ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Surgical Implant Guides Produce Implants with Acceptable Survival Rates
Clinical Question For a totally edentulous patient, is the long-term survival rate of an implant placed using a surgical guide greater than an implant placed using the freehand technique?
Clinical Bottom Line For a totally edentulous patient, surgical guides used for implant placement produce an acceptable implant survival rate. However, more research is needed to determine if surgical guides improve implant survival rate over the freehand technique.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 19521258Danza/200993 patients received 300 implantsRetrospective Cohort
Key resultsDanza placed 300 implants (66 with guides and 234 without) in two groups of patients. Many criteria were measured, including implant survival rate, which Danza defines as, "the total number of implants still in place at the end of the follow-up period." For this study the average follow-up time was 14 months (range: 1-41 months). There was a survival rate of 97% among the implants placed. The nine implants lost were placed freehand.
#2) 19663953Schneider/200918 articlesMeta-Analysis
Key resultsSchneider performed an electronic search of articles about computer-guided implant dentistry and ultimately included eighteen articles (eight accuracy studies and ten clinical studies). The data collected and analysed were only for implants placed using surgical guides, with no comparison to freehand. For implants placed with computer-guided technology, Schneider states that, "implant survival rates of 91-100% were reported after an observation time of 12-60 months."
Evidence Search "Dental Implants"[Mesh] AND ("surgical guide" OR "computer planning" OR "computer-guided")
Comments on
The Evidence
Danza performed a well-designed study that accurately compared the survival rate of implants placed using surgical guides versus implants placed freehand. During the time of the study, implants placed using a surgical guide exhibited a higher survival rate than implants placed using the freehand technique. However, the level of evidence is weak because of the short observation period. Schneider performed a literature review of articles concerning implant placement using surgical guides. Although this study provides useful insight into the placement accuracy and survival rate of implants placed using surgical guides, it fails to compare these results with implants place using the freehand technique.
Applicability The Danza study is applicable to the clinical question. The Schneider study is only somewhat applicable to the clinical question because it did not directly compare implants placed using a surgical guide and implants placed using the freehand technique.
Specialty/Discipline (General Dentistry) (Oral Surgery) (Periodontics)
Keywords Dental implants, surgical guides, computer-guided, freehand, survival rate
ID# 2249
Date of submission: 04/20/2012spacer
E-mail hutchings@livemail.uthscsa.edu
Author Brian Hutchings
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Kenneth Kalkwarf, DDS
Faculty mentor/Co-author e-mail kalkwarf@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
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Comments on the CAT
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