Complications of computer-aided-design/computer-aided-machining-guided (NobelGuide (TM)) surgical implant placement: An evaluation of early clinical results

Purpose: The aim of this study was to evaluate early clinical results of computer-aided design (CAD)/computer-aided machining (CAM)-guided surgical implant placement (NobelGuide (TM), Nobel Biocare, Yorba Linda, CA, USA) with focus on surgical and/or prosthetic complications, management, and prevention. Materials and Methods: Thirteen patients rehabilitated between March 2003 and October 2006 with CAD/CAM-guided dental implants and immediate loading (NobelGuide, Nobel Biocare) were evaluated. The treatment planning and procedures were carried out in accordance to the system protocol. The complications encountered in this case series were classified and assessed according to early (planning and procedural - surgical; prosthetic) and late complications (surgical; prosthetic). Results: The prosthetic complications outnumbered surgical complications both in the early and late treatment phases. The main early surgical complication was bony interference that prevented complete seating of the prostheses. Most of the late surgical complications were implant failures with an overall failure rate of 9%. Fracture of the carbon fiber framework prosthesis was the main late prosthetic complication. Conclusions: The NobelGuide system is a reliable treatment modality, but not without its complications. Strict adherence to the system protocol is the key prevention of complications.