title: Immediately Loaded Implants in Rehabilitation of the Maxilla: A Two-Year Randomized Clinical Trial of Guided Surgery versus Standard Procedure.
abstract: BACKGROUND
  Implant-simulation software can now be used to improve treatment planning, guide surgery, and ensure more accurate implant placement.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the outcome of a guided surgery protocol versus a conventional protocol.
  
  
  METHODS
  Twenty-six patients were randomly assigned to Guided Surgery or Conventional Surgery. In test group implants were placed in the maxilla using a tooth supported model-based surgical guide with a minimally invasive flap and immediately loaded. In control group implants were inserted with an open flap surgery following a prosthetic stent and immediately loaded.
  
  
  RESULTS
  A total of 70 implants were placed (36 test and 34 control). Statistically significant differences were found between the test group and the control group for patient opinion about self-confidence, assumption of analgesic tablets and perceived pain. The test group registered a statistically significant reduction (p < .05) as regards time of surgery and time of provisional insertion with respect to the control group.
  
  
  CONCLUSIONS
  Implants can successfully integrate in the posterior maxilla using a guided surgery approach with immediate loading. The use of guided surgery helped to reduce the surgery duration, pain intensity, related analgesic consumption, and a more predictable provisional installation.
authors: Researcher, Department of Surgical Sciences and Integrated Diagnostic, University of Genova, Genova, Italy.
authors: Leonardo
authors: L
authors: Amorfini
authors: Adjunct Assistant Professor, Department of Orthodontics, University of Genova, Genova, Italy.
authors: Marco
authors: M
authors: Migliorati
authors: Researcher, Department of Orthodontics, University of Genova, Genova, Italy.
authors: Sara
authors: http://orcid.org/0000-0002-9897-8079
authors: S
authors: Drago
authors: Assistant Professor, Department of Orthodontics, University of Genova, Genova, Italy.
authors: Armando
authors: A
authors: Silvestrini-Biavati
mesh_terms: D016301:Alveolar Bone Loss; D002985:Clinical Protocols; D019094:Dental Prosthesis, Implant-Supported; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D057893:Immediate Dental Implant Loading; D007576:Jaw, Edentulous, Partially / Q000534:rehabilitation; D008297:Male; D008437:Maxilla / Q000601:surgery; D017060:Patient Satisfaction; D012984:Software; D025321:Surgery, Computer-Assisted
keywords: clinical research; clinical trials; guided surgery; immediate loading; patient centered outcomes; prosthodontics; surgical techniques