The Need for Template-guided Implantation of One-piece Ceramic Implants

Objectives: Ceramic implants prove to be an alternative to titanium implants due to their good biocompatibility.
Although two-piece ceramic implants offer more prosthetic supply options, their clinical long-term prognosis does currently not provide the necessary evidence-based safety as one-piece ceramic implants do.
When placing one-piece implants, the soft tissue cannot be shaped by a second intervention, nor can malpositioning of the implants be adjusted with appropriate abutments. However, the implementation of a consistent digital workflow can overcome this supposed weakness.
For bridge restorations, high parallelism of the implants is important.
The aim of this study is to verify whether template-guided implantation guarantees a sufficient and safe restoration of one-piece ceramic implants.
The angular deviations of different types of templates for guided implant placement should be compared to the results of the accuracy that is achieved by placing with a freehand procedure.
Methods: In an ongoing clinical study, 12 patients each receive template-guided implants with three different types of templates (2ingis, SMOP, CoDiagnostiX). In 12 patients, only a guided pilot drill is performed. Finally, 12 patients undergo a freehand implant bed preparation. After superimposing the planed and the clinically achieved position, the angle deviation is determined. It is then calculated whether it is possible to supply small unit bridges without grinding the abutments.
Results: Initial results show a mean implant deviation of 3 ° to 5 ° for the template-guided implantation. By contrast, the average preliminary results for freehand implantation are between 10-12 °. The implants inserted with a template supported pilot hole shows mean angle deviations of 8 °. In the cases of non-guided preparations, the values also show a considerably wider dispersion.
Conclusions:
For a predictable prosthetic fit of one-piece ceramic implants, the use of a template is recommended.