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Fig 2: Initial radiographic situation, before loss of 33, 31, 41 Fig 3: Pre-surgical clinical situation.

Fig 5: Positioning of the guides. The primary part,
blue in color, is not removed until the end of the
surgical and prosthetic procedures.

Fig 4: Digital design of prosthetic implant therapy.

Fig 6: The implants with the mounters at the Fig 7: Implants inserted after removal of Fig 8: The placement of the reinforced
end of the positioning, guided by the second the portion of template used for implant provisional on the prosthetic cylinders. The
component of the guide, purple. placement. The accessibility of the operating position of the occlusal plane is exactly what
field allows the management of soft and hard was defined in the digital design phase.
tissues with access completely equivalent to
an open field surgery.

elements in the anterior sector, recently lost the last support elements to the early loss of dental elements and the use of removable dentures
of the lower arch. In the upper arch, the patient already had a fixed for many years. Additionally, the patient had a small thickness of
prosthesis on implants made 10 years earlier. Following the loss of the keratinized tissues.
remaining lower dental elements due to marginal infiltration, it was In contrast to the upper arch, which was treated few years back
necessary to convert the lower prosthesis into a complete denture. with unguided surgery and prosthetic immediate loading using the
At the patient’s request, a new lower prosthesis was designed on “One Model” technique, we opted for an entirely digital design and
fixed implants, with the same characteristics as the upper prosthesis implementation for the lower arch, utilizing guided surgery with the P
made few years back. cube method (Oxy Digital Solutions, Biomec).
The patient had limited bone volumes in the posterior sectors due The patient underwent an intraoral scan (Trios 3, 3Shape) of

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Dental Practice I May-June 2024 I Vol 20 No 3 53