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Aim: The aim of this study is to compare the surgical accuracy and efficiency of endo-osseous implant placement using a conventional method and when placed using a custom surgical guide. Materials and methods: The study was carried out in a case control design on 20 patients aged between 15 years and 60 years. In the study group (n = 10) the implants were placed with the help of a surgical stent, while in the control group (n = 10) implants were placed in a conventional manner (without surgical stent) planned only with CBCT scan. The same surgeon placed the implants in both the groups. Results: Each patient was considered in terms of the number of implants received. Each planned and actual implant was compared in terms of the 8 quantitative variables, which were used to observe and compare the accuracy of the surgical guides and conventionally placed implants. Data were analysed by a single blinded statistician using statistical software (Graphpad Prism (Version 5)). The Microsoft excel and Student T test for parametric data and Chi-square test for categorical data were used to observe significant differences between the 2 study groups. The nonparametric Chi-Square test revealed a statistically significant difference between surgical stent guided and conventional surgery in terms of buccal and lingual/palatal cortical plate to implant deviation, adjacent tooth to implant deviation, and mesiodistal angular deviation, whereas the differences between the marginal bone loss deviation, stability deviation, pain and swelling deviation, treatment time and number of sessions deviation, satisfaction deviation were not statistically significant. Conclusion: From our study, we can conclude that guided surgery is essential for insertion of the implants regardless of the surgical technique. The success of the guided surgery depends on accuracy of the clinical and/or laboratorial steps of the virtual planning. Despite all the limitations and probability of errors encountered in our study, the guided surgery is superior in better positioning of implants.
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INTRODUCTION: Patients with ischemic heart disease are placed on antiplatelet therapy (APT). This study allows a definite protocol to be set which will allow us the make the right judgment when it comes to extractions in patients on APT. MATERIALS AND METHODS: For this study, 100 patients were taken up for dental extraction after obtaining a thorough case history. Bleeding time was assessed preoperatively for all the patients and patients with normal bleeding time were taken up for surgery under local anesthesia. Local haemostatic measures were employed after the extraction. Patients were monitored for first 30 minutes at the clinic and a telephonic review of all the patients was done at 24 h-48 h interval after the procedure. If there was an active ooze from the surgical site at any point, haemostatic measures with local haemostatic agents were carried out. RESULTS: In patients with mono antiplatelet therapy, bleeding was noted in 16 patients after the 1 h time interval and was absent after 24h-48 h time intervals. The q = 32 and the P < 0.001, making it statistically significant. Regarding patients on dual APT, bleeding was noted in ten patients after 1 h, and in one patient after 24 h with no patients presenting with bleeding at the 48 h time interval. The q = 16.545 and P < 0.001, making it statistically significant. DISCUSSION: The benefits of continuing APT for patients who require dental extraction outweighs the risks of postoperative bleeding. CONCLUSION: Antiplatelets are used for the prevention of myocardial infarction, ischemic stroke, and vascular death among patients who are at high risk of these events. Antiplatelets have minimal impact on the amount and duration of bleeding following routine dental extractions.
