A case of superior intercalary edentulism performed in computer-guided implantology: a clinical case

OBJECTIVES The study aims to show how to deal with a case of upper intercalary edentulism in computer-guided implantology, instead of with conventional implantology showing potentially achievable aesthetic results. MATERIALS AND METHODS A patient comes to the attention of the authors due to an upper intercalary edentulia, in Kennedy's III class. It is decided to perform an implant-prosthetic rehabilitation in computer-guided implantology. The case is designed in digital format, combining the STL files of the extra-oral scanner of the plaster models with the files in DICOM format of the 3D examination of the upper jaw arch. A prosthetic template is thus performed on the digital model. Based on the prosthetic design, the implants are positioned and a surgical template is required, to be applied on the day of surgery. On the day of surgery, the patient is made to sign informed consent. The previously performed surgical template is placed on site and the computer-guided implantology drill kit will be used. Thanks to the guide of the surgical guide, only the operculae are performed on the crestal mucosa through the dedicated mucotomes, without opening any flap. After removing these two gingival mucosa capsules, the drills dedicated to computer-guided implantobgy are passed up to the predetermined diameter for the realization of the implant alveolus. Always through the surgical template, guided implants are applied. At the end of the intervention, the patient does not need any suturing. precisely because of the minimal invasiveness of the intervention.The following diagnostic tests are required a pre-operative orthopantomography (T0), a cone beam at the time of the case design (T1), a rx endoral at the time of dental implants application (T2), an orthopantomography and rx endoral after of prosthesis application (T3). RESULTS AND CONCLUSIONS The patient's post-operative period was null with no swelling and tenderness, the operation was not very invasive, with maximum predictability of results. Four months after the surgery, two single prosthetic crowns are screwed onto the two previously placed implants. Having established in a virtual way both the location of the implants and the prosthetic crowns, thus previewing what could have ideally been the finished work, the realization of the treatment as a whole was certainly simpler compared to a surgical technique and "traditional" prosthetic construction. CLINICAL SIGNIFICANCE In computer-guided implantology the application of implants is prosthetically guided, therefore the results are much more predictable and the surgery is much less invasive than the conventional one. Therefore in this type of surgery, the pre-operative component is much more elaborate, but the infra-operative part is much less inquisitive and invasive than conventional implant surgery.