J Korean Acad Prosthodont.  2019 Jul;57(3):312-320. 10.4047/jkap.2019.57.3.312.

Flapless implant placement with digital 3D imaging and planning system in fully edentulous patient: A case report and 5-year follow-up

• Shin MS
• Paek J

• KMID: 2453787
• DOI: http://doi.org/10.4047/jkap.2019.57.3.312

Abstract

One of the fastest growing segments of implant dentistry is the utilization of computed tomography (CT) scan data and treatment planning software in conjunction with guided surgery for implant reconstruction cases. Computer assisted planning systems and associated surgical templates have established a predictable, esthetic, functional technique for placing and restoring implants. Especially, a philosophy of restoratively driven implant placement has been generally adopted. Recently, a variety of commercial dental fields have released their scanning and fabricating protocols and methods for restorations. This process is still being investigated and developed for the most precise and predictable outcome. This case report describes a female patient who wanted dental implants in fully edentulous areas. Restoratively driven implant placements were performed with surgical guide and the patient was fully satisfied with the clinical results, and at 5-year post restorative follow-up assessment, both implant and prosthesis were proved clinical success.

Keyword

Computer guided surgery; Flapless surgery; CAD/CAM; 3D printing surgical guide, All-on-four

MeSH Terms

Dental Implants
Dentistry
Female
Follow-Up Studies*
Humans
Philosophy
Prostheses and Implants
Dental Implants

Figure

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  Fig. 1 Pre-operative panoramic view.

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  Fig. 2 Pre-operative intraoral view. (A) Occlusal view of maxilla, (B) Occlusal view of mandible, (C) Frontal view.

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  Fig. 3 Interim complete dentures were fabricated and radiographic markers were inserted for CT scan. (A) Maxillary denture, (B) Mandibular denture, (C) Frontal view.

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  Fig. 4 Three-dimensional imaging and virtual planning of implant placement.

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  Fig. 5 Surgical templates (NeoGuide, NeoBiotech, Seoul, Korea) were fabricated.

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  Fig. 6 Occlusal index was fabricated to place surgical stent intraorally using interim dentures and putty remount casts. (A) Interim dentures were used to fabricate putty remount casts, (B) Surgical template of maxilla was seated into putty casts, (C) Surgical template of mandible was seated into putty casts, (D) Occlusal index was fabricated to place surgical stent intraorally.

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  Fig. 7 Occlusal index was placed intraorally to anchor surgical templates.

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  Fig. 8 Intraoral view after implant placement. (A) Maxilla, (B) Mandible.

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  Fig. 9 Post-operative panoramic view after implant placement.

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  Fig. 10 Abutment level impression. (A) Maxilla, (B) Mandible.

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  Fig. 11 Full contour wax-up for screw type prosthesis. (A) Maxilla, (B) Mandible, (C) Canine guidance occlusal scheme.

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  Fig. 12 Zirconia framework. (A) Maxilla, (B) Mandible.

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  Fig. 13 Porcelain veneering. (A) Maxilla, (B) Mandible.

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  Fig. 14 Post-operative panoramic view.

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  Fig. 15 Intraoral photo of definitive prosthesis. (A) Maxilla, (B) Mandible, (C) Frontal view.

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  Fig. 16 5-year follow-up panoramic view.

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