Faculté des Sciences Médicales et Paramédicales, École de Médecine dentaire, ADES, CNRS, Aix-Marseille University, 27 Boulevard Jean Moulin, Marseille Cedex 5, 13555, France.
Private practice, Marseille, France.
Int J Implant Dent. 2024 May 31;10(1):28. doi: 10.1186/s40729-024-00547-w.
The rise of stereolithographic surgical guides and digital workflow, combined with a better knowledge of materials and loading principle, has enabled the placement of the temporary prosthesis at the time of implant placement. This scoping review aimed to assess the current knowledge available on stackable guides.
The review focused on fully edentulous or requiring total edentulism patients. The procedure studied was the use of stackable guides for edentulous patients in order to place immediate temporary prostheses. The clinical endpoint was immediate placement of the provisional prosthesis after surgery combined with a prior bone reduction using a stackable guide.
12 case reports or case series articles met inclusion criteria, which did not allow an analysis by a systematic review. The included studies were case reports or case series. Most of the articles showed a base stabilized by 3 or 4 bone-pins, anchored in buccal or lingual part. Regarding the accuracy of bone reduction (ranged from 0.0248 mm to 1.98 mm) and implant placement when compared to planned, only 4 articles reported quantitative data. 11 articles showed an immediate loading with the transitional prosthesis after implant placement.
There are as yet no prospective or comparative studies on the efficiency of this technique. In a reliable way, stackable guides seem to be able to guide the practitioner from the flap elevation to the placement of the temporary screw-retained implant supported prosthesis. Given the lack of studies in this specific field of guided surgery, further studies are needed to confirm the clinical relevance of this technique.
随着立体光刻手术导板和数字化工作流程的兴起，以及对材料和加载原理的深入了解，使得在植入物放置的同时能够放置临时修复体。本范围界定综述旨在评估目前关于可堆叠导板的相关知识。
综述重点关注全口无牙或需要全口无牙的患者。研究的手术过程是在无牙患者中使用可堆叠导板以放置即刻临时修复体。临床终点是在手术后即刻放置临时修复体，同时使用可堆叠导板进行预先的骨量减少。
有 12 篇病例报告或病例系列文章符合纳入标准，但不允许进行系统评价分析。纳入的研究为病例报告或病例系列。大多数文章显示基底由 3 或 4 个骨钉稳定，固定在颊侧或舌侧部分。关于骨量减少的准确性（范围为 0.0248 毫米至 1.98 毫米）和与计划相比的种植体放置情况，只有 4 篇文章报告了定量数据。11 篇文章在种植体放置后立即用过渡性修复体进行即刻负载。
目前尚无关于该技术效率的前瞻性或对照研究。在可靠的情况下，可堆叠导板似乎能够指导临床医生从皮瓣提升到临时螺丝固位种植体支持修复体的放置。鉴于在这个特定的引导手术领域缺乏研究，需要进一步的研究来证实该技术的临床相关性。
