Nobelparallel conical connection

Surgery was performed under local anesthesia using appropriate aseptic and sterile protocols. During the entire procedure, the x-clip was fixed in the exact same location as during CBCT acquisition. Registration, calibration (Figure 3), and system checks were conducted before starting the surgery, as described in the X-Guide^® manual. The X-Guide^® uses the x-clip as a reference to determine the location of the implant drill as projected during preoperative planning. Osteotomies were prepared at a maximum of 1500 rpm and guided in real time by indicating the desired drilling pathway on the computer screen. An extra calibration process was completed preceding the use of each new drill. Prior to the preparation of the implant placement, no punching of the gingival tissues was performed. NobelParallel^® Conical Connection (Nobel Biocare™, Zürich, Switzerland) implants or Nobel Active^® (Nobel Biocare™, Zürich, Switzerland) implants were installed. All implants were placed by the same operator (J.L.), who was not involved in data collection and analysis.

Six months (mean 6.3 months, range: 4.8–7.8 months) after the initial bone augmentation procedure, all patients were recalled for implant installation. Prophylactic oral antibiotics (1000 mg amoxicillin, 1 h preoperatively) were given to all patients. A standard incision on the top of the alveolar process with one to two releasing incisions was completed before removal of the previously placed osteosynthesis screws. Using a trephine burr (Komet Dental, Lemgo, Germany, external diameter 3.2, internal diameter 2.6), we retrieved a cylindrical biopsy for later histological evaluation perpendicular to the lateral aspect of the augmented bone, approximately 10 mm from the top of the alveolar crest, including augmented bone and part of the native bone [27 ]. Finally, a submerged implant (NobelParallel Conical Connection, Nobel Biocare®, Zürich, Switzerland) was installed according to the manufacturer’s guidelines and using an implant surgical guide for optimal positioning. The implant top was positioned approximately 2.5 mm apically from the buccal gingival margin with an insertion torque of 35 Ncm. All patients were seen for consultation and suture removal 1 week postoperatively.