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A Prosthetically Coupled Tripod Fixation Concept for Edentulous Surgical Guides: A Three-Case Proof-of-Concept Study
Ioan-Achim Borșanu1, Ralph-Alexandru Erdelyi2, Sergiu-Manuel Antonie1
1Clinic of Implant Supported Restorations, "Victor Babeș" University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania.
A new method using temporary reference implants in a tripod configuration significantly improved surgical guide stability for fully edentulous patients undergoing guided implant surgery. This approach enhances drilling accuracy and workflow predictability in complex dental reconstructions.
Area of Science:
- Dental Implantology
- Surgical Navigation
- Prosthodontics
Background:
- Surgical guide instability in fully edentulous patients is a significant clinical challenge, impacting drilling accuracy and predictability.
- Existing methods using fixation pins often fail to overcome mucosal resilience and micromovement, compromising guided implant surgery.
- A novel stabilization technique utilizing pre-placed tripod reference implants with multi-unit coupling is proposed.
Purpose of the Study:
- To describe and evaluate a novel stabilization approach for surgical guides in fully edentulous patients using temporary reference implants.
- To assess the feasibility, stability, and accuracy of a guided implant surgery workflow indexed to a prosthetic docking platform.
Main Methods:
- A proof-of-concept case series involving three fully edentulous patients treated with a two-stage protocol.
- Insertion of three temporary reference implants in a tripod configuration 7-10 days before definitive surgery.
- Intraoral scanning for surgical guide design, indexed to multi-unit abutments on reference implants; guide screw-retained during surgery.
Main Results:
- Achieved stable surgical guide fixation in all cases without intraoperative displacement.
- Demonstrated accurate implant placement with mean deviations (coronal, apical, angular) comparable to published guided surgery data.
- Reported uneventful removal of reference implants and no intraoperative or early postoperative complications.
Conclusions:
- Temporary reference implants in a tripod configuration offer a stable and reproducible prosthetic indexing platform for guided implant surgery in edentulous patients.
- This method shows promise for enhancing accuracy and predictability in complex implant rehabilitation cases.
- Further prospective studies are needed to validate clinical performance and long-term applicability compared to conventional methods.