CATEGORY AUSTRALASIAN DENTIST63 width and height were present in the regions of both central incisors, rst premolars, and second molars, allowing for ideal load distribution. To avoid intervention in the sinus area and minimize invasiveness, we decided to place four implants at an angled position (Figs. 8 & 9). e template was planned with mucosa support to be xed with pins on both the vestibular and palatine sides. e temporary prosthesis was made at the same time as the surgical template ensuring it could also be attached with pins (Fig. 10). u Implant #14: – Straumann® BLX 4.0×14 mm. – Primary stability: 45 N/cm. – Straumann® Screw-retained Abutment RB 30°, 4.6 mm GH, 4.5 mm. u Implant #11: – Straumann® BLX 4.0×12 mm. – Primary stability: 50 N/cm. – Straumann® Screw-retained Abutment RB, 4.6 mm GH, 3.5 mm. u Implant #21: – Straumann® BLX 4.0×12 mm. – Primary stability: 45 N/cm. – Straumann® Screw-retained Abutment RB, 4.6 mm, 3.5 mm. u Implant #24: – Straumann® BLX 4.5×14 mm. – Primary stability: 50 N/cm. – Straumann® Screw-retained Abutment RB 30°, 4.6 mm, 4.5 mm. u Implant #27: – Straumann® BLX 4.5×12 mm. – Primary stability: 25 N/cm. – Coverscrew. Straumann® XenoGraft® 0.25 was used to perform horizontal bone augmentation around implants #11 and #21 to improve the bone volume and provide a stable base for the implants. e graft material, which is well-known for its capacity to support bone regeneration, was carefully placed. Following the bone augmentation, the ap was closed using Monosyn 5/0 material, which is a sterile synthetic absorbable mono lament. is choice of suture was made for its reliable strength and minimal tissue irritation, facilitating e ective wound closure and promoting optimal healing. Once the implants were properly positioned, six temporary copings were Fig 8 Fig 9 Fig 10 Fig 12 Fig 13 Fig 11 Surgical procedure After administering general anesthesia with 1100 mg of propofol, the surgical template was securely attached to the patient using xation pins. Sedation is often used to reduce discomfort, and we chose propofol for its e ectiveness. Even with sedation, we ensured the patient’s comfort and satisfaction by administering a su cient amount of local anesthetic. e procedure began with an incision in the gingiva, followed by the careful elevation of the ap to expose the underlying bone. e template was then meticulously positioned and secured, ensuring precise tting for the guided surgery (Fig. 11). is step provided us with full surgical control and accuracy. Once the template was in place, we proceeded to shape the new gingival contour under the temporary prosthesis, ensuring optimal aesthetics and functionality for the patient’s immediate postoperative period (Fig. 12). Particular attention was given to ensure that the temporary prosthesis t correctly with the newly contoured gingiva, promoting proper healing and comfort. Next, we used the Straumann® VeloDrill™ System for guided surgery to ensure precise implant placement (Fig. 13). is advanced tool provided excellent navigational aid and signi cantly shortened the oral surgery chair time. We placed six Straumann® BLX implants in the positions of the central incisors, rst premolars, and second molars. e Straumann® VeloDrill™ System allowed us to create exact osteotomies, ensuring each implant was inserted at the perfect depth and angle for optimal stability. Additionally, the Straumann® VeloDrill™ System minimizes heat generation and delivers high drilling stability. Continuous irrigation was maintained to protect the surrounding bone. Each implant was carefully torqued to achieve primary stability for the subsequent stages of the rehabilitation plan. e implants used by location were the following: u Implant #17: – Straumann® BLX 4.5×12 mm. – Primary stability: 45 N/cm. – Straumann® Screw-retained Abutment RB 30°, 4.6 mm GH, 5.5 mm. Fig 15 Fig 14 CLINICAL
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