Single mandibular, first molar implants with flapless guided surgery and immediate function: Preliminary clinical and radiographic results of a prospective study

Statement of problem. Implant therapy is widely accepted and increasingly used by clinicians as part of fixed prosthodontics, and there is a need to develop standardized protocols for its use. The first mandibular molars are the most frequently lost teeth and, even if not indispensable, have an important role for the comfort of patients. Purpose. The purpose of this study was to develop and document a standardized method for mandibular single molar replacement performed with flapless surgery and premanufactured individualized abutments and crowns for immediate function. Material and methods. Forty-six patients received 51 Implants in the first mandibular molar region. All implants were placed with guided flapless surgery and were immediately loaded with premanufactured definitive abutments and acrylic resin provisional restorations. Definitive restorations were inserted after 3 months. Clinical and radiographic analyses were used to evaluate the treatment outcomes. Data were reported using descriptive statistics. Results. All implants inserted were stable and successful in function after 1 year, providing a 100% survival rate. Three implants reached clinical stability after an initial adverse event requiring delayed loading, thus, the survival rate for immediate function was 94%. Conclusions. The 100% survival rate suggests that safe replacement of single mandibular first molars with an immediate prosthesis is possible with flapless surgery and premanufactured individualized abutments and crowns.