Immediately restored full arch-fixed prosthesis on implants placed in both healed and fresh extraction sockets after computer-planned flapless guided surgery. A 3-year follow-up study

Background: The treatment of patients by the use of immediate implant placement in post-extractive site is a challenging procedure. Purpose: A 3-year clinical and radiological study of post-extractive implants placed using flapless guided surgery and immediately functioning. Materials and methods: Thirty-two patients (23 females and 9 males), aged between 44 and 73 years (a mean age of 59.5) were treated with immediate full arch restorations and flapless implant surgery in fresh extraction and healed sites. A double-guide technique stent in conjunction with the NobelGuide system (Nobel Biocare AB, Göteborg, Sweden) was used. Results: A total of 285 implants over 32 patients were assessed. The patients were clinically and radiologically followed for 3 years. One hundred and ninety-five implants were placed in the maxilla and 90 in the mandible. Eight patients received implants in both arches. One hundred and ninety-seven implants were placed in extraction sites (137 maxilla, 60 mandible) and 88 in healed sites (58 maxilla and 30 mandible). The overall cumulative implant survival rate (CISR) was 97.54%. Two implants failed in maxillary healed sites (CISR 96.55%), three in maxillary extraction sites (CISR 97.81%), and two in mandibular extraction sites (CISR 96.66%). No implant failed in healed mandibular sites (CSR 100%). All fixed prostheses maintained stability and good functionality during the follow-up, accounting for a cumulative prosthesis survival rate (CPSR) of 100%. The overall marginal bone level (MBL) was -0.52 mm (SD -0.18) after 6 months, -0.88 mm (SD -0.20) after 12 months, -1.05 mm (SD -0.21) after 24 months, and -1.32 mm (SD -0.41) after 36 months. Conclusions: Computer-guided surgery using double-template technique (DTT) shows a predictable outcome in the medium term, decreasing treatment timing and patient discomfort.