ACCURACY OF FLAPLESS PLACEMENT OF DENTAL IMPLANTS IN POSTERIOR MANDIBLE WITH AND WITHOUT USING STEREOLITHOGRAPHIC SURGICAL GUIDE

AbdelFattah Elhabashy, Mohamed Z. Amer, Wael S. Ahmed And Wael M. Safwat,

ABSTRACT
Problem Statement: Stereolithographic Surgical Guides Were Introduced As An Aid To Overcome Blind Technique Associated With Flapless Implant Placement And To Compensate Surgeon Experience. This Study Was Conducted To Evaluate The Accuracy Of Flapless Placement Of Dental Implants In Posterior Mandible With And Without Using Stereolithographic Surgical Guide. Patient And Method: Twelve Patients, Ten Females And Two Males, Received Sixteen Dental Implants To Replace Missing Mandibular Posterior Teeth. All Patients Were Equally Divided Into Two Groups. In 1st Group, 6 Patients Received 8 Dental Implants Using Stereolithographic Surgical Guide Without Flap Reflection. While, In 2nd Group, 6 Patients Received 8 Dental Implants Using The Conventional Surgical Guide Without Flap Reflection. All Implants Were Subjected To Immediate Loading Within 1 Week. Preoperative And Postoperative CBCT Were Performed For Both Groups To Evaluate Accuracy Of The Actually Placed Implant In The Oral Cavity Compared With The Virtually Planned Implants In The Software. All Patients Were Clinically And Radiographically Assessed At Baseline (T0), After 6 Months (T1), And After 12 Months (T2) Of Follow Up Regarding To Implant Stability, Peri-implant Pocket Depth, Modified Sulcus Bleeding Index, And Marginal Bone Level. Result: All Implants Were Successfully Osseointegrated. There Were No Statistical Significant Differences Between Planned And Placed Implants In Both Groups Regarding To Angular Deviation, Horizontal Deviations At Coronal And Apical Parts, And Vertical Deviations At Coronal And Apical Parts (P= 0.645, 0.721, 0.442, 0.234, 0.328 Respectively). No Significant Differences Were Recorded Between Both Groups Regarding To Stability, (mSBI), And (PPD) At Different Time Intervals Of Follow Up Periods Either At, (T0), (T1), Or At (T2) (P=0.721, 0.798, 0.505 Respectively), (P=0.721, 0.105, 0.721 Respectively), And (P=0.505, 1.000, 1.000 Respectively). Nevertheless, There Were Statistical Significant Differences Between Both Groups Regarding To (MBL) Either At, (T0), (T1), Or At (T2) (P=0.010*, 0.001*, 0.001*respectively). Conclusion: Both Flapless Techniques Either Aided By Stereolithographic Guide Or Aided By Conventional Guide Give Comparable Good Results Without An Additional Superiority Regarding To Accuracy Parameters Of The Implant Inserted In The First Group By Stereolithographic Guide.

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