Journal of dentistry · 2026
Digitally Guided Root Membrane Preparation Using a Dedicated Apex Guide for Immediate Implant Placement: A Retrospective Case Series.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Omar Sam, Mangano Francesco Guido
Аннотация
OBJECTIVE: To assess the clinical feasibility and 1-year outcomes of a static computer-assisted workflow using a dedicated Apex Guide for root membrane (RM) preparation and immediate implant placement.
METHODS: Fifteen consecutive patients with nine anterior and six posterior single-tooth sites were included. Cone-beam computed tomography and intraoral scans were registered for planning. A tooth-supported Apex Guide guided a 2.0-mm drill along a root-oriented trajectory; implant placement used a separate prosthetically driven guide. Feasibility, complications, survival, Pink Esthetic Score (PES), probing depth (PD), bleeding on probing (BOP), recession and peri-implant marginal bone level (PIMBL) were assessed.
RESULTS: Guided access and RM preparation were completed in all sites without intraoperative RM or facial bone damage. One RM became mobile and required removal; another developed internal exposure requiring reduction. RM retention was 93.3% (14/15), and implant and prosthetic survival were 100%. Between 6 months and 1 year, PES (12.13 ± 0.74 vs 12.20 ± 0.77; P = 0.317), PD (2.22 ± 0.15 vs 2.21 ± 0.10 mm; P = 0.655), BOP (3.34 ± 6.91% vs 2.23 ± 5.88%; P = 0.317) and PIMBL (0.280 ± 0.039 vs 0.281 ± 0.035 mm; P = 0.387) showed no significant changes. One screw loosening reduced prosthetic success to 93.3%.
CONCLUSIONS: The Apex Guide workflow was clinically feasible in this small series. RM-related complications occurred despite complete implant survival; comparative accuracy and long-term safety remain unestablished.
CLINICAL RELEVANCE: Static guidance may assist apical access during RM preparation while allowing independent, prosthetically driven implant placement.
METHODS: Fifteen consecutive patients with nine anterior and six posterior single-tooth sites were included. Cone-beam computed tomography and intraoral scans were registered for planning. A tooth-supported Apex Guide guided a 2.0-mm drill along a root-oriented trajectory; implant placement used a separate prosthetically driven guide. Feasibility, complications, survival, Pink Esthetic Score (PES), probing depth (PD), bleeding on probing (BOP), recession and peri-implant marginal bone level (PIMBL) were assessed.
RESULTS: Guided access and RM preparation were completed in all sites without intraoperative RM or facial bone damage. One RM became mobile and required removal; another developed internal exposure requiring reduction. RM retention was 93.3% (14/15), and implant and prosthetic survival were 100%. Between 6 months and 1 year, PES (12.13 ± 0.74 vs 12.20 ± 0.77; P = 0.317), PD (2.22 ± 0.15 vs 2.21 ± 0.10 mm; P = 0.655), BOP (3.34 ± 6.91% vs 2.23 ± 5.88%; P = 0.317) and PIMBL (0.280 ± 0.039 vs 0.281 ± 0.035 mm; P = 0.387) showed no significant changes. One screw loosening reduced prosthetic success to 93.3%.
CONCLUSIONS: The Apex Guide workflow was clinically feasible in this small series. RM-related complications occurred despite complete implant survival; comparative accuracy and long-term safety remain unestablished.
CLINICAL RELEVANCE: Static guidance may assist apical access during RM preparation while allowing independent, prosthetically driven implant placement.