J Korean Assoc Oral Maxillofac Surg.  2024 Apr;50(2):70-79. 10.5125/jkaoms.2024.50.2.70.

A 10-year follow-up study on clinical outcomes of dental implant rehabilitation using surgical guide

• Li H
• Eo MY
• Mustakim KR
• Kim SM

• KMID: 2555736
• DOI: http://doi.org/10.5125/jkaoms.2024.50.2.70

Abstract

Objectives
The surgical guide is a static computer-assisted device used for implant surgery planning and guidance. By taking an impression and referring to the patients’ three-dimensional computed tomography scan of the desired implant site, a surgical guide can be created. During surgery, the surgical guide aids in achieving the designed implant placement position and direction. We examined and evaluated the long-term clinical outcomes of implant surgery using surgical guides.
Materials and Methods
This study investigated a total of 15 patients with 32 implants that were placed using surgical guides from 2009 to 2011 with a mean follow-up period extended beyond 10 years. Patient demographics and implant survival rates were recorded. We analyzed marginal bone loss (MBL) by assessing the radiographs acquired at installation, three months after installation, and one month, one, two, and five years after prosthesis delivery.
Results
The mean patient age was 57.33 years at implant placement. Of the 32 implants, five implants were placed in the anterior region and 27 implants were in the posterior region. Six implants failed and three of them were replaced, resulting in an 81.25% survival rate. The mean follow-up period was 10 years and nine months. Mean MBL compared to post-installation was significantly higher than at three months after installation, and one month, one, two, and five years after prosthesis delivery. Mean MBL at three months after installation, and one month, one year, and two years were significantly higher compared to the previous visit (P<0.05). However, MBL at five years after prosthesis delivery did not differ significantly compared to at two years.
Conclusion
In this study, implant rehabilitation assisted by surgical guides exhibited favorable survival rates. With the limitation of the sample amount in this study, further research and more samples are required to evaluate the long-term clinical effectiveness of surgical guides.

Keyword

Treatment outcomes; Computer-assisted surgery; Dental implants; Marginal bone loss; Survival rates

Figure

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  Fig. 1 This figure shows the surgical procedures of implant placement using surgical guide. A 53-year-old female presented with loss of teeth in the right posterior and left anterior maxillary regions. The treatment plan was to place five implants in the areas of #14, #15, #16, #22, and #23. The surgical guide was created according to the design (A, B). The drilling procedure and implant placement were carried out on the surgical guide (C-L).

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  Fig. 2 Marginal bone loss measurement method: Longitudinal implant axis (A), horizontal line at the implant collar (B), horizontal lines located at the highest coronal level of the bone-to-implant contact point at both mesial and distal sites (C, D).

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  Fig. 3 Cases of implant failure: Patients at preoperation (A1-E1), postoperation (A2-E2), post-prosthesis delivery (A3-E3) panoramas, and the panoramas after implant failure (A4-E4). Patient A underwent the removal of #27i and crown removal of #26i; Patient B received #25i, #26i removal and #25i re-installation; Patient C underwent #16i removal; Patient D exhibits #27i implant loosening; Patient E experienced natural loosening of #16i (yellow arrowheads: implants placed using surgical guide, white arrowheads: implant failure).

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  Fig. 4 Cases with successful implant outcomes: Patients at preoperation (A1, B1, C1), postoperation (A2, B2, C2), post-functional loading (A3, B3, C3), and the most recent (A4, B4, C4) panoramas. Patient A underwent #11i, #12i, and #23i implant placement; Patient B underwent #16i implant surgery, sinus lifting, and bone graft procedures; Patient C received #36i implant placement using the surgical guide (yellow arrowheads: implants placed using the surgical guide).

Reference

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