Prosthesis-Based 3D Guide System for Maxillary Implant Placement: A Feasibility Study Using a Split-Mouth Evaluation

Area of Science:

• Dental Implantology
• Prosthodontics
• Oral Surgery

Background:

• Evaluating the adaptation of a prosthesis-based guide system for multi-implant placement in edentulous maxilla.
• Assessing short-term radiographic outcomes and clinical feasibility of the adapted guide system.
• Comparing marginal bone change between full-rough and hybrid-surface implants.

Purpose of the Study:

• To evaluate the clinical feasibility of adapting a single-implant prosthesis-based guide for multi-implant placement.
• To compare 12-month marginal bone change between full-rough and hybrid-surface implants in a split-mouth design.
• To assess patient-reported outcomes using the OHIP-14 questionnaire.

Main Methods:

• Fifteen patients with edentulous maxilla received 4-5 flapless implants using a 3D-printed prosthesis-based guide with PEEK rails and angulation sleeves.
• Implants were either full-rough surface or hybrid (rough apex/middle, machined collar).
• Radiographs at loading and 12 months assessed marginal bone loss; OHIP-14 evaluated patient outcomes.

Main Results:

• Sixty-one implants were placed; 4.9% experienced early failure. Marginal bone level increased significantly from baseline to 12 months (p < 0.001).
• Full-rough implants demonstrated less 12-month marginal bone change compared to hybrid implants in paired patients (p = 0.012).
• OHIP-14 scores showed a floor effect at one year; high intra- and inter-rater reliability (ICC = 0.85) for radiographic measurements.

Conclusions:

• The prosthesis-based guide system is feasible for flapless multi-implant rehabilitation of the edentulous maxilla.
• Full-rough implants showed less marginal bone change than hybrid implants, contrary to expectations, requiring further investigation.
• This approach offers a reduced infrastructure alternative to guided surgery platforms, needing confirmation in larger, powered trials.