Pre-surgical fixed prosrhesis planning and building for immediate implant loading.

Objective: The aim of the present study was to test the value of a new technique based on the concept of the prosthodontic-driven implant placement for the immediate loading of implants in the treatment of full and partial edentulism. Background: New CAD-CAM sistems have given clinicians the possibility to use data from computerized tomography to plan implant rehabilitation and to transfer this information to the surgical phase. The introduction of scannografic templetes and the fabrication of a pre-surgical provisional prosthesis made reliable the concept of the prosthodontic-driven implant placement. Materials and Methods: 8 patients were included: 5 were completely edentulous, 2 had full edentulous maxilla, but partial edentulous mandible, 1 was fully edentulous in the mandible. A total of 94 implants were placed. Flapless surgery was used. In 4 patient both drilling and implant placement was templete-guided, while, in the other 4, implant placement was non-guided. The provisional prosthesis was delivered as soon as the surgery finished. Final metal-ceramic restoration was delivered in 2 weeks. All patients underwent to control CT. Implant positions in the virtual planning was compared to the actual implant position obteined as visualized in the control CT. Results: Two implats were lost in the 8 patients during the first year. Success rate in repeating virtual planned implant position was 96,55% on the vestibular-oral/lingual axis; 86,21% on the mesio-distal axis and 91,38% on the whole. When implant placement was non-guided, success rates have been lower. All patients were very satisfied of the treatment received. Conclusions: This study indicates that the technique proposed could be a reliable treatment option and that the CAD-CAM sistem used is resonably precise