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Updated: Apr 24, 2026
A Postoperative Evaluation Guideline for Computer-Assisted Reconstruction of the Mandible
Published on: January 28, 2020
Cumulative survival rate of implants placed "fully guided" using CT-guided surgery: a 7-year retrospective study
Gary Orentlicher1, Andrew Horowitz2, Douglas Goldsmith3
1Section Chief, Division of Oral and Maxillofacial Surgery, White Plains Hospital, White Plains, New York; Private Practice, New York Oral, Maxillofacial, and Implant Surgery, Scarsdale, New York.
Purpose:
To evaluate the cumulative survival rates (CSRs) of dental implants placed "fully guided" using computed tomography (CT)-guided surgery, including cone beam CT (CBCT).
Materials And Methods:
Records, mountings, wax-ups, and scanning appliances were made for patients to wear during CT/CBCT scans following established manufacturer-guided surgery protocols. Virtual planning was performed using either the NobelProcera/NobelClinician or the SimPlant/Facilitate softwares. Manufacturer-produced stereolithographic guides and implant-specific instrumentation were used to place implants fully guided to planned depths and angulations. Included in the study were 177 patients, who had 796 implants placed fully guided, using 212 surgical guides.
Results:
Among 796 implants placed, there were 24 failures, for a 96.98% CSR. System CSRs were: NobelActive, 95.87%; Astra OsseoSpeed, 96.72%; NobelReplace Select Tapered, 97.02%; and NobelReplace Select Straight, 100% (P less than 0.05). Maxillary CSR was 97.62%; mandibular CSR was 95.88% (P less than 0.05). CSR for standard implants (10 mm to 13 mm) was 97.3%; short implants (less than or equal to 9 mm) was 95.1% (P less than 0.05), and long implants greater than 13 mm) was 95.2%. Implant diameter CSR was not significant (P greater than 0.05) for any diameter implant. Full-arch immediately loaded CSR (97.18%) was not different compared to full-arch unloaded (97.20%) (P less than 0.05).
Conclusions:
1) Fully guided implant CSR was 96.98%, which is comparable to "freehand" placement; 2) CSRs varied between implant systems; 3) fully guided short and long implants had lower CSRs than standard implants; 4) the diameter of fully guided implants did not affect CSR; 5) fully guided implants in the anterior maxilla and posterior mandible had reduced CSRs; 6) extraction/immediate placement using fully guided surgery had reduced CSRs; and 7) immediate loading fully guided implants did not affect CSRs.
