STACKABLE GUIDES FOR FULL ARCH REHABILITATION IN A DIGITAL WORKFLOW: CLINICAL CASE REPORT
DOI:
https://doi.org/10.47820/recima21.v4i4.2997Keywords:
digital dentistry, digital workflow, guided implant surgeryAbstract
The objective of this article is to describe a digital flow developed to test the use of software from the company Nemotec (Madrid, Spain) for the rehabilitation of a case of total maxillary and partial mandibular edentulism with a high degree of complexity, resulting in implant-supported prostheses milled in PMMA, installed at immediate load. The planning, guided installation of the implants and transsurgical adaptation of the prosthesis prototype were tested, using stackable guides. The previous prosthetic preparation consisted of the manufacture of a device made of dense silicone, based on condensation, which established the correct lip recomposition, the relationship of tooth length with the upper lip at rest and in the smile, the vertical dimension of occlusion and the recording of the position of the centric occlusion relationship. The previous design of the prostheses was used to check the design and thus the final CAD was obtained, allowing the milling of the temporary prostheses in polymethylmethacrylate, with immediate loading protocol. The analysis of the obtained result allowed us to observe that the technique is predictable, since the use of stackable guides facilitated the stages of treatment, considerably reducing the surgical time and also the time for installation of the prostheses. Based on the clinical case performed, it is possible to conclude that the digital workflow was effective for the double rehabilitation of the patient's total arches.
Downloads
References
Jaju PP, Jaju SP. Cone-beam computed tomography: time to move from ALARA to ALADA. Imaging Sci Dent 2015; 45:263-5.
Harris D, Horner K, Grondahl K, Jacobs R, Helmrot E, Benic G, et.al. O guidelines for the use of diagnostic imaging in implant dentistry 2011. A consensus workshop organized by the European Association for Osseointegration at the Medical University of Warsaw. Clin Oral Impl Res 00; 2012;1-11.
Wismeijer D, Joda T, Flugge T, Fokas G, Tahmaseb A, Bechelli D, et. al. Groups 5 ITI Consensus Report: Digital technologies. Clin Oral Impl Res 2018; 29(Suppl):436-442.
Venezia P, Torsello F, Santomauro V, Dibello V, Cavalcanti R. Full digital workflow for the treatment of an edentulous patient with guided surgery, immediate loading and 3D-printed hybrid prosthesis: the BARI Technique 2.0. A case report. Int J Environ Res Public Health 2019; 16 (5160):1-13.
Dolcini GA, Colombo M, Mangano C. From guided surgery to final prosthesis with a fully digital procedure: a prospective clinical study on 15 partially edentulous patients. Int J Dent 2016; 2016:1687-8728.
Tonellini G, Vigo R S, Novelli G. Double guided surgery in All-on-4 concept: when osteotomy is needed. Int J Dent 2018; 2018:1-7.
Naziri E, Schramm A, Wilde F. Accuracy of computer-assisted implant placement with insertion templates. Interdiscip Plast Reconstr Surg DGPW 2016; 5: 1-16.
Meloni SM, Tallarico M, Pisano M, Xhanari E, Canullo L. Immediate loading of fixed complete denture prothesis supported by 4-8 implants placed using guided surgery: a 5-year prospective study on 66 patients with 356 implants. Clin Implant Dent Relat Res 2017;19(1):195-206.
Taylor T. Fixed implant rehabilitation for the edentulous maxilla. Int J Oral Maxillofac Implants 1991 Mar; 6: 329-337.
Bidra A. Three- dimensional esthetic analysis in treatment planning for implant-supported fixed prosthesis in the edentulous maxilla: review of the esthetics literature. J Esthet Restor Dent 2011; 23(4):219-237.
Maló P, Nobre MA, Lopes A, Francischone C, Rigolizzo M. “All-on-4” immediate-function concept for completely edentulous maxillae: a clinical report on the medium (3 years) and long-term (5 years) outcomes. Clin Implant Dent Relat Res 2012; 14(1): e139-150.
Gallucci GO, Avrampou M, Taylor JC, Elpers J, Thalji G, Cooper L. Maxillary implant-supported fixed prosthesis: a survey of reviews and key variables for treatment planning. Int J Oral Maxillofac Implants 2016; 31(Suppl): s192-s197.
Sartori IAM, Sartori EM, Uhlendorf Y, Gurgel AC. Reabilitação de maxilas com implantes: importância do diagnóstico prévio. Int Oral Maxillofac Implants-edição em português 2016;1: 74-101.
