Clinical Outcomes and Cost Effectiveness of Computer-guided Versus Conventional Implant-retained Hybrid Prostheses: A Long-term Retrospective Analysis of Treatment Protocols

Background: Computer-guided systems were developed to facilitate implant placement at optimal positions in relation to the future prosthesis. However, the time, cost and, technique sensitivity involved with computer-guided surgery impedes its routine practice. The aim of this study is to evaluate survival rates and complications associated with computer-guided versus conventional implant placement in implant-retained hybrid prostheses. Furthermore, long-term economic efficiency of this approach was assessed.

Methods: Patients were stratified according to implant placement protocol into a test group, using computer-guided placement, and a control group, using traditional placement. Calibrated radiographs were used to measure bone loss around implants. Furthermore, the costs of the initial treatment and prosthetic complications, if any, were standardized and analyzed.

Results: Forty-five patients (149 implants in the test group and 111 implants in the control group) with a minimum follow-up of 5 years, and a mean follow-up of 9.6 years, were included in the study. While no significant difference was found between both groups in terms of biologic and technical complications, lower incidence of implant loss was observed in the test group (P < 0.001). A statistically significant difference in favor of the non-guided implant placement group was found for the initial cost (P < 0.05) but not for the prosthetic complications and total cost (P > 0.05).

Conclusions: Computer-guided implant placement for an implant-supported hybrid prosthesis is a valid, reliable alternative to the traditional approach for implant placement and immediate loading. Computer-guided implant placement showed higher implant survival rates and comparable long-term cost to non-guided implant placement.