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1_2017 16 expert article _ chirurgia guidata Immediate loading of variable-thread expanding tapered-body implants placed into maxillary post-extraction or healed sites using a guided surgery approach: An up-to-five-year retrospective analysis Authors_Giovanni Polizzi,* Tommaso Cantoni,* Emanuele Pasinia & Marco Tallarico**, Italy * Private Clinic BSC, Verona, Italy ** Dentistry Unit, University Hospital of Sassari, Sassari, Italy _Introduction Transitioning from a failing dentition to com- plete-arch implant rehabilitation may involve temporarily rendering the patient edentulous.1 In such cases, interim complete removable den- tal prostheses have been used after extraction of the hopeless teeth and during the osseointe- gration period. However, many patients object to a complete removable dental prosthesis for psychological, functional or esthetic reasons, and request fixed provisionalization throughout all phases of the rehabilitation process.2,3 In or- der to avoid the use of a removable prosthesis, immediate implant placement and immediate loading with a fixed interim prosthesis have been proposed for the rehabilitation of hopeless dentition.4 Indeed, immediately loaded implants placed into post-extraction sockets have recent- ly been demonstrated to provide a reliable option for replacing failing residual teeth.5 Although im- mediate loading may place implants at a higher risk of complications,6 comparable survival rates have been reported for the two loading proto- cols.7 Furthermore, immediate loading combined with implant placement in post-extraction sites may result in improved esthetic outcomes owing to preservation of osseous and gingival architec- ture, offer reduced treatment time, and provide the patient with the convenience of an immedi- ate tooth replacement.8 The risk of implant fail- ure can be minimized by proper patient selection, well trained operators, high primary implant sta- bility and lack of micromovements.9 Computer-aided design (CAD) technology allows for the transfer of patient data to a 3-D implant planning program for virtual implant placement.10 The virtual planning is then used to generate a custom-made surgical template (computer- aided manufacturing—CAM) with metallic sleeves to precisely guide each dental implant into the position planned virtually. In addition, implant-supported fixed acrylic resin prostheses can be fabricated in advance and immediately delivered to the patient. These as- pects of minimally invasive and simplified sur- gery, along with reducing the treatment time and postoperative discomfort, are beneficial to the patient.11 Favorable clinical results of com- puter-assisted template- guided surgery have been shown in several studies;12-15 however, devi- ations in 3-D position between virtual planning and actual final position of the implant in the patient’s jaw and technique related perioperative complications have to be taken into account.16-20 In 2009, Cantoni and Polizzi described a step- by step technique involving a specially designed two-piece radiographic stent that allows the patient to retain hopeless teeth until the day of the surgery, making easier the transition from failing dentition to implant-supported prosthe- ses.21 The present study aimed to retrospectively assess the survival rate of variable-thread ex- panding tapered-body implants (NobelActive, Nobel Biocare, Zurich, Switzerland) placed into maxillary post-extraction or healed sites using template-guided surgery in combination with Journal of Oral Science & Rehabilitation | Volume 2 | Issue 3/2016