Gap Magazine Implant Dentistry Today No 17

Implant Dentistry Today 16 I mplant rehabilitation in the edentulous maxilla is a challenging situation due to local anatomical, quality of the bone and prosthesis’ design, among others. The implant distribution in the maxilla is a very important factor for the long-term success. Besides that, the number of implants, primary stability and the material of the rehabilitation are crucial factors to get predictability and a satisfactory outcome. The new BLX implant presents interesting features that allow higher primary stability even in compromised situations, which encouraged us to perform immediate loading in this edentulous case. INITIAL SITUATION This female patient has presented to the clinic with an upper denture (Fig. 1), presenting low stability and poor masticatory function. The esthetics was also a complaining, but the functional aspect was more crucial for her. After the clinical examination (Fig. 2) and CBCT analysis we planned six implants, all straight, in order to support a fixed full-arch bridge (Fig 3). The provisional bridge was produced prior to the implant placement. The surgical guide was printed to perform a static guided surgery. PROCEDURE TREATMENT PLANNING Through Codiagnostix and we could see there was enough bone to place the implants, apart off two regions that would need bone graft (Fig. 4). Six straight positioned implants were planned with an adequate cross-arch distribution to support the masticatory forces and avoid cantilevers (Fig. 5). The Straumann® BLX implants would be placed using a surgical guide (Fig. 6) and the provisional prosthesis would be screwed onto the implants just after the surgery, for an immediate loading protocol. SURGICAL PROCEDURE The surgical procedure was planned flapless for the implant placement and Full Edentulous Rehabilitation with Straumann ® Pro Arch concept and BLX Guided Surgery Fig 1: Initial situation of the upper denture Fig. 2: Occlusal view of the edentulous maxilla Fig. 3: CBCT Analysis and planning of the 6 implants Fig. 4: Region without enough bone and need for a graft Fig 5a: Adequate cross-arch implant distribution Fig 5b: Implant distribution, avoiding cantilevers Fig 6: Surgical guide Fig 7: Guided sleeve placed on the top of the surgical guide A clinical case report by Leandro Soeiro Nunes – Porto Alegre, Brazil