title: Navigated flapless transmucosal implant placement in the mandible: a pilot study in 20 patients.
abstract: OBJECTIVE
  The aim of this study was to assess whether navigated flapless transmucosal implant bed preparation allows placement of dental implants in edentulous mandibles.
  
  
  METHODS
  Each patient was scheduled to receive 4 screw-shaped Ankylos (Dentsply Friadent) implants in the interforaminal region. The VISIT navigation system was used for guided drilling. The mucosa was penetrated without flap elevation. The study protocol did not allow direct visualization of the bone surface during surgery. Data analysis included computed measurements on pre- and postoperative computerized tomographic (CT) images.
  
  
  RESULTS
  Twenty patients with fully edentulous mandibles (14 male, 6 female) were included in the study. Computer-based planning for 80 implants was performed intraoperatively. Two implants (2.5%) were not primarily stable because of buccal bone fenestration, which occurred because of uncontrollable shifting of the dental implant drill. These implants were immediately removed. Postoperative CT image evaluation revealed a mean deviation of 0.7 mm in all directions.
  
  
  CONCLUSIONS
  Navigated flapless transmucosal interforaminal implant placement was found to be a precise, predictable, safe procedure in patients with smooth wide regular mandibular ridges. The technique was less accurate and more complicated in areas where irregular bone existed.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Medical University of Vienna. gert.wittwer@hirslanden.ch
authors.forename: Gert
authors.initials: G
authors.lastname: Wittwer
authors.forename: Wasiu Lanre
authors.initials: WL
authors.lastname: Adeyemo
authors.forename: Kurt
authors.initials: K
authors.lastname: Schicho
authors.forename: Michael
authors.initials: M
authors.lastname: Figl
authors.forename: Georg
authors.initials: G
authors.lastname: Enislidis
mesh_terms: D000368:Aged; D003758:Dental Implantation, Endosseous / Q000379:methods*; D015921:Dental Implants; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D007430:Intraoperative Care; D007575:Jaw, Edentulous / Q000601:surgery; D008297:Male; D008334:Mandible / Q000601:surgery*; D008875:Middle Aged; D010347:Patient Care Planning; D010865:Pilot Projects; D011300:Preoperative Care; D012449:Safety; D025321:Surgery, Computer-Assisted; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
chemical_list: D015921:Dental Implants