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Comparison between flapless-guided and conventional surgery for implant placement: a 12-month randomized clinical trial

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A Correction to this article was published on 10 May 2023

This article has been updated

Abstract

Objectives

The study was aimed at comparing implants installed with guided and conventional surgery.

Material and methods

Twenty-nine total edentulous patients were selected, and maxillary contralateral quadrants were randomly assigned to static computer-aided implant surgery (S-CAIS): flapless computer-guided surgery, and conventional surgery (CS): flap surgery with conventional planning. Tomography scans were performed at baseline and 10 days after the surgery for deviation measurement, and radiography was done at baseline and after 6 and 12 months, for peri-implant bone level (PIBL) analysis. Peri-implant fluid and subgingival biofilm were collected to evaluate bone markers and periodontal pathogens.

Results

S-CAIS showed less linear deviation at the apical point and at the midpoint and, less angular deviation (p < 0.05), with greater depth discrepancy in the positioning of the platform (p < 0.05). Higher values of vertical PIBL were observed for the S-CAIS group at baseline (p < 0.05), while lower values of horizontal PIBL were observed for CS (p < 0.05). Bone markers presented higher levels in CS (p < 0.05).

Conclusion

Flapless S-CAIS allowed smaller linear and angular deviations than the conventional technique. However, PIBL was higher in S-CAIS; the conventional technique led to a greater angiogenic and bone remodeling activity by elevating the angiogenic and bone markers levels.

Clinical relevance

Evaluating the different implant insertion techniques can guide clinical and surgical regarding the accuracy, the release pattern of bone markers, and the peri-implant bone level.

Trial registration

ReBEC-RBR-8556fzp.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Change history

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Funding

This study was supported by the São Paulo Research Foundation (FAPESP; São Paulo, SP, Brazil; processes 2018/05376–2).

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Authors and Affiliations

  1. Dental Research Division, School of Dentistry, Universidade Paulista (UNIP), São Paulo, São Paulo, Av. Dr. Bacelar, 1212, 4° Andar, Vila Clementino, São Paulo, SP, 04026-002, Brazil

    Lucas Massaru Nomiyama, Edson Ken Matumoto, Mônica Grazieli Corrêa, Fabiano Ribeiro Cirano, Fernanda Vieira Ribeiro, Suzana Peres Pimentel & Marcio Zaffalon Casati

  2. Departamento de Odontologia, Universidade Paulista (UNIP), São Paulo, Brazil

    Marcio Zaffalon Casati

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  1. Lucas Massaru Nomiyama
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Contributions

LMN: worked at the experimental phase (clinical procedures and patient recruitment).

EKM: worked at experimental phase (clinical procedures and patient recruitment).

MGC: drafting the work.

FRV: analysis, and interpretation of data for the work and laboratorial analysis.

FRC: substantial contributions to the conception or design of the work.

SPP: final approval of the version to be published and clinical procedures.

MZC: final approval of the version to be published and agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

All authors agree to be personally accountable for the author’s own contributions and for ensuring that questions related to the accuracy or integrity of any part of the work, even ones in which the author was not personally involved, are appropriately investigated, resolved, and documented in the literature.

Corresponding author

Correspondence to Marcio Zaffalon Casati.

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Ethics approval and consent to participate

All eligible patients were thoroughly informed of the nature, potential risks, and benefits of their participation in the study and signed an informed consent document. This study was approved by the ethics committee of Paulista University (2.059.143).

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Nomiyama, L.M., Matumoto, E.K., Corrêa, M.G. et al. Comparison between flapless-guided and conventional surgery for implant placement: a 12-month randomized clinical trial. Clin Oral Invest 27, 1665–1679 (2023). https://doi.org/10.1007/s00784-022-04793-3

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