Aim: To determine the restoration-type outcome of implants placed freehanded in single edentulous gaps.
Materials and methods: Forty-nine implant analogs present in working models of 46 patients representing implants placed freehand with no surgical guides in single edentulous gaps were included in this study. Each model was scanned using an optical scanner and a cone beam-CT. Simplant Pro18 software was used to create a virtual tooth replacing the missing tooth in the scanned model. Two virtual implants were created; one superimposed on the implant analog of the model and a second in relation to the virtual crown with its long axis passing through the cingulum or perpendicular to the occlusal table of the virtual crown. Measurement of angular deviation in the position of the placed implant from that of the planned implant was calculated.
Results: The average deviation in the position of placed implants was 9.78 ± 6.47 degrees angular deviation. There was no statistically significant difference in the extent of angular deviation between maxillary and mandibular implants. Whereas, there was a statistically significant difference between anterior and posterior implants. Clinically, 70.57% of the placed anterior implants, 29.41% of premolar implants, and 20% of molar implants need to be restored with cement-retained crowns.
Conclusion: For single edentulous gaps, the potential for a cement-retained implant crown is significantly higher with freehand implant placement in the anterior than in the posterior regions.
Clinical significance: With freehand implant placement in anterior single edentulous gaps, the potential for a cement-retained implant crown outcome is significantly higher than in posterior gaps. Maximum precision in implant treatment planning and placement is required in this region of the mouth to achieve optimum results.
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