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Comparison between flapless-guided and conventional surgery for implant placement: a 12-month randomized clinical
Lucas Massaru Nomiyama1, Edson Ken Matumoto1, Mônica Grazieli Corrêa1
1Dental Research Division, School of Dentistry, Universidade Paulista (UNIP), São Paulo, São Paulo, Av. Dr. Bacelar, 1212, 4° Andar, Vila Clementino, São Paulo, SP, 04026-002, Brazil.
Objectives:
The study was aimed at comparing implants installed with guided and conventional surgery.
Material And Methods:
Twenty-nine total edentulous patients were selected, and maxillary contralateral quadrants were randomly assigned to static computer-aided implant surgery (S-CAIS): flapless computer-guided surgery, and conventional surgery (CS): flap surgery with conventional planning. Tomography scans were performed at baseline and 10 days after the surgery for deviation measurement, and radiography was done at baseline and after 6 and 12 months, for peri-implant bone level (PIBL) analysis. Peri-implant fluid and subgingival biofilm were collected to evaluate bone markers and periodontal pathogens.
Results:
S-CAIS showed less linear deviation at the apical point and the midpoint and less angular deviation (p < 0.05), with greater depth discrepancy in the positioning of the platform (p < 0.05). Higher values of vertical PIBL were observed for the S-CAIS group at baseline (p < 0.05), while lower values of horizontal PIBL were observed for CS (p < 0.05). Bone markers and Tf presented higher levels in CS (p < 0.05). Flapless S-CAIS allowed smaller linear and angular deviations than the conventional technique.
Conclusion:
However, PIBL was higher in S-CAIS; the conventional technique led to a greater angiogenic and bone remodeling activity by elevating the angiogenic levels and bone markers.
Clinical Relevance:
Evaluating the different implant insertion techniques can guide clinical and surgical regarding the accuracy, the release pattern of bone markers, and the peri-implant bone level.
Trial Registration:
ReBEC-RBR-8556fzp.
