid and accurate treatment approach for fully edentulous patients.Clinical significance: The double factor technique merges the advantages of both the dynamic and static computer assisted surgery approaches, affording accurate and predictable results when treating fully edentulous patients in a minimally invasive manner.