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Esthetics of Flapless Single‐Tooth Implants in the Anterior Maxilla Using Guided Surgery: Association of Three‐Dimensional Accuracy and Pink Esthetic Score
Author(s) -
Fürhauser Rudolf,
MailathPokorny Georg,
Haas Robert,
Busenlechner Dieter,
Watzek Georg,
Pommer Bernhard
Publication year - 2015
Publication title -
clinical implant dentistry and related research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.338
H-Index - 85
eISSN - 1708-8208
pISSN - 1523-0899
DOI - 10.1111/cid.12264
Subject(s) - implant , anterior maxilla , medicine , maxilla , dentistry , orthodontics , cone beam computed tomography , dental implant , computed tomography , surgery
Background Flapless implant placement using surgical templates may guarantee predictable and esthetic results provided that preplanned implant positions are transfered precisely into surgical reality. Purpose The study aims to investigate the effect of three‐dimensional accuracy in guided implant surgery on the esthetic outcome of single‐tooth implants in the anterior maxilla. Materials and Methods Single‐tooth implants for delayed replacement of upper incisors were inserted in 27 patients using stereolithographic templates. Superimposition of postoperative cone beam computed tomography ( CBCT ) scans allowed assessment of positional inaccuracy at the implant shoulder and apex, as well as angular deviation. Objective evaluation of implant esthetics was performed after a mean follow‐up of 2.3 years using the P ink E sthetic S core ( PES ). Results Mean deviation between planned and actual implant position was 0.84 mm at the implant shoulder and significantly correlated to average PES of 12 ( p = .031). Inaccuracy toward the buccal side was most frequent (70%). Deviations ≥ 0.8 mm resulted in significantly worse implant esthetics (median PES : 9.5, interquartile range [ IQR ]: 8–11) compared with more accurate implant positions (median PES : 13, IQR : 12–13, p = .039). Conclusion Positional inaccuracy is low in guided implant surgery, but may however significantly compromise implant esthetics in the anterior maxilla.