BACKGROUND Guided implant surgery is considered as a safe and minimally invasive flapless procedure. However, flapless guided surgery, implant placement in post-extraction sockets and immediate loading of complete-arch fixed reconstructions without artificial gum are still not throughly evaluated. The aim of the present retrospective clinical study was to document the survival and success of complete-arch fixed reconstructions without artificial gum, obtained by means of guided surgery and immediate loading of implants placed also in fresh extraction sockets. METHODS A total of 12 patients (5 males and 7 females, with a mean age of 50.0 ± 13.8) were enrolled in this study. Implant planning was performed with a guided surgery system (RealGuide®, 3Diemme, Como, Italy), from which 3D-printed surgical templates were fabricated. All implants (Esthetic Line-EL®, C-Tech, Bologna, Italy) were placed through the guides and immediately loaded by means of a temporary fixed full-arch restoration without any artificial gum; the outcome measures were implant stability at placement, implant survival, complications, prosthetic success, soft-tissue stability, and patient satisfaction. RESULTS One hundred ten implants (65 of them post-extractive) were placed flapless through a guided surgery procedure and then immediately loaded by means of provisional fixed full arches. Successful implant stability at placement was achieved in all cases. After a provisionalization period of 6 months, 72 fixed prosthetic restorations were delivered. Only 2 implants failed to osseointegrate and had to be removed, in one patient, giving a 1-year implant survival rate of 98.2% (108/110 surviving implants); 8/12 prostheses did not undergo any failure or complication during the entire follow-up period. At the 1-year follow-up control, soft-tissue was stable in all patients and showed satesfactory aesthetic results. CONCLUSIONS Within the limits of this study, complete-arch fixed reconstruction by means of guided surgery and immediate loading of implants placed in fresh extraction sockets appears to be a reliable and successful procedure. Further long-term prospective studies on a larger sample of patients are needed to confirm these positive outcomes.

中文翻译：

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通过引导手术和即刻负重进行全足弓固定重建：回顾性临床研究，对12例患者进行了1年的随访。

背景技术引导植入物手术被认为是一种安全且微创的无瓣手术。然而，仍然没有全面评估无瓣引导手术，将植入物放置在拔牙后窝中以及在没有人工牙龈的情况下立即加载完整牙弓固定重建体的情况。本回顾性临床研究的目的是记录无人工牙龈的完整牙弓固定重建的生存和成功，该重建是通过引导手术和立即将植入物放置在新鲜的拔牙窝中获得的。方法本研究共纳入12例患者（男5例，女7例，平均年龄50.0±13.8）。植入计划是在有指导的手术系统（RealGuide®，3Diemme，意大利科莫）上进行的，并由此制作了3D打印的手术模板。所有植入物（EstheticLine-EL®，C-Tech，意大利博洛尼亚）均通过导板放置，并通过临时固定的全牙弓修复体立即加载，而没有任何人造牙龈；结果指标包括植入物在植入时的稳定性，植入物的存活率，并发症，修复成功，软组织的稳定性以及患者的满意度。结果一百一十个植入物（其中有六十五个在抽取后）通过引导性手术过程无瓣放置，然后立即通过临时固定的全牙弓加载。在所有情况下，均能成功实现植入时植入物的稳定性。经过6个月的临时修复，交付了72个固定的修复体。在一名患者中，只有2个植入物未能骨整合，因此必须将其移除，从而使1年植入物存活率为98。2％（108/110存活的植入物）; 在整个随访期间，8/12假体没有发生任何故障或并发症。在1年的随访控制下，所有患者的软组织均稳定，并显示出令人满意的美学效果。结论在本研究的范围内，通过引导手术和立即将新鲜种植体中的植入物立即加载完成全牙弓固定重建似乎是一种可靠而成功的方法。需要对更多患者进行进一步的长期前瞻性研究，以确认这些积极的结果。通过引导性手术和立即将新鲜种植体中的种植体立即装载完全固定的固定重建术似乎是一种可靠而成功的方法。需要对更多患者进行进一步的长期前瞻性研究，以确认这些积极结果。通过引导手术和立即将新鲜种植体中的植入物立即加载完成完整牙弓固定重建似乎是一种可靠而成功的方法。需要对更多患者进行进一步的长期前瞻性研究，以确认这些积极的结果。