Department of Periodontology, Oral and Implant Surgery, University Hospital of Liège, Domaine du Sart Tilman Bat B-35, 4000, Liège, Belgium.
Dental Biomaterials Research Unit (d-BRU), University of Liège, 4000, Liège, Belgium.
Int J Implant Dent. 2022 Feb 7;8(1):7. doi: 10.1186/s40729-022-00406-6.
To compare short-term outcomes after immediate restoration of a single implant in the esthetic zone with one-abutment one-time technique comparing a conventional (control) vs. a fully digital workflow (test).
Eighteen subjects were randomly assigned to the two groups, and a digital implant planning was performed for all. In the test group, a custom-made zirconia abutment and a CAD-CAM provisional crown were prepared prior to surgery; implants were placed using a s-CAIS guide allowing immediate restoration after surgery. In the control group, the implant was placed free-handed using a conventional surgical guide, and a custom-made zirconia abutment to support a stratified provisional crown was placed 10 days thereafter, based on a conventional impression. Implant accuracy (relative to the planning), the provisional restoration outcomes, as well as PROMs were assessed.
The implant positioning showed higher accuracy with the s-CAIS surgical guide compared to free-handed surgery (angular deviation (AD): 2.41 ± 1.27° vs. 6.26 ± 3.98°, p < 0.014; entry point deviation (CGD): 0.65 ± 0.37 mm vs. 1.27 ± 0.83 mm, p < 0.059; apical deviation (GAD): 1.36 ± 0.53 mm vs. 2.42 ± 1.02 mm, p < 0.014). The occlusion and interproximal contacts showed similar results for the two workflows (p = 0.7 and p = 0.69, respectively). The PROMs results were similar in both groups except for impression taking with intra-oral scanning preferred over conventional impressions (p = 0.014).
Both workflows allowed implant placement and immediate/early restoration and displayed similar clinical and esthetic outcomes. The fully digital workflow was associated with a more accurate implant position relative to planning.
Our results show that both conventional and digital workflow are predictive and provide similar clinical outcomes, with extra precision provided by digitalisation.
比较即刻修复单个种植体在美学区域的短期效果，比较一次使用一个基台的传统（对照）和全数字化工作流程（试验）。
18 名受试者随机分为两组，并对所有受试者进行数字化种植体规划。在试验组中，在手术前制备了定制氧化锆基台和 CAD-CAM 临时冠；使用 s-CAIS 引导器放置种植体，术后即可进行即刻修复。在对照组中，使用传统的手术导板徒手放置种植体，10 天后，根据传统的印模，放置定制氧化锆基台以支持分层临时冠。评估种植体的准确性（相对于规划）、临时修复效果以及患者报告的结果。
s-CAIS 手术导板引导的种植体定位比徒手手术更准确（角度偏差（AD）：2.41 ± 1.27°比 6.26 ± 3.98°，p<0.014；入口点偏差（CGD）：0.65 ± 0.37 mm 比 1.27 ± 0.83 mm，p<0.059；根尖偏差（GAD）：1.36 ± 0.53 mm 比 2.42 ± 1.02 mm，p<0.014）。两种工作流程的咬合和邻接接触显示出相似的结果（p=0.7 和 p=0.69）。两组患者报告的结果相似，除了使用口内扫描取模比传统取模更受欢迎（p=0.014）。
两种工作流程都允许种植体植入和即刻/早期修复，并显示出相似的临床和美学效果。全数字化工作流程与规划相比，种植体位置更准确。
我们的结果表明，传统和数字化工作流程都是可预测的，并提供相似的临床结果，数字化提供了额外的精度。
