title: A selective laser sintering prototype guide used to fabricate immediate interim fixed complete arch prostheses in flapless dental implant surgery: Technique description and clinical results.
abstract: BACKGROUND
  Extensive occlusal adjustments and misfit of the prosthesis to prosthetic components are frequent problems related to fixed interim prosthesis fabrication with immediate dental implant loading.
  
  
  OBJECTIVE
  The purpose of this clinical trial was to evaluate a prosthetic guide made with a rapid prototype model based on virtual surgical planning. This prosthetic guide was used to fabricate fixed interim prostheses that would allow immediate implant loading after computer-guided implant installation.
  
  
  METHODS
  Nine interim prostheses were made for 9 participants with complete maxillary or mandibular edentulism. The virtual prosthetic guide was planned using computer-assisted design (CAD) software and was fabricated with rapid prototyping equipment (selective laser sintering). The prosthetic guide had 3 portions: the occlusal portion, which had occlusal registration; the connection portion, which had the information of the position and angulation of the abutment/implant projection; and the mucosa portion, which had the registration of the alveolar mucosa architecture. The prosthetic guide was used by a dental technician to fabricate prostheses. A single trained examiner evaluated the passive fit of the interim prostheses, the average time required for installing the interim prosthesis and for occlusal adjustments, the satisfaction of the patient with the prosthesis; and the screws, torque, occlusion, and prosthesis status.
  
  
  RESULTS
  Passive fit was achieved between the prosthetic components and prostheses in 7 participants. The average time required for installing the fixed interim prostheses was 64.44 minutes. All participants reported being more pleased with the fixed interim prosthesis than with the prosthesis worn before implant placement. Prosthesis fractures were observed in 3 participants (2 in the maxilla and 1 in the mandible); all fractures occurred 3 months or more after delivery. No further complication was observed during 6 months of follow-up.
  
  
  CONCLUSIONS
  The prosthetic guide enabled fabrication of interim immediate prostheses that were easily seated and adjusted to accommodate any shifts in implant position occurring during computer-guided surgery. Immediate implant loading could be achieved in a reasonable operative time.
authors.affiliation: Postdoctoral researcher, Department of Diagnostic Imaging, School of Medicine, Federal University of São Paulo, São Paulo, Brazil; and Researcher, Three-Dimensional Technology Division, Renato Archer Information Technology Center, São Paulo, Brazil.
authors.forename: Giovanni de A P
authors.initials: GA
authors.lastname: Di Giacomo
authors.affiliation: Adjunct Professor, Department of Periodontics, School of Dentistry of the Federal University of Bahia, Bahia, Brazil. Electronic address: patcury@yahoo.com.
authors.forename: Patricia R
authors.initials: PR
authors.lastname: Cury
authors.affiliation: Technician, Three-Dimensional Technology Division, Renato Archer Information Technology Center, São Paulo, Brazil.
authors.forename: Airton M
authors.initials: AM
authors.lastname: da Silva
authors.affiliation: Coordinator, Three-Dimensional Technology Division, Renato Archer Information Technology Center, São Paulo, Brazil.
authors.forename: Jorge V L
authors.initials: JV
authors.lastname: da Silva
authors.affiliation: Professor, Department of Diagnostic Imaging, School of Medicine, Federal University of São Paulo, São Paulo, Brazil.
authors.forename: Sergio A
authors.initials: SA
authors.lastname: Ajzen
mesh_terms: D000328:Adult; D000368:Aged; D017267:Dental Prosthesis Design; D005260:Female; D006801:Humans; D057893:Immediate Dental Implant Loading / Q000295:instrumentation* / Q000379:methods; D008297:Male; D008334:Mandible / Q000601:surgery; D008437:Maxilla / Q000601:surgery; D008875:Middle Aged