Computer-guided flapless placement and immediate loading of four conical screw-type implants in the edentulous mandible

Aim: The aim of this prospective study was to evaluate the outcome of computer-guided flapless placement and immediate loading of four conical screw-type implants in the interforaminal region. Patients and Methods: From May to August 2003, 25 consecutive patients (m : f=16 : 9) with edentulous mandibles were included in the study. After transmucosal drilling with computer-assisted navigation, four implants were placed in the interforaminal region. The lower dentures were converted and implants immediately loaded. Results: One-hundred implants were successfully placed. In two patients, all implants had to be submerged because of insufficient primary stability of one of the implants; another patient declined to receive immediate loading of implants after surgery and was lost to follow-up. During follow-up of the remaining 22 patients with 88 immediately loaded implants, loosening of four implants (4.5%) was seen in three patients. In these cases, immediate loading was terminated and all implants submerged; subsequently, two implants were lost in one patient, while the other two implants re-osseointegrated. The cumulative survival and success rates of immediately loaded implants were 97.7% after 2 years. Prosthetic success was 100%. Conclusion: Transmucosal computer-assisted placement and immediate loading of mandibular implants is a high-end approach to edentulism that provides excellent results while being minimally invasive.