Clinical Observation of Flapless Implantation in the Posterior Tooth Area under the Guidance of the Fully Guided Template

Abstract

Objective. Compared with the conventional flap implantation, the postoperative effect of flapless implantation of a single posterior tooth under the guidance of the fully guided template was observed. Materials and Methods. 67 cases were divided into the template group (n = 35) and the flap group (n = 32) according to the wishes and actual situation of the patients. In the template group, the fully guided template was made by rapid prototyping technology, and the flapless implantation was performed under the guidance of the template in the posterior tooth area. The flap group underwent routine flap implantation. After the operation, the template group took CBCT (cone beam computed tomography) again and fitted it with that before the operation. Neck deviation, apical deviation, depth deviation, and axial angle deviation in buccolingual and mesiodistal directions were measured to observe the accuracy of the fully guided template. At the same time, the postoperative reactions of the two surgical methods were compared by recording the operation time, pain degree 24 hours after the operation, swelling degree 72 hours after the operation, and postoperative satisfaction of patients. Results. Whether in buccolingual or mesiodistal directions, the maximum values of neck deviation, apical deviation, and depth deviation were less than 2 mm. The axial angle deviation was 0.07°∼5.93° in the buccolingual direction and 0°∼4.12° in the mesiodistal direction. The guiding effect of the template was relatively reliable, and the implantation site and depth were well controlled. Although there were small deviations, the accuracy of the template could meet the clinical needs. The operation time and the VAS (visual analogue scale) score 24 hours after the operation in the template group were lower than those in the flap group ( $P<0.05$ ), and the swelling degree rating 72 hours after the operation and postoperative satisfaction of the patients were better than those in the flap group ( $P<0.05$ ). Conclusion. Compared with the conventional flap implantation, the flapless implantation in the posterior tooth area under the guidance of the fully guided template could improve the accuracy of the operation, shorten the operation time, and reduce the degree of postoperative pain and swelling, which had a certain positive clinical significance.