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Guided surgery for single-implant placement: A critical review

Single-tooth replacement by means of osseointegrated dental implants may be considered a reliable treatment option for replacing missing teeth, following both immediate and early protocols. (Photograph: Anna Jurkovska/Shutterstock)
Drs. Marco Tallarico, Silvio Mario Meloni, Luigi Canullo, Erta Xhanari & Giovanni Polizzi

Drs. Marco Tallarico, Silvio Mario Meloni, Luigi Canullo, Erta Xhanari & Giovanni Polizzi

Mon. 13. February 2017

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The objective of this review was to evaluate the scientific evidence on accuracy, as well as esthetic and clinical outcomes of single-tooth implants placed using computer-assisted, template-based surgery.

Case description
Electronic and manual literature searches of clinical studies published between January 2002 and May 2015 were carried out using specified indexing terms. Outcomes were accuracy, Pink Esthetic Score, and clinical outcomes (implant and prosthetic survival rates, complications, and marginal bone loss).

Results
A total of 706 titles and abstracts were found during the electronic and manual searches, but 563 publications were excluded (inter-reviewer agreement k = 0.78). The full texts of the remaining 143 publications were evaluated. A total of 125 papers had to be excluded because they did not fulfill the inclusion criteria (k = 0.99). Three manuscripts were added from the reference lists of all of the selected articles. A total of 21 articles were thus selected that fulfilled the inclusion criteria of and quality assessment required for this critical review.

Conclusion
Despite the high accuracy and a cumulative survival rate of 100%, there is little evidence to support the hypothesis that there is a clinical advantage of computer-assisted, template-based implant placement over conventional treatment protocols for the placement of an implant-supported single-tooth restoration. Long-term randomized clinical trials are needed to confirm these preliminary results.

Editorial note: The full article was published in the 4/2016 issue of the Journal of Oral Science and Rehabilitation. It can be access free of charge at www.dtscience.com.

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