A Novel Approach to Guided Implant Surgery: A Technical Note

Computer-guided software and kits have significantly improved the clinical applications of implant surgery. Nonetheless, some technical problems are still in evidence during clinical procedures because of cumbersome surgical tools that can limit access to implant sites, mainly in posterior areas of the mouth in the presence of bulky anatomical structures and in patients with reduced mouth-opening capacity. The present paper aimed to present a novel approach to guided implant surgery, describing the technical characteristics of an innovative guided surgical kit made up of modified sleeves and modular surgical drills. The proposed guided surgical kit is based on a novel patented system of sleeves and modular burs, with an increased length of the metal sleeves and a reduced height of the drills. The innovative design of the proposed system would allow the clinician to position guided fixtures in all clinical situations; the reduced encumbrance would be particularly helpful to gain access to the posterior areas of both maxilla and mandible, which have limited inter-arch space, with an easy and user-friendly approach. The modular system could overcome anatomical limitations, such as reduced mouth-opening capacity, and permit clinicians to maintain the stability and integrity of the surgical templates, even in cases where there is very limited intermaxillary space

Internal- vs external-connection single implants: A retrospective study in an italian population treated by certified prosthodontists

Purpose: The design of an implant connection that allows prosthetic suprastructures to be attached to implants has long been debated in the dental literature. The goal of this retrospective study was to evaluate the 5-year clinical results for a large number of single implants restored by certified prosthodontists in an attempt to establish whether different clinical outcomes could be detected for external- or internalconnection implants. Materials and Methods: All single implants with internal or external connections inserted in 27 private dental practices from January 1, 2003 to December 31, 2007 were evaluated. An initial statistical analysis was performed to describe the sample population at baseline and then to compare the two types of implant-abutment connection configurations and their clinical outcomes. All data were statistically analyzed with STATA12 (StataCorp). Results: Twenty-eight of the 85 active members of the Italian Academy of Prosthetic Dentistry (AIOP) participated in this study. The sample included 1,159 patients and 2,010 implants. Of the implants, 75 were dropped because there was no information about follow-up. Of the remaining implants, 1,431 (74.0%) were followed for at least 5 years, and 332 implants (17.2%) were followed for more than 8 years. Nearly 99% (98.9%) of the implants survived. The difference between the survival frequencies of the two types of implant-abutment connection configurations was not significant for each negative event (log-rank test, P > .05). There was no difference between the two types of implants regarding restoration fracture, implant screw loosening, and peri-implant disease. Conclusion: Within the limitations of this study, it can be suggested that there is no difference in clinical outcomes of single restorations joined to internal- or external-connection implants

The citizen project : bridging the scales with focus on megacities

International audienc