Retrospective Evaluation of the 'crown-guide': An Innovative Approach for Guided Immediate Implant Placement and Restoration.

Abstract

Aim: The aim of this study was to retrospectively evaluate whether the use of the Crown-Guide - a prefabricated provisional restoration which is incorporated into a surgical pilot guide - results in a predictable esthetic outcome in patients undergoing immediate implant placement.

Materials and methods: Patients (n=18) in need of a single implant restoration in the anterior region underwent immediate implant placement and loading using the Crown-Guide. Soft tissue grafting was performed in most cases, while bone xenografts were placed in all cases. Photographs, X-rays, and STL-files were collected at specific time points, making it possible to compare clinical, esthetic and radiographic outcomes at these points.

Results: The mean value for the Pink Esthetic Score (PES) measure was 10.73 immediately after implant placement (T1) and 11.46 at least one year after implant placement (T3), while the White Esthetic Score (WES) mean value increased from 5.27 to 8.81 across the same interval. Importantly, for both PES and WES the increases were found to be statistically significant (p<0.01 and p<0.001, respectively). In the cases with scarring (n=5), the MSI (Mucosal Scarring Index) score ranged from 3.5 to 5.25. At time T3, an average bone loss of 0.12mm and an average soft tissue loss of 0.041mm were observed, but both were found to be statistically indistinguishable from zero. The survival rate was 94.4%.

Conclusion: Immediate implant placement using the Crown-Guide offers predictable esthetic and clinical treatment outcomes, making it a practical and viable method. However, larger sample sizes are needed to confirm these findings.