Aim: The aim of this study is to analyse the use of a computer-aided three-dimensional planning protocol in combination with previously inserted reference mini-implants and CAD/CAM technology to restore completely edentulous patients in a prospective clinical trial.

Materials and methods: 35 patients, 20 with edentulous upper jaws, 10 with edentulous lower jaws and 5 patients with both edentulous upper and lower jaws, were treated. Mini-implants were used to establish a setup for computerized tomography and the fixation of the surgical template. The planning software based on 3D simulation was used to plan ideal implant placement, digitally integrating the future prosthetic and anatomic situations to design the final superstructure.

Results: 40 final superstructures were inserted and immediately loaded. 229 of the 240 inserted implants survived (95.4%), with 146 (93.6%) and 83 (98.8%) implants in the maxillary and mandibular jaws, respectively. All the final restorations fitted sufficiently.

Conclusions: Reference based guided surgery seems to be a reliable treatment option when treating edentulous patients. The CAD/CAM superstructure, inserted and loaded immediately after guided implant insertion, was produced digitally with a precise fit, mostly acceptable occlusion and good aesthetics.

Conflict of interest: None declared.