Nikolaus Fürhauser*1; Rudolf Fürhauser1; Lukas Fürhauser1; Dieter Busenlechner2; Bernhard Pommer3; Georg Jr. Mailath2

1Prosthetic Department; 2Surgical Department; 3Research Department, Academy for Oral Implantology, Vienna, Austria

Background: Flapless implant placement using surgical templates may guarantee predictable and esthetic results provided that preplanned implant positions are transferred precisely into surgical reality.

Aim/Hypothesis: The study aims to investigate the long-term effect of three-dimensional accuracy in guided implant surgery on the esthetic outcome of single-tooth implants in the anterior maxilla.

Material and Methods: Single-tooth implants for delayed replacement of upper incisors were inserted in 27 patients using stereolithographic templates. Superimposition of postoperative cone beam computed tomography (CBCT) scans allowed assessment of positional inaccuracy at the implant shoulder and apex, as well as angular deviation. Objective evaluation of implant esthetics was performed after a follow-up of 10 years using the Pink Esthetic Score (PES).

Results: Mean deviation between planned and actual implant position was 0.84 mm at the implant shoulder and significantly correlated to average PES of 12 (P = 0.031). Inaccuracy toward the buccal side was most frequent (70%). Deviations ≥ 0.8 mm resulted in significantly worse implant esthetics (median PES: 9.5, interquartile range: 8–11) compared to more accurate implant positions (median PES: 13, interquartile range: 12–13, P = 0.039).

Conclusion and Clinical implications: Positional inaccuracy is low in guided implant surgery, but may however significantly compromise outcomes in the anterior maxilla. Implant esthetics proved to be stable after 10 years of follow-up.

Disclosure of Interest: None Declared.

Keywords: aesthetic zone, long term, zirconia