Implant dentistry has seen a rise in popularity due to advancements in engineering and design. However, the success of implant placement relies on a thorough understanding of anatomy and limitations. CBCT scanning has become a crucial tool in visualizing implant sites and achieving optimal restorative outcomes. Factors such as bone availability and overall patient health play a significant role in determining candidacy for implants. Additionally, considering the desires and expectations of the patient is important to ensure satisfactory results.
In a recent case report, a patient presented with missing teeth in the maxillary posterior and mandible, along with a severe Class III occlusal relationship and deep underbite. CBCT analysis revealed collapsed posterior sinuses and insufficient bone height and width for implant support. To address these issues, sinus augmentation using the Caldwel-Luc procedure was performed, and temporary restorations were placed. The arch was also opened, and the underbite was corrected. Throughout the integration of sinus grafts, the patient’s TMJ setting, aesthetics, and function were carefully evaluated.
A “tooth-first” approach was utilized to determine the proper positioning and spacing of posterior implants. Guided surgical protocols, including virtual design and positioning of the implants, were followed prior to any surgical intervention. Osteotomies were performed to optimize the shape of the dentition. After 6 months of integration, a follow-up CBCT analysis revealed adequate bone height and width for implant placement.
Guided surgical protocols played a crucial role in maximizing implant stability and positioning. A surgical guide was created based on virtual design, ensuring its placement on hard tissue. Osteotomies were made through the guides, and guided burs were used to widen them. The Hahn Tapered Implant System was then placed and confirmed through digital radiographs. A final CBCT analysis was conducted before suturing.
Once the implants had integrated, impression techniques were employed, and zirconia implant crowns were seated. The full-arch restoration, including screw-retained implant prostheses, was completed in stages to achieve improved aesthetics and function. The patient’s expectations were met, resulting in enhanced form and function compared to the preoperative condition.
In conclusion, implant dentistry offers a predictable and aesthetically pleasing solution for patients with missing teeth. However, careful diagnosis, treatment planning, and consideration of vital anatomy are crucial for successful outcomes. CBCT scanning, guided surgical protocols, and virtual design all contribute to accurate implant placement and optimal restorative results. Ultimately, meeting the patient’s expectations and desires is paramount for overall satisfaction and success in implant therapy.