Implantology has largely developed in the past decade and most dental professionals now agree that implants should be the first line of treatment for tooth loss to provide patients with a higher quality of life as well as prevent further bone loss.
As more patients choose to invest in their oral health and proceed with implant treatment as opposed to dentures or bridges, more multiple implant cases that require care emerge.
Multiple studies conducted and published around the globe in recent years aimed to understand the difference in outcomes between the different methods of treating multiple tooth restorations, specifically Free Hand implant placement compared to Partially and Fully Guided implant placement using computerized planning.
It is highly apparent in multiple reviewed articles that significant accuracy differences were observed between Fully Guided placement cases compared to Free Hand placement when multiple implants were involved1.
The planned treatment deviation was most apparent in angular deviation with as much as 3 degrees deviation, apex placement deviations of up to 2mm and crestal deviations of up to 0.5mm. When multiple implant placement is required the accrued deviations can lead to significant accuracy loss5.
While implant survival rate does not seem to be affected by these placement deviations, patient reported pain and swelling were significantly higher in Free Hand surgeries compared to Fully Guided procedures6.
Studies also report that when screw retained restoration was planned, cement retained restoration was reverted to as compensation for gaps and angles created due to inaccurate placement results2.
Most importantly, patient well-being including pain, swelling and healing time is also significantly improved in cases with no flap elevation3,6, and can provide a less traumatic experience.
In conclusion, studies show that Fully Guided implant placement has many benefits in cases where multi-implant placement is required and can help the dental professional achieve significantly more accurate results.
Freehand placement is recommended mostly in single implant placement cases later in the practitioners experience whereas guided surgery should be considered in multi implant placements for partially or full edentulous patients4, 5.
If you are looking to bring the Fully Guided approach to your clinic – you can count on Adin dental solutions to see you through the process, step by step, until you are ready to offer your patients a full solution to fast, accurate and minimally invasive restorative oral solution.
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1 Gargallo-Albiol J, Barootchi S, Marqués-Guasch J, Wang HL. Fully Guided Versus Half-Guided and Freehand Implant Placement: Systematic Review and Meta-analysis. Int J Oral Maxillofac Implants. 2020 Nov/Dec;35(6):1159-1169. doi: 10.11607/jomi.7942. PMID: 33270056.
2 Younes F, Cosyn J, De Bruyckere T, Cleymaet R, Bouckaert E, Eghbali A. A randomized controlled study on the accuracy of free-handed, pilot-drill guided and fully guided implant surgery in partially edentulous patients. J Clin Periodontol. 2018 Jun;45(6):721-732. doi: 10.1111/jcpe.12897. Epub 2018 May 10. PMID: 29608793.
3 Tallarico M, Esposito M, Xhanari E, Caneva M, Meloni SM. Computer-guided vs freehand placement of immediately loaded dental implants: 5-year postloading results of a randomised controlled trial. Eur J Oral Implantol. 2018;11(2):203-213. PMID: 29806667.
4 Varga E Jr., Antal M, Major L, Kiscsatári R, Braunitzer G, Piffkó J. Guidance means accuracy: A randomized clinical trial on freehand versus guided dental implantation. Clin Oral Impl Res. 2020;31:417–430. https ://doi.org/10.1111/clr.13578
5Choi W, Nguyen BC, Doan A, Girod S, Gaudilliere B, Gaudilliere D. Freehand Versus Guided Surgery: Factors Influencing Accuracy of Dental Implant Placement. Implant Dent. 2017 Aug;26(4):500-509. doi: 10.1097/ID.0000000000000620. PMID: 28731896.
6 Effect of Flapless Surgery on Pain Experienced in Implant Placement Using an Image-Guided System. Source: International Journal of Oral & Maxillofacial Implants . Mar/Apr2006, Vol. 21 Issue 2, p298-304. 7p. 2 Black and White Photographs, 4 Graphs.Author(s): Fortin, Thomas; Bosson, Jean Luc; Isidori, Michel; Blanchet, Eric