title: Immediately loaded CAD-CAM manufactured fixed complete dentures using flapless implant placement procedures: a cohort study of consecutive patients.
abstract: BACKGROUND
  Data available regarding the treatment outcome for completely edentulous jaws by means of a prefabricated fixed complete denture placed immediately after flapless implant insertion using a surgical guide are only short term.
  
  
  OBJECTIVE
  The purpose of this study was to follow the survival of implants inserted in completely edentulous jaws using a flapless procedure and immediately loaded with prefabricated fixed complete dentures for several years. A second purpose was to investigate whether there is a difference in marginal bone remodeling in smoking (S) and nonsmoking (NS) patients.
  
  
  METHODS
  During a 5-year period (mean time of follow-up 2.2 years), 30 consecutive patients, 12 women, 38-74 years of age (average 56 years) were treated for complete edentulism in 1 arch in the Department of Periodontology at the University Hospitals in Leuven. The S group included 13 and the NS group 17 patients. Descriptive statistics were used to analyze the data. Two outcome parameters were analyzed: the cumulative survival rate (CSR) of individual implants and the marginal bone remodeling for up to 5 years in the 2 groups.
  
  
  RESULTS
  Nine (4.9%) implants failed. Eight of the failures occurred in 3 smoking patients. The absolute survival rate for all patients was 95%, while the cumulative survival rate (CSR) after 5 years was 91.5%. For the NS group, the CSR was 98.9%, while for the S it was 81.2%. The mean marginal bone resorption was - 2.6 and - 1.2 mm in the S and NS groups, respectively.
  
  
  CONCLUSIONS
  The present findings indicate that the treatment protocol described results in good implant survival rate even after several years. Smoking may eventually compromise the efficacy of this treatment concept.
authors.affiliation: Oral Surgeon, Department of Periodontology, Catholic University Leuven, Leuven, Belgium.
authors.forename: Anna M
authors.initials: AM
authors.lastname: Sanna
authors.forename: Liene
authors.initials: L
authors.lastname: Molly
authors.forename: Daniel
authors.initials: D
authors.lastname: van Steenberghe
mesh_terms: D000328:Adult; D000368:Aged; D000539:Alveolar Process / Q000000981:diagnostic imaging / Q000601:surgery*; D001862:Bone Resorption / Q000000981:diagnostic imaging; D015331:Cohort Studies; D017076:Computer-Aided Design; D003758:Dental Implantation, Endosseous / Q000295:instrumentation / Q000379:methods; D019094:Dental Prosthesis, Implant-Supported / Q000379:methods*; D019232:Dental Restoration Failure; D003824:Denture, Complete; D005260:Female; D006801:Humans; D007575:Jaw, Edentulous / Q000000981:diagnostic imaging / Q000534:rehabilitation*; D008137:Longitudinal Studies; D008875:Middle Aged; D012907:Smoking / Q000009:adverse effects; D025321:Surgery, Computer-Assisted / Q000379:methods*; D013997:Time Factors; D036542:Tomography, Spiral Computed / Q000379:methods; D016896:Treatment Outcome; D016474:Weight-Bearing