Immediate Loading of Four Guided Unsplinted Narrow Implants Supporting a Maxillary Overdenture: A Minimally Invasive Approach

Abstract

Little evidence is available on the loading protocols for implant-supported overdentures in the treatment of the edentulous maxilla. There are only a few case-reports available to document the feasibility of immediate loading for maxillary overdenture, and the majority of the publications include the use of splinted implants. This paper presents a case report of immediately loaded narrow diameter implants supporting a maxillary overdenture using Locator abutments. A 64-year-old, fully edentulous patient presented with a maxillary complete removable denture. A dual cone beam computed tomography scan was obtained, and the surgical planning was performed. Four 3.3 mm diameter implants were placed at the lateral incisor and second premolar positions, using a guided and flapless approach. Locator abutments were placed, and the denture was connected immediately. The patient was instructed not to remove the prosthesis for 1 week and to follow a soft diet regimen for 2 weeks. Clinical and radiographic evaluation showed positive results at 12 months, with neither prosthetic nor implant complications. This is a proof of principle case report, which demonstrates the possibility of immediately loading four guided narrow diameter implants supporting a maxillary overdenture using a Locator retention system.