Esthetics of Flapless Single‐Tooth Implants in the Anterior Maxilla Using Guided Surgery: Association of Three‐Dimensional Accuracy and Pink Esthetic Score

Abstract

Positional inaccuracy is low in guided implant surgery, but may however significantly compromise implant esthetics in the anterior maxilla.

A novel conversion method for radiographic guide into surgical guide

“…A precise implant site can reduce the stress concentration and provide an esthetic outcome for restorative dentist. In recently guide surgery studies, the mean angle deviation between the planned and placed implants is from 2.48°to 6.53°. Compared with other advocated techniques, the results of the preliminary in vivo test satisfied the clinical appearance requirements.…”

X-ray computed tomography and additive manufacturing in medicine: a review

“…The combined use of XCT and AM technologies is also now becoming more prevalent in the field of surgical guidance in production of patient specific guides to ensure correct placement of surgical screws or to inform surgeons of correct drill-hole angle and placement [88][89][90][91][92][93][94][95]. These guides are very commonly used in cranio-maxillofacial surgery, particularly in the placement of AM dental implants primarily through the use of SLA with XCT.…”

“…In keeping with these likely developments, it is worth noting that as XCT has increased in use as a metrological tool [8], a number of medical authors have similarly adopted the technology beyond its ability to recreate geometries and as a medical inspection device. Examples of this include the post-operative assessment of implant positional and angular deviation compared to the intended positioning [90], and the comparison between patient XCT data and XCT scans of AM models, through calculation of the root mean square error of surface variations [80]. Also of note as an aside to this section, Singh et al [97] recently presented a design for an AM training box to account for a lack of training objects in the field of endoscopic [63], top right: inkjetted kidney [72], centre: binder jetted cerebral aneurysm [69], bottom: binder jetted torso phantom [80].…”

Single tooth implants in the esthetic zone following a two‐stage all flapless approach: A retrospective analysis

“…Even after atraumatic tooth loss the residual alveolar bone undergoes a remodeling process coming along with changes of the anatomical conditions . Especially in the esthetic zone the appearance of the soft tissue represents a major aspect of implant success and can be considered as one of the main motivating factors for patients to call for implant therapy in this region . Thus, clinicians must consider the mid‐ and long‐term perspectives of soft and hard tissue alternations especially when restoring single tooth sites in the esthetic zone .…”

“…Flapless approaches showed highly satisfactory esthetics and are reported to cause less recessions of the mid‐facial mucosa . Therefore, in order to avoid flap raising and to facilitate the insertion of the implant in a preoperative planned position, guided implant placement using stereo‐lithographic templates are utilized . Especially in the esthetic zone guided implant placement is recommended as it allows a more precise implant placement regarding the ideal prosthetic axis compared to free‐handed insertion .…”