TY - JOUR
T1 - Navigation guided socket-shield technique for implant and pontic sites in the esthetic zone
T2 - A proof-of-concept 1-year prospective study with immediate implant placement and loading
AU - Pozzi, Alessandro
AU - Arcuri, Lorenzo
AU - Kan, Joseph
AU - Londono, Jimmy
N1 - Publisher Copyright:
© 2022 Wiley Periodicals LLC.
PY - 2022/1
Y1 - 2022/1
N2 - Objective: To assess clinical, radiological performance of novel navigation guided socket-shield technique (NSS) with immediate implant placement and loading. Materials and Methods: Eighteen patients (12 females; age 52.54 ± 4.92; 33–72) treated between January 2018 and June 2019, were investigated, and followed for at least 1 year after definitive prosthesis placement (mean 20.1 months, 18–23). Primary outcomes: implant and prosthetic success rates, surgical, biologic, prosthetic complications. Secondary outcomes: marginal bone loss (MBL), implant stability quotient (ISQ), pink esthetic score (PES), plaque and bleeding indexes. Results: Sixty-nine navigation guided socket-shield procedures were performed (27 implant-sites and 42 pontic-sites) and 27 implants (NobelParallel, NobelBiocare AG) positioned and immediately loaded. Mean insertion torque and ISQ at implant positioning were 49 ± 5.34 Ncm (36–74), 73 ± 5.72 (68–81). No implant failure was experienced. Two root-shield exposures with mucositis, ulceration and bleeding were reported at two pontic-sites (2.9%) and successfully treated. No complications were experienced at implant-site leading to an overall NSS success-rate of 100%. No prosthetic complications occurred. Mean MBL was −0.72 ± 0.26 mm (−0.42 to −1.06 mm). PES final at the last follow-up 12.84 ± 0.92. The plaque and bleeding scores were 18.5 ± 6.12 and 3.15 ± 2.21. Conclusions: Within study limitations, dynamic navigation was effective to streamline execution of socket-shield technique at implant and pontic sites, shortening treatment time and reducing complications. Navigation guided socket-shield technique was reliable to achieve digitally planned shield-to-implant distance, facilitate immediate implant placement and loading and establish the mucosal dimension needed for underlying bone-to-implant protection and esthetic integration. Clinical Significance: The investigated NSS technique overcomes the difficulties related to root preparation at implant and pontic-sites, facilitating immediate implant placement and loading. Dynamic guided surgery contributed to make socket-shield technique less technical-sensitive, shortening time for execution, reducing complication rate.
AB - Objective: To assess clinical, radiological performance of novel navigation guided socket-shield technique (NSS) with immediate implant placement and loading. Materials and Methods: Eighteen patients (12 females; age 52.54 ± 4.92; 33–72) treated between January 2018 and June 2019, were investigated, and followed for at least 1 year after definitive prosthesis placement (mean 20.1 months, 18–23). Primary outcomes: implant and prosthetic success rates, surgical, biologic, prosthetic complications. Secondary outcomes: marginal bone loss (MBL), implant stability quotient (ISQ), pink esthetic score (PES), plaque and bleeding indexes. Results: Sixty-nine navigation guided socket-shield procedures were performed (27 implant-sites and 42 pontic-sites) and 27 implants (NobelParallel, NobelBiocare AG) positioned and immediately loaded. Mean insertion torque and ISQ at implant positioning were 49 ± 5.34 Ncm (36–74), 73 ± 5.72 (68–81). No implant failure was experienced. Two root-shield exposures with mucositis, ulceration and bleeding were reported at two pontic-sites (2.9%) and successfully treated. No complications were experienced at implant-site leading to an overall NSS success-rate of 100%. No prosthetic complications occurred. Mean MBL was −0.72 ± 0.26 mm (−0.42 to −1.06 mm). PES final at the last follow-up 12.84 ± 0.92. The plaque and bleeding scores were 18.5 ± 6.12 and 3.15 ± 2.21. Conclusions: Within study limitations, dynamic navigation was effective to streamline execution of socket-shield technique at implant and pontic sites, shortening treatment time and reducing complications. Navigation guided socket-shield technique was reliable to achieve digitally planned shield-to-implant distance, facilitate immediate implant placement and loading and establish the mucosal dimension needed for underlying bone-to-implant protection and esthetic integration. Clinical Significance: The investigated NSS technique overcomes the difficulties related to root preparation at implant and pontic-sites, facilitating immediate implant placement and loading. Dynamic guided surgery contributed to make socket-shield technique less technical-sensitive, shortening time for execution, reducing complication rate.
KW - dynamic navigation
KW - guided surgery
KW - immediate implant placement
KW - immediate loading
KW - socket shield
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U2 - 10.1111/jerd.12867
DO - 10.1111/jerd.12867
M3 - Article
C2 - 34994995
AN - SCOPUS:85122365235
SN - 1496-4155
VL - 34
SP - 203
EP - 214
JO - Journal of Esthetic and Restorative Dentistry
JF - Journal of Esthetic and Restorative Dentistry
IS - 1
ER -