Accuracy of Customized Prefabricated Screw-Type Immediate Provisional Restorations after Single-Implant Placement

Abstract

Limited evidence is available comparing the differences between pre-operative and post-operative 3D implant positions from the viewpoint of prosthetics. We aimed to investigate the differences between preplanned positions of virtualprovisionalrestorationsand their actual positions following fully guidedsingle-implantplacement. Ten maxillary typodonts with missing right central incisors were imaged using cone-beam computed tomography, and digital impressions were obtained using an intraoral scanner. These data were imported into implant-planning software, following which theprovisionalrestorationswere designed.Afterdata superimposition, an appropriate implant position was determined, and a computer-assisted implant surgical guide was designed for each typodont. Orders generated from the implant-planning software were imported into relevant computer-aided design software to design the custom abutments. The abutments,provisionalrestorations, and surgical guides were fabricated, and each restoration was cemented to the corresponding abutments, generating ascrew-typeimmediateprovisionalrestoration. The implants were placed using the surgical guides, and thescrew-typeprovisionalrestorationswere engaged to the implants. The typodonts were then rescanned using the intraoral scanner. Therestorationsdesigned at the treatment planning stage were compared with those in the post-operative scan using metrology software. The angular deviation around the central axis of the implant was measured, and the differences in the crown position were converted to root mean square (RMS) values. The post-operativeprovisionalrestorationsexhibited an absolute angular deviation of 6.94 ± 5.78° and an RMS value of 85.8 ± 20.2 µm when compared with their positions in the pre-operative stage. Within the limitations of the present in vitro study, the results highlight the potential application ofcustomizedprefabricatedimmediateprovisionalrestorationsaftersingle-implantplacement.