Immediately Loaded Implants in Rehabilitation of the Maxilla: A Two-Year Randomized Clinical Trial of Guided Surgery versus Standard Procedure.

BACKGROUND: Implant-simulation software can now be used to improve treatment planning, guide surgery, and ensure more accurate implant placement. PURPOSE: The aim of this study was to evaluate the outcome of a guided surgery protocol versus a conventional protocol. MATERIALS AND METHODS: Twenty-six patients were randomly assigned to Guided Surgery or Conventional Surgery. In test group implants were placed in the maxilla using a tooth supported model-based surgical guide with a minimally invasive flap and immediately loaded. In control group implants were inserted with an open flap surgery following a prosthetic stent and immediately loaded. RESULTS: A total of 70 implants were placed (36 test and 34 control). Statistically significant differences were found between the test group and the control group for patient opinion about self-confidence, assumption of analgesic tablets and perceived pain. The test group registered a statistically significant reduction (p < .05) as regards time of surgery and time of provisional insertion with respect to the control group. CONCLUSIONS: Implants can successfully integrate in the posterior maxilla using a guided surgery approach with immediate loading. The use of guided surgery helped to reduce the surgery duration, pain intensity, related analgesic consumption, and a more predictable provisional installation.