Full arch immediate load rehabilitation with a reduced number of implants: comparative evaluation of tissue healing after flap less and open flap surgery. Follow-up at 12 months

Aim This study aims to evaluate and compare the success of implant-prosthetic rehabilitations using a digital protocol versus the traditional “All on Four” technique.

Materials and Methods Fifty patients at the Department of Dentistry of IRCCS San Raffaele Hospital were randomly divided into two groups: 25 underwent digital protocol rehabilitation and 25 underwent traditional rehabilitation. Key parameters such as Visual Plaque Index, Plaque Index, Probing Depth, and Bleeding On Probing were measured at multiple time intervals (T1, T2, T3, T4). Patient-reported outcomes on post-operative pain, swelling, bleeding, and overall satisfaction were assessed using questionnaires.

Results Guided surgery offered superior outcomes in terms of precision and patient comfort. Patients in the digital protocol group reported significantly lower post-operative pain, swelling, and bleeding, particularly in the initial months post-surgery. IPV and PI were initially lower in the digital group, indicating better oral hygiene maintenance, but these differences diminished over time. Both groups exhibited similar long-term outcomes regarding peri-implant bone loss and PPD.

Conclusion The findings highlight the advantages of digital planning and computer-assisted implant surgery, including enhanced surgical accuracy and improved patient experience. However, successful outcomes for both methods depend on careful patient selection, precise execution, and diligent post-operative care. Future research should aim to refine digital workflows further, assess their cost-effectiveness, and validate these findings in larger, long-term studies.