CATEGORY 60 AUSTRALASIAN DENTIST CLINICAL Edentulism can negatively impact masticatory function, bite force and oral health-related quality of life. Additionally, in cases of partial edentulism, aesthetics may also be affected. Implantsupported rehabilitation has become a widely accepted treatment option in such scenarios. However, the workflow is often time consuming due to the multiple steps involved in this type of treatment. The implementation of fully digital workflow for full-arch rehabilitation has been adopted in daily clinical practice, offering reduced chair time and less clinical visits. Initial situation A 58-year-old female patient, classified as ASA I, presented to the clinic with partial edentulism in both the maxillary and mandibular arches and was wearing removable prostheses. Clinical examination revealed complete edentulism in the posterior mandibular region and rotated teeth in the anterior mandibular segment. In the maxillary arch, the patient was fitted with a removable partial prosthesis. Patient's chief complaint “For a long time, I felt insecure while chewing and speaking with my removable denture. The aesthetic limitations, particularly the visibility of metal components on my anterior teeth also negatively affected my self-esteem.” Figures 1–4. Patient information Gender: Female Age: 58 Jaw: Mandible Health status: ASA I Bone type: Type I/II Local infection: No Risk factors: None Treatment plan A cone-beam computed tomography (CBCT) scan and an intraoral scan using the Straumann SIRIOS™ X3 scanner were conducted to supplement the clinical assessment. The proposed treatment plan involved the extraction of the remaining maxillary and mandibular teeth, followed by the placement of a new fully removable maxillary prosthesis and a fixed, implantsupported mandibular prosthesis, in accordance with the patient’s informed consent. Figures 5 and 6. Lower Full-Arch Rehabilitation with Straumann BLX™ and Straumann Exact™ Fig 2: Initial patient smile extraoral view Fig 3: Initial upper occlusal intraoral view Fig 4: Initial lower occlusal intraoral view Fig 5: Panoramic reconstruction of CBCT Fig 1: Patient initial smile portrait Fig 6: CBCT slices showing implant planning on coDiagnostiX® software Fig 7-8: Incision planning on both occlusal and buccal views Fig 9-10: Alveolar ridge before and after osteotomy Surgical procedure The patient was administered 4 mg of dexamethasone preoperatively to mitigate postoperative edema. The procedure commenced with the extraction of the maxillary dentition under local anesthesia using 2% Mepivacaine. Subsequently, the remaining mandibular teeth were extracted under local anesthesia with 4% Articaine. Alveolar bone recontouring was performed utilizing surgical burs to optimize the implant site morphology. Four Straumann BLX™ implants were placed using the Straumann iEXCEL™ Implant System: two implants measuring Ø3.75 x 16 mm were inserted in bone type II, and two implants measuring Ø3.75 x 12 mm were placed in bone type I. Figures 7–10.
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