Evaluación del ajuste marginal de la implantoprótesis de carga inmediata, confeccionada mediante técnicas Cad/Cam a partir de la planificación para cirugía guiada

Abstract

Las técnicas en Implantología han avanzado a pasos agigantados en los últimos años debido entre otros factores a la precisión de la cirugía guiada, al desarrollo de protocolos con éxito de carga inmediata y a la tecnología CAD/CAM. Por todo esto, este estudio propone la viabilidad de poder confeccionar prótesis implantosoportadas antes de la cirugía y que al cargarlas inmediatamente, éstas ajusten de forma pasiva. La hipótesis nula formulada fue, no existen diferencias estadísticamente significativas en la cantidad de discrepancia marginal vertical de los implantes y esoestructuras, empleando guías quirúrgicas independientes de idéntica planificación, al cargarlos de forma inmediata.

Nowadays, long term success regarding the implants is not only related to the concepts of osseointegration and survival rates, which always are crucial, but also to these concepts that our patients are demanding, which include; an esthetic and a functional result, a shorter protocol for teeth replacement, a more comfortable procedure (less pain and the avoidance of wearing removable dentures while osseointegration), so the dental team (oral surgeon, prosthodontic dentist and dental technicians) must be very well trained and coordinated in order to get a final result which includes all those ítems explained above. The recent evolution of oral Implantology is supported by several factors that enhace its final success. In our study, we focus on three of them. These are guided surgery, CAD/CAM technology and inmediate loading. From the surgical point of view, guided surgery has become one of the most important innovations. Basically, it consists of a virtual treatment plan which is designed based on a patient computerized tomography while wearing a radiographic template. After that, a surgical guide is manufactured by stereolitography and placed on the patient mouth in order to guide the drilling phase and also the implant insertion. There are many articles in the literature that analize the precision of this modality, and all of them obtained very accurate results with high precision positioning. Apart from the good results, it is also a painless technique for the patient (only flapless cases), the chairtime is reduced for both surgeon and patient, and is an easy and a very predictable technique. Regarding its disadvantages we find to that are most important, first, the lack of space in the posterior regions, which makes the access sometimes difficult or impossible in those sites, and secondly, the high cost of the guide manufacturing and the software license...