Guided surgery in implant-prosthetic rehabilitation

Abstract

Introduction. The free hand surgery does not allow the placement of implants in best position from prosthetic and biomechanical point of view. A major impact of these technologies has been the integration into the treatment planning process. The usage of digital technologies gives the possibility to use surgical guides and to minimize the position errors. Purpose. The aim of the study is to evaluate the applicability of surgical guides in the implantprosthetic treatment. Material and methods. The study was axed on 14 patients from which 7 of them were treated using guided surgery (with 13 implants). In both groups the difference between implants position after the surgery and those planned before the surgery was analyzed. The analyze was made on CBCT as well as in oral cavity using position of implant axis in buccal-lingual aspect. Results. Due to the tendency to minimize the surgical trauma and flap design, the anisotropic structure of the bone as well as the tendency to put the implant in the middle of the bone crest, in free hand surgery group the deviation of implants axis from initial plan was greater than in guided surgery group. However, a similar effect was observed in case of axes guide usage, especially in postextractional or after GBR procedures. In one of the cases, bad adaptation of the surgical guide was noticed. Conclusions. The usage of surgical guides offer big advantages in cases when accurate positioning of the implant is necessary. However, the errors in guide manufacturing and anatomical variables that may influence the implant positioning, even if guided approach is used.