Tonellini Gabriele, Saez Vigo Raquel, Novelli Giorgio
San Gerardo Hospital, Department of Maxillofacial Surgery, University of Milano-Bicocca, Milan, Italy.
Int J Dent. 2018 Feb 4;2018:2672549. doi: 10.1155/2018/2672549. eCollection 2018.
The rehabilitation of edentulous jaws with guided and flapless surgery applied to the All-on-4 concepts is a predictable treatment with a high implant and prosthetic survival rates, but there are several contraindications for this technique like when bone reduction is needed due to a high smile line in the maxilla or when there is an irregular or thin bone crest.
To report a technique with double guided surgery for bone reduction and implant placement with the All-on-4 concept.
7 patients were included in the study. Guided implant planning was performed using CBCT, and the virtual templates were created with three dedicated software. Custom surgical templates were made for the ostectomy and for implants positioning.
28 implants were placed using a double bone-supported surgical guide. The mean angular errors between the preoperative-planned implant and the postoperative-placed implant were 2.155° ± 2.03°; the mean distance errors between the planned and the placed implants were 0.763 mm ± 0.55 mm on the shoulder implant and 0.570 mm ± 0.40 mm on the apex implant.
The results of our study indicate that this treatment is predictable with an excellent survival rate allowing excellent results even when bone reduction is mandatory.
将引导式和无瓣手术应用于全口4颗种植体理念来修复无牙颌是一种可预测的治疗方法，种植体和修复体的存活率很高，但该技术存在一些禁忌症，比如上颌笑线过高需要进行骨减量时，或者存在不规则或薄的牙槽嵴时。
报告一种采用双引导手术进行骨减量和按照全口4颗种植体理念植入种植体的技术。
7例患者纳入本研究。使用锥形束计算机断层扫描（CBCT）进行种植体引导规划，并使用三款专用软件创建虚拟模板。制作定制手术模板用于骨切除术和种植体定位。
使用双骨支持手术导板植入28颗种植体。术前规划种植体与术后植入种植体之间的平均角度误差为2.155°±2.03°；肩部种植体的规划种植体与植入种植体之间的平均距离误差为0.763mm±0.55mm，根尖种植体的平均距离误差为0.570mm±0.40mm。
我们的研究结果表明，即使在必须进行骨减量的情况下，这种治疗方法也是可预测的，具有出色的存活率，能取得优异的效果。
