Evaluation of the precision obtained with a fixed surgical template in the placement of implants for rehabilitation of the completely edentulous maxilla: a clinical report.

The fabrication of a complete maxillary implant-supported prosthesis in a patient with slight resorption of the alveolar ridge and a high lip line presents a professional challenge. The implants must be placed with high precision to achieve good esthetics, phonetics, and function. A fixed surgical template using microimplants has been developed for this purpose. The objective of this investigation was to compare a fixed surgical template (FST) to a conventional movable surgical template (MST) for the precise placement of implants in the slightly resorbed edentulous maxilla. Three patients (28 implants), edentulous in the maxilla, with slight ridge resorption, in whom the implants were placed with an FST, were compared with 5 controls having the same characteristics and implants placed with an MST (35 implants). After completion of the prosthesis, occlusal photographs (1:1) were taken, and these images were scanned and transferred to a drawing program in which the contours of the teeth, the ideal emergence position of the occlusal hole of the abutment screw, and its real position were drawn. A blind evaluation was made using the following variables: frequency of location of the abutment screw hole outside of the tooth contour, and the relative measurements of the area of coincidence between the circle that represents the ideal position and real position. A significantly smaller frequency of implants outside the tooth contour was seen with the FST (7%) than with the MST (46%) (P < .0008). Also, a significantly higher relative area of coincidence was observed between ideal position and real position in the FST (0.61) than in the MST (0.38) (P < .003). This study revealed that considerably higher precision was associated with the use of an FST.