A Technique for Restoring Severely Resorbed Edentulous Mandible with a Computer-aided Design and Computer-aided Manufacturing Surgical Guide and an Implant-supported Fixed Dental Prosthesis in Two Days
Citation Information :
Turkyilmaz I, Isler SC, Uraz A. A Technique for Restoring Severely Resorbed Edentulous Mandible with a Computer-aided Design and Computer-aided Manufacturing Surgical Guide and an Implant-supported Fixed Dental Prosthesis in Two Days. J Contemp Dent Pract 2019; 20 (4):524-528.
Aim: The aim of this report is to describe a technique, in which a severely resorbed edentulous mandible was restored with computer-aided design/computer-aided manufacturing (CAD/CAM) surgical guide and an implant-supported fixed dental prosthesis in two days.
Background: The quality of life of edentulous patients is generally restricted due to functional and psychosocial problems associated with complete dentures. These issues become worse over time due to ongoing bone resorption. Implant-supported prostheses have been utilized to overcome these problems.
Case description: A 79-year-old patient with a severely resorbed edentulous maxilla and mandible presented to our clinic. After the cone beam computed tomography (CBCT) scans were performed, five implants were virtually placed via a 3-dimensional software. Then, a CAD/CAM surgical guide was fabricated with a stereolithographic method. Her mandible was restored with five implants by using the CAD/CAM surgical guide and the implant-supported prosthesis with CAD/CAM titanium framework in 2 days.
Conclusion: The severely resorbed edentulous mandible was successfully restored with five dental implants, and the implant-supported fixed dental prosthesis via the CAD/CAM milled titanium framework.
Clinical significance: The technique using software and hardware portrayed in this report may be a feasible option to restore similar patients if it is executed by trained restorative dentists adhering to strict guidelines.
Turkyilmaz I, Tozum TF, Fuhrmann DM, Tumer C. Seven-year follow-up results of TiUnite implants supporting mandibular overdentures: early versus delayed loading. Clin Implant Dent Relat Res 2012;14 Suppl 1:e83-90.
Turkyilmaz I, Tozum TF. 30-Year Outcomes of Dental Implants Supporting Mandibular Fixed Dental Prostheses: A Retrospective Review of 4 Cases. Implant Dent 2015;24:620-624.
Turkyilmaz I, Company AM, McGlumphy EA. Should edentulous patients be constrained to removable complete dentures? The use of dental implants to improve the quality of life for edentulous patients. Gerodontology. 2010;27:3-10
Ozan O, Orhan K, Turkyilmaz I. Correlation between bone density and angular deviation of implants placed using CT-generated surgical guides. J Craniofac Surg 2011;22:1755-1761.
Cushen SE, Turkyilmaz I. Impact of operator experience on the accuracy of implant placement with stereolithographic surgical templates: an in vitro study. J Prosthet Dent 2013;109:248-254.
Abduo J. Fit of CAD/CAM implant frameworks: a comprehensive review. J Oral Implantol 2014;40:758-766.
Faeghinejad M, Proussaefs P, AlHelal A, Lozada J. The CAD/CAM Compound Prosthesis: Digital Workflow for Fabricating Cement- Retained Zirconia Prosthesis Over Screw-Retained Milled Titanium Bars. Int J Periodontics Restorative Dent. 2019;39:39-47
Apostolakis D, Kourakis G. CAD/CAM implant surgical guides: maximum errors in implant positioning attributable to the properties of the metal sleeve/osteotomy drill combination. Int J Implant Dent. 2018;4:34.
Reyes A, Turkyilmaz I, Prihoda TJ. Accuracy of surgical guides made from conventional and a combination of digital scanning and rapid prototyping techniques. J Prosthet Dent. 2015;113:295-303.
Laederach V, Mukaddam K, Payer M, Filippi A, Kuhl S. Deviations of different systems for guided implant surgery. Clin Oral Implants Res. 2017;28:1147-1151.
Rungcharassaeng K, Caruso JM, Kan JY, Schutyser F, Boumans T. Accuracy of computer-guided surgery: A comparison of operator experience. J Prosthet Dent. 2015;114:407-413.
Zhou W, Liu Z, Song L, Kuo CL, Shafer DM. Clinical Factors Affecting the Accuracy of Guided Implant Surgery-A Systematic Review and Meta-analysis. J Evid Based Dent Pract 2018;18:28-40.
Cassetta M, Di Mambro A, Giansanti M, Stefanelli LV, Cavallini C. The intrinsic error of a stereolithographic surgical template in implant guided surgery. Int J Oral Maxillofac Surg 2013;42:264-275.
Turbush SK, Turkyilmaz I. Accuracy of three different types of stereolithographic surgical guide in implant placement: an in vitro study. J Prosthet Dent. 2012;108:181-188.
Ozan O, Turkyilmaz I, Ersoy AE, McGlumphy EA, Rosenstiel SF. Clinical accuracy of 3 different types of computed tomography-derived stereolithographic surgical guides in implant placement. J Oral Maxillofac Surg. 2009;67:394-401.
Lopes A, Malo P, de Araujo Nobre M, Sanchez-Fernandez E. The Nobel Guide® All-on-4® Treatment Concept for Rehabilitation of Edentulous Jaws: A Prospective Report on Medium- and Long-Term Outcomes. Clin Implant Dent Relat Res. 2015;17 Suppl 2:e406-416.
Valente F, Schiroli G, Sbrenna A. Accuracy of computer-aided oral implant surgery: a clinical and radiographic study. Int J Oral Maxillofac Implants. 2009;24:234-242.
Vieira DM, Sotto-Maior BS, Barros CA, Reis ES, Francischone CE. Clinical accuracy of flapless computer-guided surgery for implant placement in edentulous arches. Int J Oral Maxillofac Implants. 2013;28:1347-1351.
Van Assche N, van Steenberghe D, Quirynen M, Jacobs R. Accuracy assessment of computer-assisted flapless implant placement in partial edentulism. J Clin Periodontol. 2010;37:398-403.
Ortorp A, Jemt T, Back T, Jalevik T. Comparisons of precision of fit between cast and CNC-milled titanium implant frameworks for the edentulous mandible. Int J Prosthodont. 2003;16:194-200.
Takahashi T, Gunne J. Fit of implant frameworks: an in vitro comparison between two fabrication techniques. J Prosthet Dent. 2003;89:256-60.
Katsoulis J, Mericske-Stern R, Enkling N, Katsoulis K, Blatz MB. In vitro precision of fit of computer-aided designed and computer-aided manufactured titanium screw-retained fixed dental prostheses before and after ceramic veneering. Clin Oral Implants Res. 2015;26:44-49.
Almasri R, Drago CJ, Siegel SC, Hardigan PC. Volumetric misfit in CAD/ CAM and cast implant frameworks: a university laboratory study. J Prosthodont. 2011;20:267-274.
Abduo J, Lyons K, Bennani V, Waddell N, Swain M. Fit of screwretained fixed implant frameworks fabricated by different methods: a systematic review. Int J Prosthodont. 2011;24:207-220.