Implant treatment software planning and guided flapless surgery with immediate provisional prosthesis delivery in the fully edentulous maxilla. A retrospective analysis of 15 consecutively treated patients.

Aims: To evaluate the clinical outcome of fully edentulous patients in the maxilla, who were treated with immediately loaded implant-supported cross-arch bridges using computer-aided implant surgery. Materials and methods: The clinical outcome of 15 consecutive patients (5 males and 10 females) with a mean age of 52 years (range 40 to 70), with edentulous arches and treated with implantsupported cross-arch bridges was evaluated. Two computed tomography scans were performed, the first with the patient wearing the denture/radiographic guide and the radiographic index, and the second of the denture alone. The guided flapless surgical procedure was performed under local anaesthesia. Ninety implants were placed. The implant length ranged from 10 to 13 mm and the implant diameter was either 4.3 or 5 mm. All implants were immediately loaded with screw-retained provisional acrylic prostheses prepared in advance and delivered immediately after surgery. Clinical and radiographic follow-up visits were scheduled at 6, 12 and 18 months from surgery; implant survival rate, marginal bone levels, patient satisfaction and any complications were recorded. Results: After the follow-up period of 18 months, two patients each lost one implant. After 18 months, patients lost, on average, 1.6 mm of peri-implant marginal bone. A patient satisfaction questionnaire at 18 months revealed a very high level of satisfaction with the treatment. Conclusion: Although limited by the number of patients, it can be concluded that software- and computed tomography-guided surgical planning for completely edentulous arches provides reliable results with high success rates. Keywords: computed tomography-guided implant surgery, immediate loading, software planning