Immediate loading of a fixed full-arch prosthesis on four template-guided implants.

Area of Science:

• Dental Implantology
• Prosthodontics
• Guided Surgery

Background:

• Fixed full-arch prostheses on four implants for the edentulous maxilla are an alternative to the generally recommended five implants.
• Precise 3D-guided implant placement is crucial for immediate provisional restoration.
• A three-point support system ensures surgical template stability during guided surgery.

Observation:

• A three-point support using teeth and temporary implants facilitated guided surgery.
• Virtual planning optimized implant positioning to utilize existing bone, minimizing augmentation.
• A metal-reinforced provisional restoration was fabricated using a drilling template.
• Four implants were placed using a tooth-/implant-supported guide.
• Angulated distal implants were managed with 17-degree angled abutments.
• The provisional restoration was delivered 3 hours after implant placement.
• A definitive micro-layered zirconia prosthesis was placed 9 months later.

Findings:

• Guided implant surgery with a template from virtual planning achieved high accuracy in implant placement.
• This accuracy facilitated immediate prosthodontic rehabilitation.
• Micro-layered monolithic zirconia is a viable material for screw-retained full-arch prostheses.

Implications:

• Precise implant placement via surgical templates shortens treatment time and improves patient recovery.
• Immediate prosthodontic rehabilitation benefits both patients and dental professionals.
• The use of micro-layered monolithic zirconia shows promise for screw-retained full-arch restorations.