Custom-Made Radiographic Template, Computed Tomography, and Computer-Assisted Flapless Surgery for Treatment Planning in Partially Edentulous Patients: A Prospective 12-Month Study

Purpose: It was proposed that technologies derived from computer-aided design (CAD)/computer-aided manufacturing (CAM) and computed tomography may be useful for flapless implant treatment procedures. However, most of the studies examining the effectiveness of this method were performed in fully edentulous patients, with little or no attention paid to partially edentulous patients. The aims of this study were 1) to evaluate the concept of computer-assisted implant placement including a treatment planning procedure based on computed tomography scan images by use of a flapless surgical approach in partially edentulous cases and 2) to validate the reliability of this concept in a prospective 12-month clinical study. Materials and Methods: Sixteen patients with partially edentulous areas in their mandibles were included in this study. A total of 57 implants were inserted by use of a CAD/CAM drill template, specially designed for flapless implant surgery. To assess the degree of pain and discomfort, the patients were examined at 2 clays and 1 week after surgery. Patient satisfaction and implant functionality were further evaluated at follow-up intervals of 1, 3, 6, and 12 months postoperatively. A specially designed visual analog scale was used for data acquisition. Results: The mean pain score on the visual analog scale at follow-up was within the range for little or no pain. Two implants failed early in 1 patient. All of the other implants were in a good functional state throughout the study. The mean marginal bone loss after 1 year of follow-up was 0.6 mm (SD, 0.2) mesially and 0.5 mm (SD, 0.1) distally. Conclusion: This prospective study showed that the use of CAD/CAM technology and flapless implant surgery may be considered reliable for partial edentulous patients. (C) 2010 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved. j Oral Maxillofac Surg 68:1353-1359, 2010