Esthetic Outcome of Computer-Guided Versus Free-Hand Immediate Implant Placement In Fresh Extraction Sockets in Esthetic Zone, A Randomized Clinical Trial

Abstract

Aim: to compare the esthetic outcome of two surgical techniques used in single immediate implant placement
(computer guided vs free hand) in the esthetic zone in terms of pink esthetic score (PES) and gingival
recession (GR).
Methods: This was a randomized clinical trial, where twenty patients with a failing tooth in the esthetic zone
were recruited for immediate implant placement and restored with non-functional provisional crowns. They
were randomly allocated to either computer guided (test group) or free hand (control group). Six months
after surgery the patients were restored with their definitive crowns. Pink esthetic score was recorded twice
(after surgery and after definitive crown), while gingival recession was recorded after the definitive crown.
Results: No statistically significant difference was found between the mean differences of pink esthetic score
between both groups and within each group overtime. Regarding gingival recession, 2 implants showed
gingival recession in the computer guided group while none in the free hand group.
Conclusions: Within the limitations of this study (sample size and follow-up duration), immediate implant
placement using computer guided surgical guides would consume more time, effort and expenses yet it
provided similar results with the free hand which seems beneficial for the learning curve for unexperienced
clinicians.