Rehabilitation of a Dentate Mandible Requiring a Full Arch Rehabilitation. Immediate Loading of a Fixed Complete Denture on 8 Implants Placed With a Bone-Supported Surgical Computer-Planned Guide: A Case Report

摘要

The use of technologies that merge computerized tomography X-ray imaging and 3-ndimensional (3D) planning software allow the surgeon to digitally elaborate on the computernthe position, length, and diameter of every implant to be placed. Following this approach,nthe placement is guided in a 3D digital model, and the implants are placed in the finalnposition avoiding eventual anatomic structures. In this case report, the patient’s remainingnmandibular teeth were extracted, and the patient received 8 implants with the help of ancomputer surgical guide. The case was planned using SimPlant and a bone-supported guide.nBecause of the high precision of the planning, it was possible to realize a provisionalnrehabilitation before the actual surgery. The planning allows placement of parallel implantsnto optimize the prosthetic procedure and outcome. An immediate provisional implant wasnfixed with a flow composite on the temporary abutments and then refined in the dentalnlaboratory. The patient received the provisional rehabilitation the same day of the surgery.nAfter 6 weeks of healing, the final impression was taken and the prosthesis was finalized withna computer-aided design/computer-aided manufacturing titanium full-arch screwednframework with composite veneering. A 6-month follow-up showed good integration of thenprostheses and success of all 8 implants. The use of surgical computer-guided planningnchanges the surgeon’s approach: whereas before the use of conventional guides permitted ancertain degree of offset from what was planned, the use of computer guides allows thenimplant to be inserted in a far more precise way. It is obvious that careful planning is the keynfactor to avoid implant misplacement.