Digitally Guided Root Membrane Preparation Using a Dedicated Apex Guide for Immediate Implant Placement: A Retrospective Case Series.

IF 5.8 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of dentistry Pub Date : 2026-10-16 DOI:10.1016/j.jdent.2026.107113

Sam Omar, Francesco Guido Mangano

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引用次数: 0

Abstract

Objective: To assess the clinical feasibility and 1-year outcomes of a static computer-assisted workflow using a dedicated Apex Guide for root membrane (RM) preparation and immediate implant placement.

Methods: Fifteen consecutive patients with nine anterior and six posterior single-tooth sites were included. Cone-beam computed tomography and intraoral scans were registered for planning. A tooth-supported Apex Guide guided a 2.0-mm drill along a root-oriented trajectory; implant placement used a separate prosthetically driven guide. Feasibility, complications, survival, Pink Esthetic Score (PES), probing depth (PD), bleeding on probing (BOP), recession and peri-implant marginal bone level (PIMBL) were assessed.

Results: Guided access and RM preparation were completed in all sites without intraoperative RM or facial bone damage. One RM became mobile and required removal; another developed internal exposure requiring reduction. RM retention was 93.3% (14/15), and implant and prosthetic survival were 100%. Between 6 months and 1 year, PES (12.13 ± 0.74 vs 12.20 ± 0.77; P = 0.317), PD (2.22 ± 0.15 vs 2.21 ± 0.10 mm; P = 0.655), BOP (3.34 ± 6.91% vs 2.23 ± 5.88%; P = 0.317) and PIMBL (0.280 ± 0.039 vs 0.281 ± 0.035 mm; P = 0.387) showed no significant changes. One screw loosening reduced prosthetic success to 93.3%.

Conclusions: The Apex Guide workflow was clinically feasible in this small series. RM-related complications occurred despite complete implant survival; comparative accuracy and long-term safety remain unestablished.

Clinical relevance: Static guidance may assist apical access during RM preparation while allowing independent, prosthetically driven implant placement.

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数字引导根膜准备使用专用的顶端指南立即种植体安置：回顾性病例系列。

目的：评估静态计算机辅助工作流程的临床可行性和1年的结果，使用专用的Apex指南进行根膜（RM）准备和立即种植体放置。方法：连续15例患者，9个前牙位，6个后牙位。锥束计算机断层扫描和口内扫描登记用于计划。齿支撑的Apex导轨引导2.0 mm的钻头沿根导向轨迹；种植体放置使用单独的假体驱动引导。评估可行性、并发症、生存率、粉红色美学评分（PES）、探探深度（PD）、探探出血（BOP）、退行性和种植体周围边缘骨水平（PIMBL）。结果：所有部位均完成了引导下的入路和骨移植准备，术中无骨移植及面骨损伤。一个RM变得可移动，需要移除；另一种是内部暴露，需要减少。RM保留率为93.3%(14/15)，种植体和假体成活率100%。6个月至1年期间，PES（12.13±0.74 vs 12.20±0.77;P = 0.317）、PD（2.22±0.15 vs 2.21±0.10 mm; P = 0.655）、BOP（3.34±6.91% vs 2.23±5.88%;P = 0.317）和PIMBL（0.280±0.039 vs 0.281±0.035 mm; P = 0.387）无显著变化。一颗螺钉松动使假体成功率降低至93.3%。结论：Apex指南工作流程在临床上是可行的。尽管种植体完全存活，但仍有rm相关并发症发生；相对准确性和长期安全性仍未确定。临床相关性：静态引导可以在RM准备过程中帮助根尖通道，同时允许独立的假体驱动种植体放置。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of dentistry 医学-牙科与口腔外科

CiteScore

7.30

自引率

11.40%

发文量

349

审稿时长

35 days

期刊介绍： The Journal of Dentistry has an open access mirror journal The Journal of Dentistry: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The Journal of Dentistry is the leading international dental journal within the field of Restorative Dentistry. Placing an emphasis on publishing novel and high-quality research papers, the Journal aims to influence the practice of dentistry at clinician, research, industry and policy-maker level on an international basis. Topics covered include the management of dental disease, periodontology, endodontology, operative dentistry, fixed and removable prosthodontics, dental biomaterials science, long-term clinical trials including epidemiology and oral health, technology transfer of new scientific instrumentation or procedures, as well as clinically relevant oral biology and translational research. The Journal of Dentistry will publish original scientific research papers including short communications. It is also interested in publishing review articles and leaders in themed areas which will be linked to new scientific research. Conference proceedings are also welcome and expressions of interest should be communicated to the Editor.