Multi goal, guided approach as a minimally invasive treatment: a case report

Abstract

The use of surgical guides provides accuracy, predictability and shortens clinical time. Templates are widely used in implant dentistry. Studies present also the application of guides for targeted endodontic microsurgery. Nevertheless, most studies focus on one application of guided surgery. This case report presents single guided surgery for implants placement, sinus floor elevation and endodontic microsurgery. The 3-in-1 surgery was planned as an alternative to a staged approach. A 57-year-old female required endodontic microsurgery of tooth 24 and implants in sites 25 and 26 where sinus lift procedure was needed. One complex surgery was performed using the flapless approach for implant placement. OneCAS kit was used for guided, hydrostatic sinus floor elevation and OneGuide kit for implant placement and targeted micro endodontic apicoectomy through the VISTA approach. Retro preparation and retro fill were done. Implants and healing abutments were placed according to the virtual plan. Tapered implants 4.0 × 10 and 4.5 × 8.5 were placed with ISQ 78 and 76, respectively, for 25 and 26 sites. Healing was uneventful and sutures were removed after 7 days. After 4 months, impressions were taken for crowns on teeth 24 and 27 and implants 25 and 26. After one year from initial surgery no complications happened, clinical and radiological examinations reveal proper healing of all treated sites. Multi goal approach and combining a few surgeries in one, supported by proper planning and guided execution may be an option for low invasive and efficient treatment.