Background: Stereolithographic surgical guides provide significant benefits during the simultaneous placement of multiple implants with regard to the final prosthetic plan. However, deviation from the planning poses a significant risk. Deviations of implants that were placed by bone‐, tooth‐, and mucosa‐supported stereolithographic surgical guides were examined in this study.Methods: After enrolling 54 eligible patients, 294 implants were planned on cone‐beam computerized tomography CB(CT)‐derived images. Sixty guides, both single‐ and multiple‐type, were produced using two commercial systems. Mucosa‐supported guides were fixed with osteosynthesis screws. Implants were inserted, and at the end of osseointegration period, a new CB(CT) scan was performed. Preoperative planning was merged with the new CB(CT) data to identify the deviations between the planned and placed implants for each support type and manufacturer. The Kruskal‐Wallis and Mann‐Whitney U tests were used for comparison (P <0.05).Results: There were no damage‐related complications in any critical anatomy. Implants that were placed by bone‐supported guides had the highest mean deviations (5.0° ± 1.66° angular, and 1.70 ± 0.52 mm and 1.99 ± 0.64 mm for implant shoulder and tip, respectively), whereas the lowest deviations were measured in implants that were placed by mucosa‐supported guides (2.9° ± 0.39° angular, and 0.7 ± 0.13 mm and 0.76 ± 0.15 mm for implant shoulder and tip, respectively).Conclusions: Computer‐aided planning and manufacturing surgical guides in accordance with CB(CT) images may help clinicians place implants. Rigid screw fixation of a single guide incorporating metal sleeves and a special drill kit further minimizes deviations.

Background: Maxillary sinus lifting procedure enables clinicians to place implant‐supported prostheses even in cases with very limited vertical bone height of the maxillary sinus. The aim of this study was to evaluate the implant success with regard to effects of the sinus membrane perforations that occurred during sinus lifting surgery.Methods: The study group consisted of 91 patients (29 females and 54 males) with edentulous posterior maxilla. Implant placement combined with sinus lifting surgery was performed, and 259 implants were inserted. Sinus membrane perforations were detected in 12 sinus sites. After proper treatment of perforations, 26 implants were placed into perforated sinus areas. Baseline panaromic radiographs were taken before the beginning of prosthetic treatment. Panaromic radiographs taken at the last recall were used for evaluation and compared to the baseline panaromic radiographs using image analysis software to reveal the peri‐implant resorption rate for the implants placed in perforated and non‐perforated sinus area. The modified sulcus bleeding index and plaque index were used for the assessment of soft tissue conditions.Results: Eleven implants were lost during the follow‐up period, resulting in an overall survival rate of 95.9%. Two failures occurred in the group with sinus perforations. There was no statistically significant difference regarding peri‐implant bone resorption (P = 0.778) and soft tissue conditions for implants placed into perforated‐augmented sinus areas and augmented sinus areas.Conclusion: Within the limits of this study, perforation of the sinus membrane did not compromise the osseointegration process or the success of dental implants placed in the augmented maxillary sinus.