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Clinical case: Navigated digital full mouth implant rehabilitation

This clinical case performed by Dr Selene Kuo (Taiwan) shows the advantages of the digital Implantology in cases where the patient suffers from unacceptable mastication function and teeth/soft tissue esthetic.

Clinical case description:

  • Gender: Male
  • Age: 65 years old
  • ASA Score (Saklad): ASA 1
  • Periodontal condition/oral hygiene: Fair
  • Treatment reason: Missing anterior teeth and lack of proper posterior support which jeopardized mastication and esthetics
  • Implant location: #12,14,16,17,22,24,26,27/ #32,35,37,42,44,46,47
  • Bone quality (Misch): Type 2
  • Alveolar process height: variation among implant sites
  • Alveolar process width: variation among implant sites

Solution:

  • Implant line: BEGO Semados RSX® implant line
  • Guided surgery? Yes - computer-aided dynamic guided surgical technique
  • Graft procedure: Left sinus augmentation / Guided bone regeneration over immediate implant placement site
  • Provisional prosthetic rehabilitation protocol: Upper & Lower Jaw full arch immediate provisionalization with milled PMMA provisional prosthesis
  • Final prosthetic rehabilitation protocol: Titanium milled framework with cemented individual zirconia crowns  

BEGO Implant Systems Prosthetic components:

X-Ray initial situation
X-Ray initial situation
Clinical initial situation
Clinical initial situation
Prototype design
Prototype design
Printed PMMA Prototype Try-In
Printed PMMA Prototype Try-In
Implants position planning
Implants position planning
Design of the Upper Jaw provisional prosthesis
Design of the Upper Jaw provisional prosthesis
Design of the Lower Jaw provisional prosthesis
Design of the Lower Jaw provisional prosthesis
Milled PMMA upper Jaw provisional prosthesis
Milled PMMA upper Jaw provisional prosthesis
Milled PMMA lower Jaw provisional prosthesis
Milled PMMA lower Jaw provisional prosthesis
Upper Jaw implants in position (computer-aided dynamic guided surgery)
Upper Jaw implants in position (computer-aided dynamic guided surgery)
PS MultiPlus Abutments in position, fitting test of the provisional prosthesis. MultiPlus Healing Post in position for suturing/graft procedures.
PS MultiPlus Abutments in position, fitting test of the provisional prosthesis. MultiPlus Healing Post in position for suturing/graft procedures.
MultiPlus Titanium Abutment. Direct pick-up with autopolymerized PMMA.
MultiPlus Titanium Abutment. Direct pick-up with autopolymerized PMMA.
Upper Jaw provisional prosthesis in position
Upper Jaw provisional prosthesis in position
PS MultiPlus Abutments in position, fitting test of the provisional prosthesis. MultiPlus Healing Post in position for suturing/graft procedures.
PS MultiPlus Abutments in position, fitting test of the provisional prosthesis. MultiPlus Healing Post in position for suturing/graft procedures.
One week follow-up
One week follow-up
One week follow-up
One week follow-up
Six months after implant placement, osseointegration was accomplished
Six months after implant placement, osseointegration was accomplished
Impression with MultiPlus Closed-tray impression components for fabrication of the impression jig.
Impression with MultiPlus Closed-tray impression components for fabrication of the impression jig.
Impression jig fabrication for impression with MultiPlus Open-tray impression components.
Impression jig fabrication for impression with MultiPlus Open-tray impression components.
Accuracy of the jig with the MultiPlus Open-tray impression components checked with X-Rays, jig splinting and impression taking.
Accuracy of the jig with the MultiPlus Open-tray impression components checked with X-Rays, jig splinting and impression taking.
Accuracy of the jig with the MultiPlus Open-tray impression components checked with X-Rays, jig splinting and impression taking.
Accuracy of the jig with the MultiPlus Open-tray impression components checked with X-Rays, jig splinting and impression taking.
MultiPlus implant analogues connected to the MultiPlus Open-tray impression components, production of the master casts, accuracy among implants and cast verified with jig.
MultiPlus implant analogues connected to the MultiPlus Open-tray impression components, production of the master casts, accuracy among implants and cast verified with jig.
Articulation of master casts and vinyl index fabrication
Articulation of master casts and vinyl index fabrication
Artificial teeth set-up
Artificial teeth set-up
Clinical trial of the artificial teeth set-up
Clinical trial of the artificial teeth set-up
Final prosthesis metal framework design
Final prosthesis metal framework design
Metal framework finalized and in position
Metal framework finalized and in position
X-Ray images of the metal framework passive fitting
X-Ray images of the metal framework passive fitting
Fabrication of the individual zirconia crowns
Fabrication of the individual zirconia crowns
Polished and glazed zirconia crowns individually cemented on metal framework with self-curing resin cement.
Polished and glazed zirconia crowns individually cemented on metal framework with self-curing resin cement.
Artificial soft tissue was applied with heat processed pink composite
Artificial soft tissue was applied with heat processed pink composite
Final prosthesis clinical occlusal equilibration on the articulator
Final prosthesis clinical occlusal equilibration on the articulator
Final prosthesis clinical occlusal equilibration
Final prosthesis clinical occlusal equilibration
Delivery of the final prosthesis
Delivery of the final prosthesis
Final prosthesis in position – 2 years follow-up
Final prosthesis in position – 2 years follow-up

We would like to thank Dr Selene Kuo for this interesting Clinical Case and his approval to provide the data. Do you like to share a photo story of a Clinical Case solved with products from BEGO? Then please get in touch with us!