Desjardins RP. Prosthesis design for osseointegrated implants in the edentulous maxilla. Int J Oral Maxillofac Implants 1992;7: 311-320.
Papaspyridakos P, Yehuda DB, Rajput N, Weber HP. Digital workflow: from surgery to final full-arch implant prosthesis in three visits. Compend Contin Educ Dent 2018 Jul/Aug; 39(7): e1-e4.
Joda T, Zarone F, Ferrari M. The complete digital workflow in fixed prosthodontics: a systematic review. BMC Oral Health 2017; 17(124): 1-9.
Maló P, Rangert B, Nobre M. “All-on-four” immediate-function concept with Branemark System implants for completely edentulous mandibles: a retrospective clinical study. Clin Implant Dent Relat Res 2003;5 (suppl 1):2-9.
Maló P, Nobre MA, Lopes A, Ferro A, Gravito I. All-on-4 treatment concept for the rehabilitation of the completely edentulous mandible: a 7-year clinical and 5-year radiographic retrospective case series with risk assessment for implant failure and marginal bone level. Clin Implant Dent Relat Res. 2015; Oct; 17 (suppl2): e531-41.
Ping D, Lin Y, Li JH, Luo J, Qiu LX, Chen B, Cui HY. The All-on-four implant therapy protocol in the management of edentulous Chinese patients. Int J Prosthodont 2013; 26:509-516.
Polido WD, Aghaloo T, Emmett TW, Taylor TD, Morton D. Number of implants placed for complete-arch fixed prostheses: a systematic review and meta-analysis. Clin Oral Impl Res 2018; 29(Suppl16):154-183.
Sanna AM, Molly L, Steenberghe DV. Immediately loaded CAD-CAM manufactured fixed complete dentures using flapless implant placement procedures: a cohort study of consecutive patients. J Prosthet Dent 2007;97: 331-339.
Papaspyridakos P, Chen CJ, Chuang SK, Weber HP. Implant loading protocols for edentulous patients with fixed prostheses: a systematic review and meta-analysis. Int J Oral Maxillofac Implants 2014; 29 (suppl): 256-270.
Ganguly R, Ramesh A, Pagni S. The accuracy of linear measurements of maxillary and mandibular edentulous sites in cone-beam computed tomography images with different fields of view and voxel sizes under simulated clinical conditions. Imaging Sci Dent 2016;46: 93-101.
Bidra AS. A technique for systematic bone reduction for fixed implant-supported prosthesis in the edentulous maxilla. J Prosthet Dent 2015; Jun;113(6):520-3.
Mijiristsky E, Zaken HB, Scacham M, Cinar IC, Tore C, Nagy K, Ganz SC. Variety of surgical guides and protocols for bone reduction prior to implant placement: a narrative review. Int J Environ Res Public Health 2021;18(2341): 1-16.
Lanis A, Tahmaseb A. Computer-assisted boné reduction and static computer-guided implant surgery in a fully edentulous patient: a technique report. Int J Comput Dent 2021; 24(2):165-179.
Costa AJMC, Neto ADT, Burgoa S, Gutierrez V, Cortes ARGC. Fully digital workflow with magnetically connected guides for full-arch implant rehabilitation following guided alveolar ridge reduction. J Prosthodon 2020 (0):1-5.
Ting-shu S, Jian S. Intraoral digital impression technique: a review. J Prosthodon 2015; 24:313-321.
Sartori IAM, Sartori EM, Thomé G. Implantodontia contemporânea. São Paulo: Napoleão-Quintessence ; 2021.
Downloads
Published
Issue
Section
Categories
License
Copyright (c) 2023 RECIMA21 - Revista Científica Multidisciplinar - ISSN 2675-6218
This work is licensed under a Creative Commons Attribution 4.0 International License.
Os direitos autorais dos artigos/resenhas/TCCs publicados pertecem à revista RECIMA21, e seguem o padrão Creative Commons (CC BY 4.0), permitindo a cópia ou reprodução, desde que cite a fonte e respeite os direitos dos autores e contenham menção aos mesmos nos créditos. Toda e qualquer obra publicada na revista, seu conteúdo é de responsabilidade dos autores, cabendo a RECIMA21 apenas ser o veículo de divulgação, seguindo os padrões nacionais e internacionais de publicação.
