Comparison of the accuracy of guided and conventional surgery for implant placement
- Conditions
- Edentulous arcadeC05.500.480
- Registration Number
- RBR-8556fzp
- Lead Sponsor
- niversidade Paulista
- Brief Summary
The objective was to compare implants installed with guided and conventional surgery, through tomographic, radiographic, immune-enzymatic, microbiological, and patient-centered evaluations.Twenty-nine 29 total edentulous patients were selected, and maxillary contralateral quadrants were randomly assigned to: Guided surgery (GS): flapless computer-guided surgery; Conventional surgery (CS): flap surgery with conventional planning. Tomography scans were performed at baseline and 10 days after the surgery to measurement deviations and radiographic evaluations were done at baseline, and after 6 and 12 months, for analysis of peri-implant bone level (PIBL). Peri-implant fluid and subgingival biofilm for the evaluation of bone markers and periodontal pathogens. The implants installed with GS showed less linear deviation at the apical point and the midpoint and less angular deviation (p<0.05). However, they presented a greater depth discrepancy in the positioning of the platform (p <0.05). Higher values of vertical PIBL were observed for GS group at baseline (p<0.05), while lower values of horizontal PIBL were observed for CS, independently of time-point evaluated (p<0,05). Bone markers, Tf and morbidity presented higher levels in CS (p<0.05). It can be concluded that the use of flapless GS for the installation of dental implants in maxillary total edentulous patients allows smaller linear and angular deviations, as well as less morbidity, than the conventional technique. However, PIBL was higher in GS and apparently the conventional technique led to a greater angiogenic and bone remodeling activity by the elevation of the levels of angiogenic, and bone markers.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Data analysis completed
- Sex
- Not specified
- Target Recruitment
- Not specified
Total edentulous maxillary patients; minimum bone thickness of 5.5 mm for implant placement; minimum bone height of 9 mm for placement of 6 implants.
Pregnancy; lactation; antibiotic therapy in the last 6 months, long-term use of medications that could alter osseointegration, such as anti-inflammatory drugs, bisphosphates or immunosuppressive drugs; graft needs before or during surgery; history of previous regenerative procedures in the area designated for implant installation;Patients with severe complications associated with type 2 diabetes, cardiovascular disease; peripheral vascular diseases such as ulcers, gangrene or amputation; neuropathies; nephropathies.
Study & Design
- Study Type
- Intervention
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Found outcome 1: Implants installed with guided less angular deviation.;Expected outcome 1: It is expected that angular deviation between the angles formed between the planned and executed in the guided surgery is low than that obtained in the conventional surgery. The angular deviation was measured by the comparisson between a cone beam computed tomography done before and one week after the surgical procedure. The postoperative CT scan was matched with the virtual planning using a three-dimensional voxel-based registration. ;Expected outcome 2: It is expected that Linear deviations in guided surgery are low than that from conventional surgery. The linear deviation was measured by the comparisson between a cone beam computed tomography done before and one week after the surgical procedure. The postoperative CT scan was matched with the virtual planning using a three-dimensional voxel-based registration.
- Secondary Outcome Measures
Name Time Method It is expected that the levels of angiogenesis- and bone-related markers are lower in guided surgery than in conventional surgery. These markers were measured by imonoenzimatic assay at 7, 14, 30, and 90 days after implant insertion. ;It is expected low morbidity in guided surgery than in conventional surgery. Patient Perceptions Regarding Therapy were measured by pain scale questionnaire -VAS.<br>;It is expected that peri-implant bone loss is lower in guided surgery when compared to conventional surgery. To evaluate peri-implant bone loss, periapical radiographs were taken immediately after prosthesis (baseline) installation and at 6 and 12 months after surgery, with the parallel technique using a radiograph positioner.;It is expected that the quantification of Aa, Pg, and Tf is low in guided surgery than in conventional surgery. Microbiogical evaluation was done by real-time polymerase chain reaction (PCR).