Precision of flapless implant placement using real-time surgical navigation: a case series.

PURPOSE: To demonstrate the predictability of flapless surgery using navigation surgery. MATERIALS AND METHODS: Computer-generated preoperative implant planning was compared to actual placement by CT (computerized tomography) scanning of patients before and after surgery. Once pre- and postoperative coordinates of virtual implants were obtained, linear distances and angles were calculated. Coronal and apical errors consisted of the shortest distance from the preoperative planning to the postoperative overlay. RESULTS: Fourteen implants were placed in 6 patients who received CT scans before and after implant placement. Preoperative implant planning using software was compared to actual placement. The average discrepancy of the head of the implant was 0.89 mm +/- 0.53 SD (range, 0.32 to 1.96). The average discrepancy of the apex of the implant was 0.96 mm +/- 0.50 SD (range, 0.25 to 1.99). The average angle discrepancy and standard deviation were 3.78 degrees +/- 2.76 SD (range, 0.60 to 9.87). CONCLUSION: Optical computerized navigation is vulnerable to technological and technical errors. Yet, the present case series suggests that less than 1 mm of mean linear deviation and less than 4 degrees of angular deviation might be attainable.

Advanced concepts in implant dentistry: creating the "aesthetic site foundation".

To obtain optimal and predictable aesthetics, deficiencies caused by soft and particularly hard tissue loss can be managed by various methods, such as orthodontic tooth eruption, socket preservation, and guided bone regeneration. However, in complex cases, these methods are often insufficient. Here, the authors introduce advanced concepts in aesthetic implant dentistry, such as "Aesthetic Site Foundation", "Aesthetic Guided Bone Regeneration" and "Implant Rectangle" that will guide the clinician in the quest to optimal aesthetic outcomes.