Abstract
ABSTRACT Precise planning for dental implant placement requires appreciation of anatomical limitations and restorative purpose. Diagnosis can be made by complementary exams such as panoramic radiography and cone-beam computed tomography. The purpose of this study was to rehabilitate the upper and lower jaw of a patient with severe periodontal disease using a guided osteotomy and implants placed with free hands and Morse taper implants. The concept of guided surgery was used to prepare the alveolar bone to place eight implants, four implants in the upper jaw and four implants in the lower jaw, all have achieved a minimum torque of 60 Ncm. The modified suture technique was used to better stabilize the soft tissue around the mini conical abutments. The analogues were scanned by CAD/CAM for confection of the metallic structures of the bridges. On the third day, the upper and lower full arch prostheses were installed and simultaneous bilateral contacts were adjusted. After 12 months of patient follow-up, the implants and prostheses were in good condition of aesthetics and function, maintaining the success of the rehabilitation. Within the limitations of this clinical case, it can be concluded that the implants placed with free hands was facilitated by a previous guided osteotomy.
Highlights
Edentulous patients have been benefited from the use of full implant-supported by dentures, which promotes greatly improvement of chewing, phonetic and aesthetic capacity [1,2]
Immediate loading is characterized by the installation of the total prosthesis within 7 days, provided the implants have a minimum torque of 30 Ncm [6]
As it will be necessary some osteotomy to regularize the alveolar bone, it was suggested a guided osteotomy and implants placed with free hands
Summary
Edentulous patients have been benefited from the use of full implant-supported by dentures, which promotes greatly improvement of chewing, phonetic and aesthetic capacity [1,2]. Immediate loading is characterized by the installation of the total prosthesis (full arch) within 7 days, provided the implants have a minimum torque of 30 Ncm [6]. Passive fit between the metal structure of the prostheses and the implants is important for maintaining the rehabilitation long-term success [6,7,8]. This clinical aspect is obtained when the structure is in contact simultaneously with all abutments, without bending or tensile forces [7,8]. Due to mechanical problems related to the bone/implant/prosthesis system, new implant designs and prosthetics interfaces have been studied and developed [9]
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