Objectives: The aim of this randomized control trial was to compare immediate restoration procedure with a one abutment one-time technique using a conventional versus full digital workflow. Surgical accuracy, provisional fit and patient reported outcome measures (PROMs) of.
Objectives: The aim of this randomized control trial was to compare immediate restoration procedure with a one abutment one-time technique using a conventional versus full digital workflow. Surgical accuracy, provisional fit and patient reported outcome measures (PROMs) of. Material and method: Sites with single edentulous spaces and neighboring natural teeth were randomized into static computer-aided implant surgery (s-CAIS) or freehand placement implant surgery groups. In both groups, digital implant planning was performed using data from cone beam computed tomography (CBCT) and surfaces scans. In the s-CAIS group, a surgical guide was produced and used for fully guided implant surgery, while in the freehand group, the implants were placed in a freehand manner. the deviations in angles, shoulders and apexes between planned and actual implant positions were measured based on postoperative optic impressions. In the test group, a custom-made zirconia abutment and a provisional restoration were immediately placed using a full digital workflow whereas in the control group, a physical impression was taken, and the abutment and crown were placed 10 days post-surgery. Loading outcomes (interproximal contact, occlusal contact, white esthetic score (WES)) were assessed as the PROMs.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
18
placement of implant with local anesthesia using full guided surgery protocol versus free- hande one
placement of dental implant with conventionnal freehand technic
CHU de Liège - Service de Médecine Dentaire
Liège, Belgium
Assessment of the surgical accuracy
The STL files (stereolithography files) were superimposed with pre-operative CBCT (Cone beam computed tomography) images using automated surface best fit matching with the iterative closest point algorithm in the treatment evaluation mode, coDiagnostiX® software version 9.7 (Dental Wings Inc). The mean deviations at the implant shoulder and apex between the planned and actual implant positions were measured in millimeters (mm), as well as the divergence of the implant axis in degrees. All measurements were performed by a single dentist, who conducted the virtual implant planning in all cases.
Time frame: The day of the surgery
Clinical fit of the provisional restoration measurements
The measurements were based on the adaptation of the provisional crown. Interproximal contacts were evaluated according to the criteria described by Syrek (Syrek et al., 2010). Dental floss (Johnson \& Johnson Reach®, Waxed dentotape, New Brunswick, NJ, USA) was used to check the interproximal contact. A score from 1 to 4 was given to the fitting criteria (the higher the score, the better the adaptation).
Time frame: 10 days post surgery
WES
To evaluate the esthetic outcomes of the provisional crown, the White Esthetic Score (WES) was reported. The highest WES score was 10, which represented a close match with the clinical single-tooth crown present at the contralateral natural tooth or neighboring teeth. The WES was evaluated by a blinded prosthodontic, based on photography.
Time frame: 10 days post surgery
Patient-reported outcomes measures (PROMs)
PROMs were obtained using a VAS form immediately after the immediate restoration of the implant. Five questions were used: 1. Do you feel your provisional tooth as a natural tooth? (0 = not at all to 10, absolutely). 2. Do you find your provisional tooth looks like a natural tooth? (0 = not at all to 10, absolutely). 3. How much discomfort did you feel during the physical impression? (0 = little or 10, a lot) for the control group. How much discomfort did you feel during the optical impression? (0 = little to 10, a lot) for the test group. 4. Would you be willing to undergo this treatment again? (0= not at all to 10, absolutely). 5. Are you satisfied with the aesthetics outcomes of your provisional tooth. (0 = not at all to 10, absolutely).
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Time frame: 10 days post surgery