Computer Guided Implantology Accuracy and Complications

The computer-based method allows the computerized planning of a surgical implantology procedure, using computed tomography (CT) of the maxillary bones and prosthesis. This procedure, however, is not error-free, unless the operator has been well trained and strictly follows the protocol. A 70-year-old woman whom was edentulous asked for a lower jaw implant-supported prosthesis. A computer-guided surgery was planned with an immediate loading according to the NobelGuide technique. However, prior to surgery, new dentures were constructed to adjust the vertical dimension. An interim screwed metal-resin prosthesis was delivered just after the surgery; however, after only two weeks, it was removed because of a complication. Finally, a screwed implant bridge was delivered. The computer guided surgery is a useful procedure when based on an accurate 3D CT-based image data and an implant planning software which minimizes errors. 1. Introduction The computer-based technique allows the virtual planning of a surgical implantology procedure by using a CT/CBCT of the maxillary bones and prosthesis [1–3] with an analysis of the jaw in all three dimensions. Therefore, it is possible to plan a precise position of the implant respect to the anatomical structures as well as the prostheses, improving the predictability of implant placement, obtaining a prosthetically driven planning [4]. An accurate surgical guide is generated that is also used by the dental technician to fabricate a definitive cast with the precise position of the implants before the surgery. Therefore, a definitive or interim prosthesis can be constructed prior to the surgical procedure, therefore, obtaining an immediate function. The NobelGuide (Nobel Biocare AB, G？teborg, Sweden) technique permits the surgical installation of the implants without raising a flap, reducing significantly the operating time and the impact on the patient and patient’s morbidity (postoperative pain and swelling) [5]. Several studies [3, 6, 7] reported a cumulative survival rate similar to the conventional surgical procedures, with a few complications. In the present case report, immediate implant borne prostheses were construct via a computer-assisted implantology and prosthodontics; however, a late surgical complication occurred and in turn CAD/CAM titanium implant bridge was delivered. 2. Case Presentation and Results A 70-year-old Caucasian woman came into our practice and was in good physical health with no medical risks. She had been wearing two complete dentures (Figure 1) and desired to rehabilitate her edentulous jaws